【摘要】 背景:种植体周围骨缺损的大小与其完全修复所需要时间成正比,并认为骨缺损大于1mm者,应争取植骨,以利于新骨生长和种植体的早期固位。目的:比较珊瑚颗粒和羟基磷灰石颗粒在即刻种植愈合过程中的作用。设计:分组观察对比实验。单位:武汉大学人民医院口腔科。材料:羟基磷灰石涂层种植体,羟基磷灰石颗粒,珊瑚颗粒,成年杂种犬3只。方法:实验于2002-08/2003-04在武汉大学人民医院口腔科完成。麻醉下将3只犬股骨钻6个孔(每侧股骨3个孔),造成骨缺损。在所有近心端一组种植体周的骨缺损中植入珊瑚颗粒(珊瑚颗粒组),在所有远心端的一组种植体周的骨缺损中植入羟基磷灰石颗粒(羟基磷灰石颗粒组),中间一组种植体周的骨缺损中不植入任何材料(空白对照组)。术后2,3,4个月麻醉状态各处死犬1只,取犬种植区骨段各组材料标本进行X射线检查及扫描电镜观察。主要观察指标:犬种植区骨段各组材料X射线检查及各组标本扫描电镜观察结果。结果:①种植区骨段各组材料X射线检查结果:4个月,珊瑚颗粒组和羟基磷灰石颗粒组种植体与骨组织紧密结合。空白对照组尚有部分骨组织缺损。②种植区骨段各组标本扫描电镜观察结果:4个月,珊瑚颗粒组新生骨组织完全成熟,珊瑚颗粒残留少许。羟基磷灰石颗粒组新生骨组织完全成熟,羟基磷灰石颗粒仍大量存在,颗粒无明显吸收。空白对照组,种植体颈部存在部分空隙。结论:即刻种植体周骨缺损>1mm以上应植入植骨材料。作为植骨材料,珊瑚颗粒较羟基磷灰石颗粒有更好的骨引导活性,能降解吸收为骨组织替代,而羟基磷灰石颗粒不能吸收,影响骨改建。更多还原

【Abstract】 BACKGROUND: The direct ratio is formed between the size of osseous defect around implant and the required time of complete repair. It is viewed that bone implantation is suggested if osseous defect is larger than 1 mm, which benefits the bone regeneration and early fixation of implant.OBJECTIVE: To compare the effects between coralline granules and hydroxyapatite (HA) during union after immediate implantation. DESIGN: Group observation and controlled experiment was designed.SETTING: Department of Stomatology Renmin Hospital of Wuhan University.MATERIALS: HA coated implant, HA granule, coralline granule and 3 adult mongrel dogs.METHODS: The experiment was performed in Department of Stomatology, Renmin Hospital of Wuhan University from August 2002 to April 2003. Under anesthesia, 6 foramens were drilled on femurs of 3 dogs (3 foramens on each side) to result in osseous defect. Coralline granules were embedded in the osseous defect around the implant in all of proximal ends (coralline granule group, CG group), HA granules were embedded in the osseous defect around the implant in all of distal ends (HA group) and nothing was embedded in the defect around the implant in the center (the control). One dog was sacrificed under anesthesia on the 2nd, 3rd and 4th months after operation successively and the samples were collected from the implanted section in each group for X-ray examination and scanning electronic microscopic observation.MAIN OUTCOME MEASURES: X-ray examination on implanted sections and scanning electronic microscopic observation on samples in each group.RESULTS: ① X-ray examination on implanted sections in each group: on the 4th month, it was observed that implants and osseous tissue were closely integrated in CG group and HA group and there was still partial osseous defect in the control group. ② Scanning electronic microscopic observation on samples in each group: on the 4th month, it was discovered that the regenerated osseous tissue was matured completely in CG group and few coralline granule residue was left. In HA group, the regenerated osseous tissue was matured completely, but there was still a large amount of HA granules left and the granules had not been absorbed obviously. In the control group, the space appeared partially in the implanted cervical region.CONCLUSION: The implantation of artificial bone is suggested if the osseous defect around immediate implant is larger than 1 mm. As the implanting materials, coralline granules and HA granules act on the most advantageous guide activity.Coralline granules can be degraded and substituted with osseous tissue,but HA granules cannot be absorbed, which affects osseous reconstruction.更多还原