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评价不同的移植物材料在大鼠正畸牙移动背景下对牙槽裂修复的影响。

Evaluation of different grafting materials for alveolar cleft repair in the context of orthodontic tooth movement in rats.

机构信息

Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany.

Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.

出版信息

Sci Rep. 2021 Jun 30;11(1):13586. doi: 10.1038/s41598-021-93033-x.

Abstract

To minimize the postoperative risks posed by grafting autologous transplants for cleft repair, efforts are being made to improve grafting materials for use as potential alternatives. The aim of this study was to compare the bone graft quality of different bone substitutes including the gold standard autografts during the healing processes after cleft repair in the context of orthodontic treatment. In 21 Wistar rats, a complete, continuity-interrupting cleft was created. After 4 weeks, cleft repair was performed using autografts from the hips' ischial tuberosity, human xenografts, or synthetic bone substitutes [beta-tricalcium phosphate (β-TCP)/hydroxyapatite (HA)]. After another 4 weeks, the first molar movement was initiated in the reconstructed jaw for 8 weeks. The bone remodeling was analyzed in vivo using micro-computed tomography (bone mineral density and bone volume fraction) and histology (new bone formation). All the grafting materials were statistically different in bone morphology, which changed during the treatment period. The β-TCP/HA substitute demonstrated less resorption compared to the autologous and xenogeneic/human bone, and the autografts led to a stronger reaction in the surrounding bone. Histologically, the highest level of new bone formation was found in the human xenografts, and the lowest was found in the β-TCP/HA substitute. The differences between the two bone groups and the synthetic materials were statistically significant. Autografts were confirmed to be the gold standard in cleft repair with regard to graft integration. However, parts of the human xenograft seemed comparable to the autografts. Thus, this substitute could perhaps be used as an alternative after additional tissue-engineered modification.

摘要

为了最大限度地降低自体移植修复腭裂术后的风险,人们正在努力改进移植材料,以寻找潜在的替代品。本研究旨在比较不同骨替代物(包括金标准自体移植物)在正畸治疗背景下腭裂修复后的成骨质量。在 21 只 Wistar 大鼠中,构建了完全、连续性中断的腭裂。4 周后,使用来自臀部坐骨结节的自体移植物、人异种移植物或合成骨替代物(β-磷酸三钙(β-TCP)/羟基磷灰石(HA))进行腭裂修复。4 周后,在重建的颌骨中启动第一磨牙移动,持续 8 周。使用微计算机断层扫描(骨矿物质密度和骨体积分数)和组织学(新骨形成)对体内骨重塑进行分析。所有移植材料在骨形态学上均有统计学差异,且在治疗期间发生变化。与自体和异种/人骨相比,β-TCP/HA 替代物的吸收较少,而自体移植物导致周围骨的反应更强。组织学上,在人异种移植物中发现了最高水平的新骨形成,而在β-TCP/HA 替代物中发现了最低水平。两种骨组与合成材料之间的差异具有统计学意义。自体移植物被证实是腭裂修复的金标准,就移植物整合而言。然而,部分人异种移植物似乎与自体移植物相当。因此,经过进一步的组织工程修饰后,这种替代物可能可以用作替代物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a353/8245488/06d8ff71fd94/41598_2021_93033_Fig1_HTML.jpg

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