BMP与透明质酸钠复合物对放疗后种植体骨愈合影响的实验研究

THE EFFECT OF THE MIXTURE OF rhBMP-2 AND HYALURONAN ON BONE REACTIONS TO TITANIUM IMPLANTS IN IRRADIATED DOG MANDIBLES

目的 (1)观察放疗对狗下颌种植体周围骨形成蛋白 (BMP)分布与活性的影响 ;(2 )观察局部应用BMP与透明质酸钠复合物对放疗后种植体骨愈合作用的影响。方法 4只成年雄性杂种狗 ,拔除双侧下颌第 3、4前磨牙和第 1磨牙 ,形成无牙区。拔牙后 3个月 ,用电子直线加速器照射一侧下颌无牙区 ,单一剂量 15Gy。另一侧不接受照射 ,作为对照。放疗后 3个月 ,狗双侧下颌无牙区植入纯钛种植体各 4枚 ,其中每侧各 2枚种植体在局部使用BMP与透明质酸钠的复合物。种植术后 1 5个月和 3个月分别处死 2只动物取材。结果 (1)放疗侧种植体周围骨的BMP免疫染色范围和强度均明显弱于非放疗侧 ;(2 )局部应用BMP与透明质酸钠的复合物后 ,放疗侧种植体 -骨接触率和骨小梁体积百分比有明显增加。结论 (1)放疗后种植体周围BMP明显减少 ,活性显著下降 ;(2 )局部应用BMP与透明质酸钠复合物可以加快放疗后狗下颌骨的再生和重建 ,提高放疗后狗下颌纯钛种植体的种植体 -骨接触率和骨小梁体积百分比。

Objective To evaluate the effect of the mixture of rhBMP-2 and hyaluronan on bone reactions to titanium implants in irradiated dog mandibles. Methods Four dogs were divided into two groups. One side of each mandible was irradiated with a single 15Gy dose. The other side served as control. Three months after irradiation, four titanium implants were inserted in each side of the mandible. Two of them were placed with the mixture of rhBMP-2 and hyaluronan. The dogs were sacrificed at 1 5 and 3 months after implants inserted. Results (1) The distribution and the intersity of BMP around implant in nonirradiated sides were larger than in irradiated sides. (2) BCSR and tVsp of implants was significiantly larger than the mixture of rhBMP-2 and hyaluronan (P<0 05) was applied in irradiated sides. Conclusion The use of the mixture of rhBMP-2 and hyaluronan can obviously improve the bone regeneration in irradiated dog mandibles and increase BCSR of titanium implants and the quantity of the trabecular bone.