华西口腔医学杂志

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邻近拔牙创植入正畸微种植体骨界面愈合的组织学研究

周阳明1,2  胡赟2,3  郑雷蕾1,2  赵志河4  唐甜4  邓锋1,2  卫光曦1,2  霍金凤1,2  张晓歌4   

  1. 1.重庆医科大学附属口腔医院正畸科；2.口腔疾病与生物医学重庆市重点实验室；3.重庆医科大学附属口腔医院预防与儿童牙病科，重庆 401147；4.口腔疾病研究国家重点实验室华西口腔医院正畸科（四川大学），成都 610041
  • 收稿日期:2012-09-20 修回日期:2013-05-15 出版日期:2013-10-01 发布日期:2013-10-01
  • 通讯作者: 郑雷蕾，Tel：15086986968
  • 作者简介:周阳明（1986—），男，重庆人，住院医师，硕士
  • 基金资助:

    国家自然科学基金资助项目（81000463，10902075）；重庆市自然科学基金资助项目（cstc2012jja10053）；重庆市教育委员会科学技术研究基金资助项目（kj120329）；重庆市医学科研计划基金资助项目（2012-2-126）

Histopathological study on the healing of orthodontic implant-bone interface adjacent to extraction

Zhou Yangming1,2, Hu Yun2,3, Zheng Leilei1,2, Zhao Zhihe4, Tang Tian4, Deng Feng1,2, Wei Guangxi1,2, Huo Jinfeng1,2, Zhang Xiaoge4.   

  1. 1. Dept. of Orthodontics, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China; 2. Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing 401147, China; 3. Dept. of Preventive and Pediatric Dentistry, The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 401147, China; 4. State Key Laboratory of Oral Diseases, Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2012-09-20 Revised:2013-05-15 Online:2013-10-01 Published:2013-10-01

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摘要：

目的  通过组织形态学观察和定量测定，比较拔牙创对种植体—骨界面愈合进程的影响，并对正畸微种植体骨整合的安全范围进行探讨。方法  12只雄性Beagle犬，按不同愈合时间段（1、3、8、12周）随机分成4组，建立邻近拔牙创植入正畸微种植体实验动物模型。在植入微种植体后愈合的第1、3、8、12周处死各组动物，制备含种植钉的硬组织切片，观察组织学形态，并测定微种植体—骨界面骨接触率（BIC）。结果  实验组和对照组在植入后第3周开始出现组织学变化的明显差异：实验组骨界面骨吸收活跃；对照组骨界面出现新生骨层，周边存在活跃成骨细胞。对照组在植入后前8周，BIC值随着时间的增加而增加。实验组BIC值在植入3周后有所下降，到第8周达到峰值（80.08％），随后进入平台期。两组BIC的差异表现在植入后第3周：实验组BIC（44.35％）小于对照组（55.46％），二者差异有统计学意义（P<0.01）。结论  拔牙创对微种植体周围骨重建进程会产生影响，早期表现为加重骨吸收，但在随后的时间里骨形成效应会迅速加强。

关键词: 拔牙创, 骨整合, 骨接触率, 骨重建

Abstract:

Objective  Osseointegration of orthodontic microscrew implant is influenced by tooth extraction. This study aims to evaluate the safety margin of the osseointegration of orthodontic implants by investigating the healing process of the implant-bone interface through histopathological studies and quantitative determination. Methods  Twelve male beagles were selected and randomly divided into four groups. An orthodontic microscrew was implanted beside the tooth extraction area. Animals were killed in 1, 3, 8, and, 12 weeks to investigate tissue response. Histomorphological observation and bone implant contact ratio (BIC) tests were performed at different healing time after implantation. Results  A new bone was formed on the implant-bone interface of the control group. Bone resorptions were also detected in the experimental group 3 weeks after implantation. The BIC level of the control groups increased during the first 8 weeks; no change was observed anymore after the 8th week. On the other hand, the BIC value in the experimental group decreased in the first 3 weeks. It then increased rapidly and reached its peak of 80.08% in the 8th week. No significant difference was found between the experimental and control groups in the first 3 weeks. After the 3rd week, the BIC value of the experimental group (44.35%) was lower than that of the control group (55.46%) (P<0.01). Conclusion  The healing process after implantation was influenced by tooth extraction. Bone resorption was detected at an early stage. However, vigorous bone remodeling was observed subsequently.

Key words: extraction, osseointegration, bone implant contact ratio, bone remolding

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