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目的探讨富血小板血浆(PRP)与多孔矿化骨(BPBM)修复下颌双皮质骨缺损作用。方法 54只健康白兔分为3组,制作下颌双皮质骨缺损模型,治疗1组植入PRP+BPBM+GBR,治疗2组植入BPBM+GBR,对照组植入明胶海绵,用X线、光学显微镜、电子显微镜观察术后4、8、12周骨缺损修复情况,测定血中碱性磷酸酶(ALP)、钙磷变化。结果 PRP血小板为全血4.19~4.43倍;X线片示在4、8、12周时治疗1和2组骨密度明显高于对照组;HE染色见在4周时治疗1组缺损边缘有少许新骨生成,移植物部分降解,治疗2组新骨形成较少;在8周时治疗1组新骨数量明显多于治疗2组;12周时治疗1组充填物吸收被新骨代替,新生骨骨小粱和骨陷窝增多;治疗2组成骨细胞和新骨数量比治疗1组少;对照组新骨形成明显减少。电镜发现,治疗1组各时间点成骨细胞突起和向移植物浸润能力、成骨细胞内线粒体和粗面内质网数量多于治疗2组,治疗2组成骨细胞内线粒体数量和成骨细胞突起向移植物浸润能力强于对照组。在4、8、12周时治疗1组和治疗2组碱性磷酸酶和钙磷含量与对照组比有显著性差异。结论联合PRP和BPBM及GBR技术对下颌双皮质骨缺损有良好修复能力,其作用与PRP中高浓度血小板分泌生长因子和BPBM多孔支架结构有关。
Objective To investigate the effect of platelet-rich plasma (PRP) and porous mineralized bone (BPBM) on mandibular double cortical bone defects. Methods 54 healthy rabbits were divided into three groups to make the mandibular double cortical bone defect model. One group was implanted with PRP + BPBM + GBR, the other two groups were implanted with BPBM + GBR. The control group was implanted with gelatin sponge, Optical microscope and electron microscope were used to observe the repair of bone defects at 4, 8, and 12 weeks after operation. Alkaline phosphatase (ALP), calcium and phosphorus in the blood were measured. Results The PRP platelets were 4.19-4.44 times of whole blood. The X-ray showed that the bone mineral density of group 1 and 2 at 4, 8 and 12 weeks was significantly higher than that of the control group. HE staining showed that there was a little margin at the 4th week New bone formation and partial degradation of the graft. The formation of new bone in the two groups was less. At 8 weeks, the number of new bone in one group was significantly more than that in the second group. At 12 weeks, Bone sorrows and lacunae increased; the number of osteoblasts and new bone in treatment group 2 was less than that in treatment group 1; and the formation of new bone in control group was significantly reduced. Electron microscopy showed that the number of mitochondria and rough endoplasmic reticulum in osteoblasts was more than that in the treatment group 2 in the treatment of osteoblast protrusion and graft infiltration in each group at 1 time point. The number of mitochondria in osteoblasts and the number of osteoblasts Protrusion infiltration ability of the graft is stronger than the control group. At 4, 8, and 12 weeks, there was a significant difference between the two groups in the treatment of alkaline phosphatase and calcium and phosphorus. Conclusions The combination of PRP, BPBM and GBR has a good ability to repair mandibular double cortical defects, and its role is related to the high concentrations of platelet-secreting growth factor (PRP) and the porous scaffolds of BPBM.