【摘要】 背景:目前,自体骨髓浓缩物主要应用于骨科、重症肢体缺血患者,其在口腔颌面外科尤其是种植外科应用较少,在种植体周围促进新骨再生的效果也有待研究。目的:评价自体骨髓浓缩物在种植体周围骨缺损修复中的作用。方法:于实验犬髂后上棘处抽取骨髓5 mL,对浓缩前后的骨髓进行细胞计数。在实验犬的双侧下颌前磨牙区植入种植体,并于近中制作4 mm×4 mm×4 mm的骨缺损,随机植入骨髓浓缩物混合明胶海绵、自体骨、明胶海绵。术后4,12周对骨缺损标本进行组织学观察分析,并计算新骨生成率和新骨密度。结果与结论:骨髓细胞平均浓缩倍数为(2.78±0.22)倍。浓缩骨髓中,可观察到更多和更大的克隆单位。组织学分析发现,4周时骨髓浓缩物明胶海绵组的新骨生成率和密度均明显高于自体骨组和明胶海绵组(P<0.05),12周时骨髓浓缩物明胶海绵组新骨生成率明显低于自体骨组,但高于明胶海绵组(P<0.05),3组新骨密度差异无显著性意义(P>0.05)。结果显示自体骨髓浓缩物能够显著提高种植体周围骨缺损内早期新生骨的质量。更多还原

【Abstract】 BACKGROUND: Autologous bone marrow aspirate concentrate is often applied in patients from Department of Orthopedics and those with severe limb ischemia, but rarely applied in Department of Oral and Maxillofacial Surgery, especially in Department of Oral Implantology. The effect of autologous bone marrow aspirate concentrate on promoting peri-implant bone regeneration deserves further studies. OBJECTIVE: To evaluate the effect of bone marrow aspirate concentrate in the repair of peri-implant bone defect. METHODS: Bone marrow 5 mL was extracted from posterior superior iliac spine of experimental dogs and bone marrow cells were counted before and after concentration. Bone defect(4 mm × 4 mm × 4 mm) was prepared in the middle of bilateral mandibular premolar, which was randomly implanted with gelatin sponge plus bone marrow aspirate concentrate, autologous bone and gelatin sponge. At 4 and 12 weeks after surgery, bone defect specimens were histologically observed. The new bone formation rate and new bone mineral density were calculated. RESULTS AND CONCLUSION: After centrifugation, the concentrations of nucleated cells in bone marrow aspirate concentrate were increased by(2.78±0.22) times. More colony-forming units were found after cell culture.Histological analysis showed that, significantly higher new bone formation rate and new bone mineral density occurred in gelatin sponge plus bone marrow aspirate concentrate group, compared with autologous bone group and gelatin sponge group at 4 weeks(P < 0.05). The new bone formation rate in gelatin sponge plus bone marrow aspirate concentrate group was significantly lower than that of autologous bone group, and higher than that of gelatin sponge group at 12 weeks(P < 0.05). However, the difference of new bone mineral density in the three groups was not significant(P > 0.05). Autologous bone marrow aspirate concentrate can significantlyimprove new bone mineral density and quantity in the pre-implant bone defect.更多还原