骨髓浓缩物(BMAC)对牙种植体周成骨结构影响的显微影像学分析

Effects of Bone Marrow Aspirate Concentrate on the Peri-implant Osseous Defects,A Micro-CT Study

目的:利用Micro-CT图像分析骨髓浓缩物(Bone Marrow Aspirate Concentrate,BMAC)对牙种植体周骨缺损的成骨结构影响。方法:选用健康成年杂种犬6只,拔除每只犬双侧下颌第三和第四前磨牙(P3和P4)作为实验牙位。3个月后在每只犬拔牙处植入4颗种植体,同期在种植体近中造箱状骨缺损,选2处骨缺损移植骨髓浓缩物(BMAC组),另2处分别移植自体牙槽骨(AB组)和空白明胶海绵(对照组)。术后第4、12周各处死3只实验犬,标本行Micro-CT扫描重建,分析缺损区内的骨形态学参数。结果:植入后第4周,骨髓浓缩物组(BMAC组)和自体牙槽骨组(AB组)的Tb.Sp值低于对照组,有统计学意义(P<0.05)。结论:骨髓浓缩物可以缩短骨再生时间,术后第4周成骨质量优于自体牙槽骨;Micro-CT可有效分析种植体周围骨小梁空间结构。

Objective： Using Micro-CT image to analyse the osteogenic effect of bone marrow aspirate concentrate on the peri-implant osseous defects. Methods： Six healthy adult mongrel dogs were selected, which were extracted of mandibular third and fourth premolars （P3 and P4） to create edentulous regions. Three months later, four im plants were inserted in the site of the extracted regions in each dog, and osseous defects at the mesial of the implants were created. Two defects were filled with bone marrow aspirate concentrate （group BMAC）, the others were filled with autologous alveolar bone （group AB） and Gelatin sponge （control group） respectively. Three dogs were sacrificed at the end of the 4th week and 12th week respectively. The specimens were scanned by Micro--CT（Xra dia, CA, USA）. The scanning data were reconstructed and the trabecular parameters were analyzed by software （Skyscan,Bruker,Belgium）. Results： At the end of the 4th week, there was a significant difference among three groups in Trabecular separation （Tb. Sp）. Conclution： Bone marrow aspirate concentrate could accelerate the bone regeneration of peri-implant osseous defects; Bone quality repaired by bone marrow aspirate concentrate is better than which repaired by autologous alveolar bone; Micro-CT can analyse peri-implant trabecular microstructural effectively.