在即刻种植术中应用两种不同方法处理骨缺损效果的比较

Evaluation of two methods for bone defects in immdiate implantation:a comparetive study

目的:比较珊瑚羟基磷灰石(CHA)复合富血小板血浆(PRP)或覆盖生物膜在即刻种植术中对骨再生效果的影响。方法:8只成年实验用犬,拔除双侧第2、3、4下颌前磨牙,同期植入种植体,制备种植体颈部的环状骨缺损,每侧植入3颗种植体,将种植体随机分为3组:A组,植入珊瑚羟基磷灰石和富血小板血浆的混合物;B组植入珊瑚羟基磷灰石,并覆盖可吸收胶原膜;C组作为对照组,不植入任何材料。术后3个月处死动物,先后进行大体观察、组织形态学观察、及生物力学测定,比较组间差异。结果:A组新生骨质较优,骨量多,B组骨缺损区无软组织长入,两者间骨结合率差异无统计学意义(P>0.05)。C组骨再生效果较差,与A、B两组相比,差异有统计学意义(P<0.05)。3组标本生物力学测试结果差异均有统计学意义。结论:两种处理方法对种植体周的骨再生均有积极作用,富血小板血浆在促进骨组织生长方面优势明显,生物膜在阻挡软组织长入方面效果较优。

Objective： To compare the effect of coralline hydroxyapatite （CHA） in combination with Platelet-rich Plasma （PRP） and CHA coverd with bioresorbable mambrane for bone regeneration in immediate impahion. Method： In 8 beagle dogs, the second and the third and the fourth premolars on both sides of the mandible were extracted and immediate implantation were palced. Make a circumferental gap around the neck of implant.The implant were divided into three groups randomly： PRP with CHA （group A） ： CHA covered with bioresorbable collagen membrane （Group B） ： kept blank （Group C）. 3 month later,dogs were sacrificed. The speimens were removed and studided by gross observation,histological observation, biomechanist test to examine the result of bone regeneration. Result： The valume and the quality of the new bone was better in Group A; There was no soft tissue ingrowth between the implant and bone in Group B~ no significant difference between the two groups in bone-implant contacts （BIC） test （P 〉0.05）. The effect of bone regeneration was worse in Group C, and significant difference with Group A and Group B. Significant difference with 3 groups in biomechanist test （P 〈0.05）. Con- clusion：Two methods own the activity effect dealing with bone deftct around implant,PRP was better in promote bone regeneration, bioresorbable was effecting better in preventing of tissue formination.