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生物活性二氧化硅-磷酸钙复合材料(SCPC)植入拔牙窝与未植入拔牙窝的骨再生及移植材料吸收情况:临床、影像学和组织学研究结果

Bone regeneration and graft material resorption in extraction sockets grafted with bioactive silica-calcium phosphate composite (SCPC) versus non-grafted sockets: clinical, radiographic, and histological findings.

作者信息

Adel-Khattab Doaa, Afifi Nermeen S, Abu El Sadat Shaimaa M, Aboul-Fotouh Mona N, Tarek Karim, Horowitz Robert A

机构信息

Department of Oral Medicine, Periodontology and Diagnosis, Ain Shams University Faculty of Dentistry, Cairo, Egypt.

Department of Oral Pathology, Ain Shams University Faculty of Dentistry, Cairo, Egypt.

出版信息

J Periodontal Implant Sci. 2020 Dec;50(6):418-434. doi: 10.5051/jpis.2000040002.

Abstract

PURPOSE

The purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets.

METHODS

Ten patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively.

RESULTS

A radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density.

CONCLUSIONS

The resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03897010.

摘要

目的

本研究旨在评估硅磷酸钙复合材料(SCPC)颗粒对拔牙窝骨再生的影响。

方法

选择10例患者进行分模型研究。对每位患者,术后6个月通过临床、影像学、组织形态计量学和免疫组织化学评估分析SCPC植入窝和未植入对照窝的骨愈合情况。

结果

使用锥形束计算机断层扫描进行的影像学评估显示,SCPC植入窝的牙槽嵴尺寸变化最小,高度和宽度分别减少0.39 mm和1.79 mm。在种植体植入时拔牙后6个月获取核心骨活检样本并进行分析。SCPC植入窝中成熟骨、编织骨和残余颗粒所占的平均面积百分比分别为41.3%±12%、20.1%±9.5%和5.3%±4.4%。同一时间点未植入对照窝中形成的成熟骨和编织骨的面积百分比分别为31%±14%和24.1%±9.4%。组织化学和免疫组织化学分析显示,植入窝中有密集矿化的I型胶原束,骨桥蛋白表达强度高。新形成的骨血管化良好,有大量活跃的成骨细胞、哈弗斯系统和骨细胞,表明其成熟。相比之下,未植入对照窝中的新骨不成熟,富含III型胶原,骨细胞密度低。

结论

6个月内SCPC颗粒的吸收与比未处理窝更好的新骨形成相协调。SCPC是一种可吸收的骨移植材料,通过对骨细胞功能的刺激作用增强骨形成和成熟。

试验注册

ClinicalTrials.gov标识符:NCT03897010。

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