Arosarena Oneida A, Collins Wesley L
Division of Otolaryngology, Department of Surgery, University of Kentucky Medical Center, Lexington 40536, USA.
Arch Otolaryngol Head Neck Surg. 2003 Oct;129(10):1125-30. doi: 10.1001/archotol.129.10.1125.
To compare the osteogenic abilities of 2 growth factors (bone morphogenic protein 5 [BMP-5] and prostaglandin E1 [PGE1]) and 2 carriers (collagen/polylactic acid [PLA] and collagen/calcium hydroxyapatite cement [HAC]) in the repair of a rat mandibular body defect.
Prospective controlled trial. Subjects Twenty-nine Sprague-Dawley rats.
Critical size defects were created in the bilateral mandibular bodies of the rats. Each hemimandible was assigned to an experimental group. The defects were filled with PLA (group 1), PLA with BMP-5 (group 2), PLA with PGE1 (group 3), HAC (group 4), HAC with BMP-5 (group 5), or HAC with PGE1 (group 6). The control group (group 7) had unfilled defects. The animals were killed after 12 weeks, and the nondemineralized specimens were processed histologically. Stereologic techniques were used to determine the volume fractions of new bone, osteoid, marrow, remaining implant, and fibrous tissue in each defect.
The HAC/BMP-5 group (group 5) contained significantly more new bone than the PLA/BMP-5 group (group 2) (P =.02), the HAC and HAC/PGE1 groups (groups 4 and 6) (P =.002), and the control group (group 7) (P<.01). The HAC/BMP-5 group also had less fibrous tissue than the HAC group and the HAC/PGE1 group (P<.001). Groups 5 and 6 had less fibrous tissue than group 7 (P<.01). The groups containing PGE1 demonstrated significantly more osteoid development than the other experimental groups (P<.001).
Inclusion of BMP-5 in an implant with calcium hydroxyapatite cement resulted in the formation of significantly larger fractions of new bone and less fibrous tissue ingrowth than occurred in the other experimental groups. The presence of PGE1 resulted in larger amounts of osteoid deposition, suggesting the potential for delayed bone healing.
比较两种生长因子(骨形态发生蛋白5 [BMP - 5]和前列腺素E1 [PGE1])以及两种载体(胶原蛋白/聚乳酸[PLA]和胶原蛋白/羟基磷灰石水泥[HAC])在修复大鼠下颌骨体缺损中的成骨能力。
前瞻性对照试验。对象为29只Sprague - Dawley大鼠。
在大鼠双侧下颌骨体制造临界尺寸缺损。每侧半下颌骨分配至一个实验组。缺损分别用PLA(第1组)、含BMP - 5的PLA(第2组)、含PGE1的PLA(第3组)、HAC(第4组)、含BMP - 5的HAC(第5组)或含PGE1的HAC(第6组)填充。对照组(第7组)为未填充缺损。12周后处死动物,对未脱钙标本进行组织学处理。采用体视学技术测定每个缺损中新生骨、类骨质、骨髓、残留植入物及纤维组织的体积分数。
HAC/BMP - 5组(第5组)的新生骨明显多于PLA/BMP - 5组(第2组)(P = 0.02)、HAC组和HAC/PGE1组(第4组和第6组)(P = 0.002)以及对照组(第7组)(P < 0.01)。HAC/BMP - 5组的纤维组织也少于HAC组和HAC/PGE1组(P < 0.001)。第5组和第6组的纤维组织少于第7组(P < 0.01)。含PGE1的组类骨质形成明显多于其他实验组(P < 0.001)。
在羟基磷灰石水泥植入物中加入BMP - 5,与其他实验组相比,可形成比例明显更大的新生骨且纤维组织向内生长更少。PGE1的存在导致大量类骨质沉积,提示可能存在骨愈合延迟的情况。