聚己内酯-20%磷酸三钙支架联合富血小板血浆治疗下颌骨临界尺寸缺损的初步研究。

Polycaprolactone-20% tricalcium phosphate scaffolds in combination with platelet-rich plasma for the treatment of critical-sized defects of the mandible: a pilot study.

作者信息

Rai Bina, Ho Kee Hai, Lei Yang, Si-Hoe Kuan-Ming, Jeremy Teo Choon-Mengjeremy, Yacob Kamal Bin, Chen Fulin, Ng Fooi-Chin, Teoh Swee Hin

机构信息

Department of Oral and Maxillofacial Surgery, National University of Singapore, Singapore.

出版信息

J Oral Maxillofac Surg. 2007 Nov;65(11):2195-205. doi: 10.1016/j.joms.2006.11.026.

DOI:10.1016/j.joms.2006.11.026

PMID:17954314

Abstract

PURPOSE

Our group has recently fabricated 3-dimensional scaffolds of unique architecture to mediate favorable cell binding, proliferation, and differentiation. In this study, the osteoconductive and bioactive polycaprolactone-20% tricalcium phosphate (PCL-TCP) scaffolds were assessed for the treatment of critical-sized defects of the mandible, with respect to new bone formation. Platelet-rich plasma (PRP) was combined with some scaffolds to test if bone regeneration could be enhanced.

MATERIALS AND METHODS

Autologous PRP was prepared from whole blood collected from 8 mongrel dogs. In each dog, 3 defects (18 x 10 x 7 mm) were created at either the left or right mandible and treated with 1 of 2 treatment modalities: 1) grafting with scaffolds alone; or 2) grafting with scaffolds loaded with PRP. The scaffolds were stabilized using 2 dental implants each to prevent rotation. Micro-CT and histologic analysis were carried out on samples after 6 and 9 months.

RESULTS

Micro-CT measurements showed that PRP-treated defects had 98.3% and 58.3% more bone volume fraction than defects grafted with scaffolds alone at 6 and 9 months, respectively (P < .05). No significant difference was noted between caudal and frontal situated PRP-treated defects, but a significant difference was observed between male and female dogs. Histologic analyses verified the deposition of osteoid and new bone trabeculae throughout the section at 6 months. The defect margins were filled with mature bone trabeculae at 9 months but the middle section of the scaffolds manifested disturbed mineralization. The scaffolds experienced 33% degradation from 6 to 9 months. PRP treatment had negligible effect on the degradation of the scaffolds.

CONCLUSIONS

The pilot study showed that the treatment of critical-sized defects of the mandible with PCL-TCP scaffolds may be augmented by the addition of PRP.

摘要

目的

我们的团队最近制造了具有独特结构的三维支架，以促进良好的细胞黏附、增殖和分化。在本研究中，评估了具有骨传导性和生物活性的聚己内酯-20%磷酸三钙（PCL-TCP）支架在治疗下颌骨临界尺寸缺损方面的新骨形成情况。将富血小板血浆（PRP）与一些支架相结合，以测试是否可以增强骨再生。

材料与方法

从8只杂种犬采集的全血中制备自体PRP。在每只犬的左或右下颌骨制造3个缺损（18×10×7mm），并用以下2种治疗方式之一进行治疗：1）仅用支架移植；或2）用负载PRP的支架移植。每个支架使用2颗牙种植体进行固定以防止旋转。在6个月和9个月后对样本进行显微CT和组织学分析。

结果

显微CT测量显示，在6个月和9个月时，PRP处理的缺损分别比仅用支架移植的缺损具有多98.3%和58.3%的骨体积分数（P<.05）。在PRP处理的缺损中，尾侧和额侧缺损之间未观察到显著差异，但在雄性和雌性犬之间观察到显著差异。组织学分析证实，在6个月时整个切片中有类骨质和新骨小梁沉积。在9个月时缺损边缘充满成熟骨小梁，但支架中间部分表现出矿化紊乱。支架在6至9个月间降解了33%。PRP处理对支架降解的影响可忽略不计。