Ramalingam Sundar, Al-Rasheed Abdulaziz, ArRejaie Aws, Nooh Nasser, Al-Kindi Mohammed, Al-Hezaimi Khalid
Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Odontology. 2016 May;104(2):199-210. doi: 10.1007/s10266-015-0211-8. Epub 2015 Jul 9.
Guided bone regeneration (GBR) procedures using graft materials have been used for reconstruction of osseous defects. The aim of the present in vivo micro-computed tomographic (µCT) and histologic study was to assess in real time the bone regeneration at GBR sites in standardized experimental calvarial defects (diameter 3.3 mm) using β-tricalcium phosphate (β-TCP) with and without collagen membrane (CM). A single full-thickness calvarial defect was created on the left parietal bone in young female Wistar albino rats (n = 30) weighing approximately 300 g and aged about 6 weeks. The animals were randomly divided into three groups for treatment, based on calvarial defect filling material: (1) control group (n = 10); (2) β-TCP + CM group (n = 10); (3) β-TCP group (n = 10). Real-time in vivo µCT analyses were performed immediately after surgery and at 2, 4, 6 and 10 weeks to determine the volume and mineral density of the newly formed bone (BVNFB, MDNFB) and remaining β-TCP particles (VRBP, MDRBP). The animals were killed at 10 weeks and calvarial specimens were evaluated histologically. In the control group, MDNFB increased significantly at 6 weeks (0.32 ± 0.002 g/mm(3), P < 0.01) compared to that at baseline. In β-TCP + CM group, BVNFB (1.10 ± 0.12 mm(3), P < 0.01) and MDNFB (0.13 ± 0.02 g/mm(3), P < 0.01) significantly increased at the 4th week than baseline. In the β-TCP group, BVNFB (1.13 ± 0.12 mm(3), P < 0.01) and MDNFB (0.14 ± 0.01 g/mm(3), P < 0.01) significantly increased at 6 weeks compared to that at baseline. Significant reduction in VRBP was neither seen in the β-TCP + CM group nor in the β-TCP group. While in the β-TCP + CM group MDRBP was reduced significantly at 6 weeks (0.44 ± 0.9 g/mm(3), P < 0.01) from baseline (0.98 ± 0.03 g/mm(3)), similar significant reduction in MDRBP from baseline (0.92 ± 0.07 g/mm(3)) was seen only at 10 weeks (0.45 ± 0.06 g/mm(3), P < 0.05) in the β-TCP group. Histologic findings at 10 weeks revealed greater amount of NFB with osteocytes in the matrix, in the β-TCP + CM group than in the β-TCP group. Biomechanical assessment of NFB for hardness (H) and elastic modulus (E) revealed significantly higher values for the β-TCP + CM group (H = 612.6 ± 4.28 Mpa; E = 13.57 ± 0.07 Gpa) when compared to those of the control (H = 192.1 ± 4.93 Mpa; E = 6.76 ± 0.04 Gpa) and the β-TCP groups (H = 241.9 ± 6.29 Mpa; E = 4.34 ± 0.06 Gpa). In conclusion, based on real-time assessment, NFB is formed in calvarial defects as early as 4 weeks following GBR with β-TCP + CM as compared to 6 weeks when β-TCP alone was used.
使用移植材料的引导骨再生(GBR)程序已被用于骨缺损的重建。本体内微计算机断层扫描(µCT)和组织学研究的目的是实时评估在标准化实验性颅骨缺损(直径3.3毫米)中,使用含和不含胶原膜(CM)的β-磷酸三钙(β-TCP)时GBR部位的骨再生情况。在体重约300克、年龄约6周的年轻雌性Wistar白化大鼠(n = 30)的左顶骨上制造单个全层颅骨缺损。根据颅骨缺损填充材料,将动物随机分为三组进行治疗:(1)对照组(n = 10);(2)β-TCP + CM组(n = 10);(3)β-TCP组(n = 10)。术后立即以及在2、4、6和10周进行实时体内µCT分析,以确定新形成骨的体积和矿物质密度(BVNFB、MDNFB)以及剩余的β-TCP颗粒(VRBP、MDRBP)。在10周时处死动物,并对颅骨标本进行组织学评估。在对照组中,与基线相比,MDNFB在6周时显著增加(0.32±0.002克/立方毫米,P < 0.01)。在β-TCP + CM组中,BVNFB(1.10±0.12立方毫米,P < 0.01)和MDNFB(0.13±0.02克/立方毫米,P < 0.01)在第4周时比基线显著增加。在β-TCP组中,BVNFB(1.13±0.12立方毫米,P < 0.01)和MDNFB(0.14±0.01克/立方毫米,P < 0.01)在6周时与基线相比显著增加。在β-TCP + CM组和β-TCP组中均未观察到VRBP的显著降低。虽然在β-TCP + CM组中,MDRBP在6周时从基线(0.98±0.03克/立方毫米)显著降低(0.44±0.9克/立方毫米,P < 0.01),但在β-TCP组中,仅在10周时(0.45±0.06克/立方毫米,P < 0.05)才观察到MDRBP从基线(0.92±0.07克/立方毫米)有类似的显著降低。10周时的组织学结果显示,与β-TCP组相比,β-TCP + CM组中基质中有更多含骨细胞的新形成骨(NFB)。对NFB的硬度(H)和弹性模量(E)进行生物力学评估发现,与对照组(H = 192.1±4.93兆帕;E = 6.76±0.04吉帕)和β-TCP组(H = 241.9±6.29兆帕;E = 4.34±0.06吉帕)相比,β-TCP + CM组的值显著更高(H = 612.6±4.28兆帕;E = 13.57±0.07吉帕)。总之,基于实时评估,与单独使用β-TCP时6周相比,在使用β-TCP + CM进行GBR后,颅骨缺损中最早在4周时就形成了NFB。