de Oliveira Neto Patricio José, Cricchio Giovanni, Hawthorne Ana Carolina, Okamoto Roberta, Sennerby Lars, Lungren Stefan, Salata Luiz Antonio
Department of Oral and Maxillofacial Surgery and Periodontics, Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
Clin Implant Dent Relat Res. 2012 Dec;14(6):861-71. doi: 10.1111/j.1708-8208.2010.00321.x. Epub 2010 Dec 22.
The bone tissue responses to Cyanoacrylate have been described in the literature, but none used N-butyl-2-cyanoacrilate (NB-Cn) for bone graft fixation.
The aims of the study were: (a) to analyze the bone grafts volume maintenance fixed either with NB-Cn or titanium screw; (b) to assess the incorporation of onlay grafts on perforated recipient bed; and (c) the differences of expression level of tartrate-resistant acid phosphatase (TRAP) protein involved in bone resorption.
Eighteen New Zealand White rabbits were submitted to calvaria onlay grafting on both sides of the mandible. On one side, the graft was fixed with NB-Cn, while on the other hand the bone graft was secured with an osteosynthesis screw. The computed tomography (CT) was performed just after surgery and at animals sacrifice, after 1 (n = 9) and 6 weeks (n = 9), in order to estimate the bone grafts volume along the experiments. Histological sections of the grafted areas were prepared to evaluate the healing of bone grafts and to assess the expression of TRAP protein.
The CT scan showed better volume maintenance of bone grafts fixed with NB-Cn (p ≤ 0.05) compared with those fixed with screws, in both experimental times (analysis of variance). The immunohistochemical evaluation showed that the TRAP expression in a 6-week period was significantly higher compared with the 1-week period, without showing significant difference between the groups (Wilcoxon and Mann-Whitney). Histological analysis revealed that the NB-Cn caused periosteum damage, but provided bone graft stabilization and incorporation similar to the control group.
The perforation provided by screw insertion into the graft during fixation may have triggered early revascularization and remodeling to render increased volume loss compared with the experimental group. These results indicate that the NB-Cn possesses equivalent properties to titanium screw to be used as bone fixation material in osteosynthesis.
文献中已描述了骨组织对氰基丙烯酸酯的反应,但尚无研究使用正丁基-2-氰基丙烯酸酯(NB-Cn)进行骨移植固定。
本研究的目的是:(a)分析用NB-Cn或钛螺钉固定的骨移植体积维持情况;(b)评估覆盖移植骨在穿孔受体床的整合情况;(c)参与骨吸收的抗酒石酸酸性磷酸酶(TRAP)蛋白表达水平的差异。
18只新西兰白兔接受双侧下颌骨覆盖移植。一侧,移植骨用NB-Cn固定,另一侧用骨固定螺钉固定。术后即刻以及术后1周(n = 9)和6周(n = 9)动物处死时进行计算机断层扫描(CT),以评估实验过程中骨移植的体积。制备移植区域的组织学切片,以评估骨移植的愈合情况并评估TRAP蛋白的表达。
CT扫描显示,在两个实验时间点(方差分析),与用螺钉固定的骨移植相比,用NB-Cn固定的骨移植体积维持更好(p≤0.05)。免疫组织化学评估显示,6周时的TRAP表达明显高于1周时,两组之间未显示出显著差异(Wilcoxon和Mann-Whitney检验)。组织学分析显示,NB-Cn导致骨膜损伤,但提供了与对照组相似的骨移植稳定和整合效果。
与实验组相比,固定过程中螺钉插入移植骨造成的穿孔可能引发了早期血管再生和重塑,导致体积损失增加。这些结果表明,NB-Cn具有与钛螺钉相当的特性,可作为骨固定材料用于骨合成。