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阿仑膦酸盐对拔牙后牙槽骨吸收的影响。

The effect of alendronate on resorption of the alveolar bone following tooth extraction.

作者信息

Altundal H, Güvener O

机构信息

Department of Oral Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.

出版信息

Int J Oral Maxillofac Surg. 2004 Apr;33(3):286-93. doi: 10.1006/ijom.2002.0472.

Abstract

Maintenance of alveolar bone width and height following tooth loss is essential with regard to the restoration of missing teeth with endosseous dental implants or prosthodontics approaches. A various amount of alveolar ridge resorption is likely to occur after tooth extraction at the buccal and lingual alveolar bone plates. Bisphosphonates, alendronate, is well known for its potent inhibition of osteoclast-mediated bone resorption. The objective of this study was to examine the inhibitory effect of alendronate on alveolar bone resorption following tooth extraction in rats. Male Wistar Albino rats were divided into three groups: baseline group, saline-treated group and alendronate-treated group. The saline-treated group was administered with daily saline solution for 2 and 4 weeks respectively while the alendronate-treated group was given a daily amount of 0.25 mg/kg alendronate subcutaneously for the same periods. The level of urinary calcium, creatinine, and serum calcium, alkaline phosphatase and phosphate were measured. Serum alkaline phosphatase level was measured as a marker of osteoblastic activity. Histopathological sections of 4 microm thickness were obtained from the right first mandibular molar region in a bucco-lingual direction. The number of osteoclasts, osteoblasts, and haversian canals, the number and size of resorptive lacunae, and osteoid formation were evaluated histopathologically. The mean thickness of buccal and lingual alveolar bone was measured. In the alendronate-treated group, both buccal and lingual alveolar bone volume reduction was significantly less than the saline treated group. Significant reduction in serum and urinary calcium levels and the number of osteoclasts revealed the pronounced suppression of bone resorption in the alendronate-treated group.

摘要

对于采用骨内牙种植体或修复学方法修复缺失牙而言,牙齿缺失后维持牙槽骨的宽度和高度至关重要。拔牙后,颊侧和舌侧牙槽骨板很可能会出现不同程度的牙槽嵴吸收。双膦酸盐类药物阿仑膦酸钠以其对破骨细胞介导的骨吸收的强大抑制作用而闻名。本研究的目的是检测阿仑膦酸钠对大鼠拔牙后牙槽骨吸收的抑制作用。雄性Wistar白化大鼠被分为三组:基线组、生理盐水治疗组和阿仑膦酸钠治疗组。生理盐水治疗组分别在2周和4周内每日给予生理盐水溶液,而阿仑膦酸钠治疗组在相同时间段内每日皮下注射0.25mg/kg阿仑膦酸钠。检测尿钙、肌酐水平以及血清钙、碱性磷酸酶和磷酸盐水平。测定血清碱性磷酸酶水平作为成骨细胞活性的标志物。从右侧第一下颌磨牙区域沿颊舌方向获取4微米厚的组织病理学切片。组织病理学评估破骨细胞、成骨细胞和哈弗斯管的数量、吸收陷窝的数量和大小以及类骨质形成情况。测量颊侧和舌侧牙槽骨的平均厚度。在阿仑膦酸钠治疗组中,颊侧和舌侧牙槽骨体积的减少均显著低于生理盐水治疗组。血清和尿钙水平的显著降低以及破骨细胞数量的减少表明阿仑膦酸钠治疗组的骨吸收受到明显抑制。

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