Shindo M L, Costantino P D, Friedman C D, Chow L C
Department of Otolaryngology, Head and Neck Surgery, University of Southern California, Los Angeles 90033-4605.
Arch Otolaryngol Head Neck Surg. 1993 Feb;119(2):185-90. doi: 10.1001/archotol.1993.01880140069012.
This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans.
本研究调查了一种新型磷酸钙骨水泥的应用，该骨水泥凝固后成为固体微孔羟基磷灰石，用于面部骨增量。在6只犬中，双侧眶上嵴用这种羟基磷灰石骨水泥进行增量。一侧，将羟基磷灰石骨水泥直接置于骨膜下袋内的骨上。另一侧，将骨水泥置于胶原膜小管内，然后插入骨膜下袋。胶原小管的使用便于骨水泥轻松、精确地放置。在整个研究期间，所有植入物均保持其初始增量高度。它们耐受性良好，无挤出或移位，且无明显持续炎症反应。在3个月、6个月和9个月进行的组织学研究显示，当骨水泥直接置于骨上时，观察到植入物逐渐被骨替代（羟基磷灰石与下方骨的骨结合），且体积无损失。相比之下，当插入骨水泥 - 胶原小管组合时，主要观察到纤维性连接。尽管有这种纤维性连接，但羟基磷灰石 - 胶原植入物牢固地与下方骨结合，且未观察到植入物吸收。羟基磷灰石骨水泥可成功用于颅面骨骼的实验性增量，可能适用于人类的此类用途。
