富血小板纤维蛋白联合诱导骨基质修复兔口腔种植体周围骨缺损

Platelet-rich fibrin combined with induced bone matrix repairs bone defects around oral implants in rabbits

背景:富血小板纤维蛋白及人工骨材料已广泛应用于种植体周骨缺损的修复及再生,但二者以不同比例混合应用于种植体周围成骨方面的研究较少。目的:探讨富血小板纤维蛋白与医用诱导骨基质联合应用,对兔种植体周围骨缺损再生修复的效果。方法:12只大耳白兔建立口腔种植体周围骨缺损模型,沿右侧下颌骨下缘制备直径为5 mm、深为2 mm的圆柱形骨缺损区共3个,自近中至远中依次编号为1,2,3号,置入钛螺纹钉后,分别填入富血小板纤维蛋白与骨基质2∶1混合物、1∶1混合物、1∶2混合物;另一侧下颌骨相同操作制备3个骨缺损,自远中向近中编号依次为4,5,6号,分别置入钛螺纹钉,4号作为空白对照,5号填入富血小板纤维蛋白,6号填入骨基质。12只兔随机分为造模术后4,8,12周组,每组4只。各组分别随机选出1只兔,于处死前10 d注射盐酸四环素25 mg/kg,处死前3 d注射钙黄绿素5 mg/kg,进行荧光标记。分别于造模术后4,8,12周时处死动物,行大体观察、苏木精-伊红染色、荧光标记、甲苯胺蓝酸性品红染色,并对成骨效果进行统计学分析。结果与结论:①骨形成率大小依次为:富血小板纤维蛋白/医用诱导骨基质2∶1>富血小板纤维蛋白>富血小板纤维蛋白/医用诱导骨基质1∶1>富血小板纤维蛋白/医用诱导骨基质1∶2>医用诱导骨基质>空白对照;②提示富血小板纤维蛋白与医用诱导骨基质均有良好的骨缺损修复效果;富血小板纤维蛋白和医用诱导骨基质联合应用时,随着富血小板纤维蛋白含量的增高,成骨效果更佳;富血小板纤维蛋白与医用诱导骨基质联合应用能加速种植体骨愈合。

BACKGROUND:Platelet-rich fibrin and artificial bone materials have been widely used in the repair and regeneration of peri-implant bone defects.However,there was a lack of research on the osteogenesis of the two materials in different proportions.OBJECTIVE:To investigate the effect of platelet-rich fibrin combined with bone matrix on the regeneration of peri-implant bone defects in rabbits.METHODS:A bone defect model around the oral implant was established in 12 large-ear white rabbits.Three cylindrical bone defect areas with a diameter of 5 mm and a depth of 2 mm were prepared along the lower edge of the right mandible,which were numbered 1-3 from the mesial to the distal.After placement of titanium screws,the 2:1,1:1,and 1:2 mixtures of platelet-rich fibrin and bone matrix were used respectively to fill in the defects.Another three same bone defects were prepared along the lower edge of the left mandible,which were numbered 4-6 from the distal to the mesial.Titanium screw screws were placed,No.4 defect was filled with nothing as a blank control,No.5 was filled with platelet-rich fibrin,and No.6 was filled with bone matrix.Twelve rabbits models were randomized into 4-,8-,12-week groups,with 4 rabbits in each group.One rabbit from each group was randomly selected,killed and fluorescently labeled.Tetracycline(25 mg/kg)and calcein(5 mg/kg)were subcutaneously administered at 10 and 3 days before death,respectively.Other animals were killed at 4,8,and 12 weeks after modeling,and the osteogenic effect was statically analyzed by general observation,hematoxylin-eosin staining,fluorescent labeling,and methylene blue/acid fuchsin staining.RESULTS AND CONCLUSION:Bone formation rate from high to low was:platelet rich fibrin/bone matrix 2:1>platelet rich fibrin>platelet rich fibrin/bone matrix 1:1>platelet rich fibrin/bone matrix 1:2>bone matrix>blank control.Both platelet-rich fibrin and bone matrix have a good effect in bone repairing bone defect.When platelet rich fibrin and medical induced bone matrix are used in combination,the osteogenic effect becomes better with the increase of platelet-rich fibrin concentration.The combined application of platelet-rich fibrin and bone matrix can accelerate bone healing of implants.