华西口腔医学杂志 ›› 2012, Vol. 30 ›› Issue (4): 425-429.doi: 10.3969/j.issn.1000-1182.2012.04.024

• 专栏论著 • 上一篇    下一篇

骨缝牵引中联合应用骨形态发生蛋白-2和骨保护素的实验研究

姚玉胜1 黄华1 常世民2 王程越1 王桂君3   

  1. 1.辽宁医学院附属第二医院口腔颌面外科, 锦州121000; 2.北京友谊医院口腔颌面外科, 北京100050;3.辽宁医学院药学系, 锦州121000
  • 收稿日期:2011-03-14 修回日期:2011-11-05 出版日期:2012-08-01 发布日期:2012-08-01
  • 通讯作者: 王桂君,Tel:0416-4197472
  • 作者简介:姚玉胜(1970—),男,辽宁人,副主任医师,博士
  • 基金资助:

    辽宁省教育厅基金资助项目(L2010281)

The effect of bone morphogenetic protein-2 and osteoprotegerin in trans-sutural distraction osteogenesis

Yao Yusheng1, Huang Hua1, Chang Shimin2, Wang Chengyue1, Wang Guijun3.   

  1. 1. Dept. of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Liaoning Medical College, Jinzhou 121000, China; 2. Dept. of Oral and Maxillofacial
    Surgery, Beijing Friendship Hospital, Beijing 100050, China; 3. Pharmacy Department, Liaoning Medical College, Jinzhou 121000, China
  • Received:2011-03-14 Revised:2011-11-05 Online:2012-08-01 Published:2012-08-01

摘要:

目的探索上颌骨在骨缝牵引时加入缓释骨形态发生蛋白-2(BMP-2)和骨保护素(OPG)对新骨形成的影响。方法以24只杂种犬为研究对象,随机分为A、B、C组。通过手术在上颌骨腭横缝植入自制的新型牵引器。A、C组术后5 d在牵引区附近注射缓释重组人骨形态发生蛋白-2/聚乳酸-羟基乙酸共聚物/纤维蛋白胶(rhBMP-2/PLGA/FS),B、C组在牵引3周后注射人骨保护素/纤维蛋白胶(rhOPG/FS)。牵引1、2、4、6周后处死动物,采集标本进行组织学染色,并通过组织计量学方法检测腭横缝的组织改建情况。结果A、C组骨缝区成骨细胞功能活跃,透射电镜显示细胞内有大量高尔基复合体、线粒体及粗面内质网。牵引6周时,A、B、C组成骨细胞指数分别为38.5±7.7、35.7±6.5、41.7±11.0,破骨细胞指数分别为5.9±1.0、1.2±0.3、2.8±0.4,骨小梁厚度分别为(38.36±13.28)、(66.20±9.16)、(51.85±9.92)μm;B、C组表现出骨密度增加及破骨细胞指数下降。结论本实验所用牵引器能促进新骨生成;BMP-2与OPG在骨缝牵引过程中有协同作用,可以促进新骨形成及骨改建。

关键词: 牵引成骨术, 骨形态发生蛋白-2, 骨保护素

Abstract:

Objective To determine if locally administered bone morphogenetic protein-2(BMP-2) and osteoprotegerin(OPG) improved osteogenesis and new bone formation by trans-sutural distraction osteogenesis. Methods Twenty four dogs were divided into three groups randomly and received new internal trans-sutural distraction osteogenesis treatment. Five days after operation, infusion apparatus with double-tube was inserted to submucosa near the distracted zone
to deliver controlled release agent of recombinant human bone morphogenetic protein-2/poly(lactic-co-glycolic acid)/fibrin sealant(rhBMP-2/PLGA/FS) in group A and group C. Recombinant human osteoprotegerin/fibrin sealant(rhOPG/FS) was injected three weeks later in group B and group C. Histology staining and bone histomorphometry were used to measure the changes of maxillary bone sutura after distraction for 1, 2, 4 and 6 weeks. Results New bone formation
observed in distracted zone showed a significant increase in group A and C. Transmission electron microscope showed the osteoblast and osteocyte were active with dilated rough endoplasmic reticulum and a large number of chondriosomes and Golgi complex. After distraction for 6 weeks, indexes of osteoblast of group A, B, and C were 38.5±7.7, 35.7±6.5, and 41.7±11.0, indexes of osteoclast(Ioc) were 5.9±1.0, 1.2±0.3, and 2.8±0.4, bone trabecula thicknesses were (38.36±13.28),(66.20±9.16), and(51.85±9.92)μm respectively. Increased bone density and decreased Ioc were found in group B and C. Conclusion The new elastic distractor is effective in inducing new bone formation. BMP-2 and OPG combination acts synergistically, and leads to significant enhancement of bone formation and remodeling.

Key words: distraction osteogenesis, bone morphogenetic protein-2, osteoprotegerin