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局部和全身应用唑来膦酸对下颌骨牵张成骨影响的比较

Comparison of the Effects of Local and Systemic Zoledronic Acid Application on Mandibular Distraction Osteogenesis.

作者信息

Dundar Serkan, Artas Gokhan, Acikan Izzet, Yaman Ferhan, Kirtay Mustafa, Ozupek Muhammed Fatih, Asutay Fatih, Kom Mustafa

机构信息

*Department of Periodontology, Faculty of Dentistry †Department of Medical Pathology, Faculty of Medicine, Firat University, Elazig ‡Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakir §Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya ||Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyon Kocatepe University, Afyon Karahisar ¶Department of Surgery, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey.

出版信息

J Craniofac Surg. 2017 Oct;28(7):e621-e625. doi: 10.1097/SCS.0000000000003629.

Abstract

Bisphosphonates are antibone resorptive drugs that are used to prevent bone tissue resorption in several skeletal diseases. The aim of this study was to examine the effects of systemic and local applications of zoledronic acid (ZA) on newly regenerated bone in a model of experimental distraction osteogenesis (DO). To do this mandibular DO was applied to 30 adult female Sprague Dawley rats, which were randomly divided into 3 groups: control, DO only, systemic zoledronic acid (SZA), and local zoledronic acid (LZA). In the LZA group, the gap between the bone fragments was filled with a gelatin sponge soaked in 2 mg of ZA and 0.1 mL of sterile saline. In the SZA group, a single dose of 0.1 mg/kg ZA was administered systemically. After the surgery, there was a 5-day latent waiting period and 10-day distraction phase. Following a 28-day consolidation period, the rats were euthanized and their mandibles were collected. The distracted bone area was seen to be filled with newly regenerated bone tissue in all 3 groups, both histologically and histomorphometrically. In addition, amounts of new bone formation, osteoblast cella, osteoclast (OC) cells, osteopontin, and vascular endothelial growth factor in the SZA and LZA groups were found to be higher when compared with the controls. Furthermore, in the SZA group, new bone formation, osteoblast, OC, osteopontin, and vascular endothelial growth factor were detected in significant amounts compared with the LZA group. Osteoclast numbers did not differ in a statistically significant manner in the SZA group with respect to the LZA group. Based on the results of this study, systemic and local applications of ZA could increase the formation of new bone in patients of DO, and systemic application is a more effective method compared with local application.

摘要

双膦酸盐是抗骨吸收药物,用于预防多种骨骼疾病中的骨组织吸收。本研究的目的是在实验性牵张成骨(DO)模型中,研究唑来膦酸(ZA)全身和局部应用对新再生骨的影响。为此,对30只成年雌性Sprague Dawley大鼠进行下颌DO,并将其随机分为3组:对照组、仅DO组、全身唑来膦酸(SZA)组和局部唑来膦酸(LZA)组。在LZA组中,骨碎片之间的间隙用浸泡在2 mg ZA和0.1 mL无菌盐水中的明胶海绵填充。在SZA组中,全身给予单剂量0.1 mg/kg ZA。手术后,有5天的潜伏等待期和10天的牵张期。经过28天的巩固期后,对大鼠实施安乐死并收集其下颌骨。从组织学和组织形态计量学上看,所有3组中牵张的骨区域均可见新再生的骨组织填充。此外,与对照组相比,SZA组和LZA组中的新骨形成量、成骨细胞、破骨细胞(OC)、骨桥蛋白和血管内皮生长因子的含量更高。此外,与LZA组相比,SZA组中检测到大量的新骨形成、成骨细胞、OC、骨桥蛋白和血管内皮生长因子。SZA组与LZA组相比,破骨细胞数量在统计学上无显著差异。基于本研究结果,ZA的全身和局部应用可增加DO患者的新骨形成,且全身应用是比局部应用更有效的方法。

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