三种异种骨材料修复牙周骨缺损的比较

Three kinds of heterogeneous bone materials for repair of periodontal bone defects

背景:目前,牙周病的治疗方法主要有自体骨移植、同种异体骨移植、异种骨移植与人工骨替代材料植入等,然而每一种方法都有自己的优缺点。目的:比较煅烧骨、冻干骨和Bio-oss骨各自单独使用修复牙周骨缺损的效果。方法:将36只新西兰大白兔随机均分为4组,制备单侧牙周骨缺损模型,其中3组于骨缺损处分别植入煅烧骨、冻干骨和Bio-oss骨,以未植入任何材料者作为空白对照。术后4,8,l2周处死动物,获取完整标本,进行大体、X射线及组织学观察。结果与结论:煅烧骨组、冻干骨组、Bio-oss骨组术后4,8,12周的骨密度、新生牙骨质高度、新生牙槽骨高度及新生牙周膜高度均高于空白对照组,且缺损处骨组织逐渐连续,牙根面可见新生牙周组织形成,随着时间的推移逐渐成熟、增多。煅烧骨组术后4周新生牙槽骨高度高于冻干骨组(P<0.05);冻干骨组术后12周新生牙周膜高度明显高于煅烧骨组、Bio-oss骨组(P<0.05)。结果表明煅烧骨的成骨诱导能力优于Bio-oss骨与冻干骨,冻干骨促进牙周膜再生的能力优于煅烧骨、Bio-oss骨。

BACKGROUND：Currently, the treatment methods for periodontal disease mainly include autogenous bone graft, bone alograft, bone xenograft, and bone substitute implantation, and each method has its own merits and demerits. OBJECTIVE：To compare the effects of calcined bone, freeze-dried bone and Bio-oss bone used alone on the repair of periodontal bone defects. METHODS： A total of 36 healthy rabbits were randomly divided into four groups, and unilateral periodontal tissue defect model was established in each group. These four groups were respectively treated with calcined bone, freeze-dried bone and Bio-oss bone, and nothing （blank control group）. After 4, 8 and 12 weeks, animals were sacrificed respectively for a complete specimen used in gross, X-ray and histological observations. RESULTS AND CONCLUSION：Compared with the blank control group, the bone density, new cementum height, new alveolar height and new periodontal ligament height were al higher in the calcined bone, freeze-dried bone and Bio-oss bone groups at 4, 8, 12 weeks after treatment. As time went on, defected bone tissues gradualy became continuous, newborn periodontal tissues were visible on the root surface and gradualy became mature and increased in number. At 4 weeks after treatment, the new alveolar bone height was higher in the calcined bone group than the freeze-dried bone group （P 〈 0.05）; at 12 weeks after treatment, the new periodontal ligament height was significantly higher in the freeze-dried bone group than the calcined bone group and Bio-oss bone group （P 〈 0.05）. These results show that the calcined bone is superior to the freeze-dried bone and Bio-oss bone in terms of osteogenic induction, but the freeze-dried bone is better than the calcined bone and Bio-oss bone to promote the periodontal ligament regeneration.