Du Zhibin, Chen Jiang, Yan Fuhua, Xiao Yin
Department of Oral Implant, Affiliated Stomatological Hospital of Fujian Medical University, Fuzhou, China.
Clin Oral Implants Res. 2009 Feb;20(2):145-50. doi: 10.1111/j.1600-0501.2008.01630.x. Epub 2008 Dec 1.
Osteoporosis is known to impair the process of implant osseointegration. The recent discovery that statins (HMG-CoA reductase inhibitors) act as bone anabolic agents suggests that statins can be used as potential agents in the treatment of osteoporosis. Therefore, we hypothesized that statins will promote osteogenesis around titanium implants in subjects with osteoporosis.
Fifty-four female Sprague Dawley rats, aged 3 months old, were randomly divided into three groups: Sham-operated group (SHAM; n=18), ovariectomized group (OVX; n=18), and ovariectomized with Simvastatin treatment group (OVX+SIM; n=18). Fifty-six days after being ovariectomized (OVX), screw-shaped titanium implants were inserted into the tibiae. Simvastatin was administered orally at 5 mg/kg each day after the placement of the implant in the OVX+SIM group. The animals were sacrificed at either 28 or 84 days after implantation and the undecalcified tissue sections were obtained. Bone-to-implant contact (BIC) and bone area (BA) within the limits of implant threads were measured around the cortical (zone A) and cancellous (zone B) bone regions. Furthermore, bone density (BD) of zone B in a 500 microm wide zone lateral to the implants was also measured.
There were no significant differences in BIC and BA measurements in zone A in any of the three groups at either 28 or 84 days after implantation (P>0.05). By contrast, in zone B, significant differences in the measurement of BIC, BA, and BD were observed at 28 and 84 days between all three groups. Bone healing decreased with lower BIC, BA, and BD around implant in OVX group compared with other two groups, and Simvastatin reversed the negative effect of OVX on bone healing around implants with the improvement of BIC, BA, and BD in zone B.
Osteoporosis can significantly influence bone healing in the cancellous bone around titanium implants and Simvastatin was shown to significantly improve the osseointegration of pure titanium implants in osteoporotic rats.
已知骨质疏松会损害种植体骨整合过程。他汀类药物（HMG-CoA还原酶抑制剂）作为骨合成代谢剂的最新发现表明，他汀类药物可作为治疗骨质疏松症的潜在药物。因此，我们假设他汀类药物将促进骨质疏松症患者钛种植体周围的骨生成。
将54只3月龄雌性Sprague Dawley大鼠随机分为三组：假手术组（SHAM；n = 18）、卵巢切除组（OVX；n = 18）和卵巢切除加辛伐他汀治疗组（OVX+SIM；n = 18）。卵巢切除（OVX）56天后，将螺旋形钛种植体植入胫骨。在OVX+SIM组中，种植体植入后每天口服5 mg/kg辛伐他汀。在植入后28天或84天处死动物，获取不脱钙组织切片。测量皮质骨（A区）和松质骨（B区）区域内种植体螺纹范围内的骨-种植体接触（BIC）和骨面积（BA）。此外，还测量了种植体外侧500微米宽区域内B区的骨密度（BD）。
植入后28天或84天，三组中任何一组在A区的BIC和BA测量值均无显著差异（P>0.05）。相比之下，在B区，三组在28天和84天的BIC、BA和BD测量值存在显著差异。与其他两组相比，OVX组种植体周围的BIC、BA和BD较低，骨愈合减少，辛伐他汀通过改善B区的BIC、BA和BD逆转了OVX对种植体周围骨愈合的负面影响。
骨质疏松可显著影响钛种植体周围松质骨的骨愈合，辛伐他汀可显著改善骨质疏松大鼠纯钛种植体的骨整合。
