Bifano C A, Edgin W A, Colleton C, Bifano S L, Constantino P D
Department of Oral/Maxillofacial Surgery, Keesler Medical Center, Keesler Air Force Base, Miss 39534-2567, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 May;85(5):512-6. doi: 10.1016/s1079-2104(98)90282-7.
The purpose of this study was to answer the following two questions: (1) Can hydroxyapatite cement in combination with demineralized freeze dried bone feasibly augment the dimension of an atrophic edentulous canine mandible? (2) What is the histologic fate of an augmentation graft composed of hydroxyapatite cement and demineralized freeze dried bone placed on the surface of an atrophic edentulous canine mandible?
Each of four mixed-breed canines (weighing 50 to 60 pounds) underwent bilateral mandibular dental extraction (canine to second molar) and radical alveolectomy. After 4 months of healing, a bilateral subperiosteal mandibular augmentation graft was put into place, with hydroxyapatite cement/demineralized freeze dried bone on the surface of one hemimandible and porous granular hydroxyapatite and demineralized freeze dried bone on the surface of the other hemimandible. The animals were killed after functioning on a soft diet for 9 months, and the grafted hemimandibles were harvested.
Both hydroxyapatite cement and granular hydroxyapatite grafts appeared to augment the edentulous atrophic canine mandible. On histologic exam, the hydroxyapatite cement grafts showed osteoconduction and subperiosteal and endosteal osteonal bone formation, whereas the granular hydroxyapatite grafts showed only osteoconduction. Neither graft material showed chronic or acute inflammation.
Hydroxyapatite cement can function feasibly as a mandibular augmentation device. The histologic fate of hydroxyapatite cement is different from that of granular hydroxyapatite. It has a fate comparable to autograft or allograft cortical bone grafts.
本研究旨在回答以下两个问题：（1）羟基磷灰石水泥联合脱矿冻干骨能否切实增加萎缩性无牙下颌犬的骨量？（2）置于萎缩性无牙下颌犬表面的由羟基磷灰石水泥和脱矿冻干骨组成的植骨块的组织学转归如何？
4只杂种犬（体重50至60磅）均接受双侧下颌牙拔除术（犬齿至第二磨牙）及根治性牙槽骨切除术。愈合4个月后，进行双侧下颌骨骨膜下植骨，一侧半下颌表面植入羟基磷灰石水泥/脱矿冻干骨，另一侧半下颌表面植入多孔颗粒状羟基磷灰石和脱矿冻干骨。动物在食用软食9个月后处死，取出植骨的半下颌骨。
羟基磷灰石水泥和颗粒状羟基磷灰石植骨均似乎增加了无牙萎缩性下颌犬的骨量。组织学检查显示，羟基磷灰石水泥植骨表现出骨传导性以及骨膜下和骨内膜骨单位骨形成，而颗粒状羟基磷灰石植骨仅表现出骨传导性。两种植骨材料均未显示慢性或急性炎症。
羟基磷灰石水泥可切实作为下颌骨增量装置发挥作用。羟基磷灰石水泥的组织学转归与颗粒状羟基磷灰石不同。其转归与自体骨或同种异体皮质骨移植相当。
