唑来膦酸局部治疗对骨质疏松时自体髂骨移植内种植体骨结合的影响

Effect of Local Treatment with Zoledronate Acid on Osseointegration of Dental Implants in Autologous Iliac Graft in Osteoporotic Rabbits.

目的:研究唑来膦酸局部治疗对骨质疏松时自体髂骨移植内种植体骨结合的影响。方法:30只雌性家兔随机分成A、B、C 3组。B、C组行双侧卵巢切除术,A组接受假手术。术后12周测量股骨骨密度(BMD)。在家兔右侧胫骨近中干骺端制备骨缺损,行自体髂骨移植及同期种植体植入术,A、B组植入HA涂层种植体,C组植入唑来膦酸钠涂层种植体。术后第2、12周处死动物,制作硬组织切片,进行组织形态学观察及骨计量学检测。结果:A、B组BMD显著低于C组(P<0.01)。术后2周,B、C组间TCBI、BCR、BVC相似,均显著低于A组(P<0.01)。术后12周,A组TCB、IBCR、BVC最高,C组次之,B组最低(P<0.01)。和2周比较,12周时TCB除B组略降低外(P<0.05),A组和C组变化均不明显;IBCR各组均显著增高(P<0.01);而BVC则是B组降低(P<0.05),A组和C组显著增高(P<0.01)。结论:唑来膦酸局部应用则可拮抗骨质疏松的影响,使种植体骨结合率增加。

Objective： To investigate the effect of local treatment with zoledronate acid on osseointegration of dental implants in autologous iliac graft in osteoporotic rabbits.Methods： Thirty female rabbits were randomly divided into three groups： A,B and C.Animals in group B and C received bilatreal ovariectomy and group A underwent sham operation.12 weeks after surgery,femoral bones of rabbits were examined for bone mineral density to verify osteoporosis status.Then bone defects were made at the proximal metaphyses of tibiae and autologous iliac bone graft with simultaneous placement of HA coated titanium implants（group A and B） or zoledronate acid immobilized HA-implants（group C） were performed.Animals were killed at 2 and 12 weeks after bone graft surgery and undecalcified sections were prepared and examined histologically and histomorphometrically.Results： Osteoporotic status was verified in ovariectomized rabbits by significantly decreased BMD when compared to sham-operated animals.At 2 weeks after implantation surgery,thickness of cortical bone,bone volume in cancellous area and implant-bone contact rate in group B and C were similar,but all were significantly lower than those in group A.At 12weeks,TCB,IBCR and BVC were highest in group A,followed by group C,and lowest in group B.Compared with 2 weeks,no significant changes for TCB were found at 12 weeks both in group A and in group C,while TCB in group B was slightly decreased.IBCR and BVC at 12 weeks were significantly increased in all groups when compared with those at 2 weeks,except BVC in group B,which was significantly decreased.Conclusion： Experimental osteoporosis can accelerate resorption of bone grafts and decrease cancellous bone volume and implant-bone contact rate,while local treatment with zoledronate acid may resist the negative influence of osteoporosis and increase osseointagration of dental implants.