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低水平激光治疗和血小板浓缩物对骨修复的影响:组织学、组织形态计量学、免疫组织化学和影像学研究。

Effects of low-level laser therapy and platelet concentrate on bone repair: Histological, histomorphometric, immunohistochemical, and radiographic study.

机构信息

Department of Dentistry. Graduate Program in Dentistry, Universidade Positivo (Head: Dr. Flares Baratto-Filho, DDS), Curitiba, Brazil.

Department of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brazil.

出版信息

J Craniomaxillofac Surg. 2017 Nov;45(11):1846-1853. doi: 10.1016/j.jcms.2017.08.008. Epub 2017 Aug 19.

DOI:10.1016/j.jcms.2017.08.008
PMID:28935484
Abstract

PURPOSE

Low-level laser therapy (LLLT) can increase bone metabolism, cell proliferation, and maturation, and reduce inflammation, while platelet concentrate (PC) assists bone healing process by releasing proteins and growth factors. Here, we evaluated the efficacy of combined LLLT and PC therapy in the healing of critical-size bone defects.

MATERIALS AND METHODS

Calvarial critical-size defects 5 mm in diameter were made in 48 Wistar rats. Bones were removed, milled, and used as autogenous bone grafts. Animals were randomized into four groups: LP (LLLT + PC), PC, L (LLLT), and C (control, autogenous graft only). Animals were sacrificed at day 30 and 60 post-surgery. Specimens were submitted to radiographic (digital and conventional), histological, histomorphometric, and immunohistochemical analyses.

RESULTS

Digital radiography was shown to be a better image analysis method compared with conventional radiography. Histological analysis demonstrated a significant difference in bone formation between animals in group L (p = 0.049) at day 60 than in other groups. Higher rates of inflammatory infiltrates and fibrosis were observed in the LP and PC groups at days 30 and 60, whereas the groups not receiving PC showed a higher rate of bone maturity. The inflammatory processes were reduced in the animals in the L group, together with new bone formation and maturation. Groups L and C had higher scores of positive osteocalcin immunostaining in bone and extracellular matrix.

CONCLUSIONS

LLLT reduces inflammation and contributes to increased bone formation. PC treatment was shown to maintain connective tissue and to induce fibrosis during bone repair. Combined LLLT and PC treatment did not improve bone repair.

摘要

目的

低水平激光疗法(LLLT)可以增加骨代谢、细胞增殖和成熟,减少炎症,而血小板浓缩物(PC)通过释放蛋白质和生长因子来辅助骨愈合过程。在这里,我们评估了 LLLT 和 PC 联合治疗在治疗临界尺寸骨缺损中的疗效。

材料和方法

在 48 只 Wistar 大鼠的颅骨上制造直径为 5mm 的临界尺寸骨缺损。将骨头取出、研磨,并用作自体骨移植物。动物随机分为四组:LP(LLLT+PC)、PC、L(LLLT)和 C(对照,仅自体移植物)。动物在手术后第 30 天和第 60 天被处死。标本进行了放射学(数字和常规)、组织学、组织形态计量学和免疫组织化学分析。

结果

数字放射照相术被证明是一种比常规放射照相术更好的图像分析方法。组织学分析表明,第 60 天 L 组动物的骨形成有显著差异(p=0.049)。在第 30 天和第 60 天,LP 和 PC 组观察到更高的炎症浸润和纤维化率,而未接受 PC 治疗的组显示出更高的骨成熟率。L 组的炎症过程减少,同时有新骨形成和成熟。L 和 C 组在骨和细胞外基质中有更高的骨钙素免疫染色阳性评分。

结论

LLLT 可减少炎症并促进骨形成。PC 治疗被证明可维持结缔组织并在骨修复过程中诱导纤维化。LLLT 和 PC 联合治疗并未改善骨修复。

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