| 摘要: | 有越來越多的關於骨粉材料和骨髓間葉幹細胞（Bone marrow stem cells, BMSCs）在骨缺損重建中的研究被報導。然而，Biphasic 和 Algipore 合成骨粉材料與 BMSCs 結合的再生潛力尚不清楚。因此，本研究旨在評估含氫氧基磷灰石（hydroxyapatite, HA）與β-三鈣磷酸鹽（β-tricalcium phosphate, β-TCP）的混合物（Biphasic）和高純度羥基磷灰石（hydroxyapatite, HA）（Algipore）與添加BMSCs的在植體周圍骨缺損方面重建的差異。
在實驗中，本研究使用了雄性的紐西蘭白兔 (male, New Zealand white rabbits)。設計了四個不同骨粉材料的，並嘗試有否加入 BMSCs 的實驗組。植體植入即刻、術後第 4 周和第 8 週，測量其植體穩定性的參數（Implant stability parameters, ISQ）。並在術後 4 和 8 週後，將此實驗動物實行安樂死，並將其植入物及周圍骨塊取出，並嵌入甲基丙烯酸甲酯（Methyl methacrylate）固定骨塊，並將其用於微米級電腦斷層（Micro-CT）和組織形態學已進行分析，以評估骨與植入物的接觸（bone-implant contact, BIC）。使用 SPSS (Statistical Package for the Social Sciences) 和one-way analysis of variance（ANOVA） 進行統計分析。
這項研究的結果為植體手術後的 ISQ（植體穩定性的參數，Implant stability parameters）術後初始值約為 40 ，在 8 週時為 80，逐漸增加。此外，植體手術後的 PTV（periotest value）在術後初始測量數值為 5，在術後 4 週時數值顯示為 -0.9，逐漸下降。四個實驗組在顯微 CT 分析中呈現出相似的癒合趨勢。本研究的組織形態計量學分析結果表明，含有BMSCs的組別，BIC略有增加，因此4週時4組BIC值無顯著差異；然而，在 8 週內，Algipore 加入 BMSCs 組別和 單放 Biphasic 組別間的 BIC 顯著（P <0.05）。有趣的是，在 X 射線能量色散光譜（Energy-dispersive X-ray spectroscopy, EDS） 實驗中顯示出鈣磷比（Calcium to phosphorus ratio, Ca/P） Algipore（1.67）比Biphasic（1.44） 更高 。
總之，我們的結果表明 Algipore 和 Biphasic 都可以有效地重建植體周圍骨缺損。此外，載有 BMSCs 的 Algipore 在植體穩定性和骨整合方面表現出最佳潛力。
A rising number of studies relevant to bone grafting materials and bone marrow mesenchymal stem cells (BMSCs) in bone defect reconstruction are reported and much-needed nowadays. However, the regeneration potentials of Biphasic and Algipore synthetic bone grafting materials combined with BMSCs are unclear. Therefore, this study aimed to evaluate the differences between the HA mixture with beta-tricalcium phosphate (beta-TCP) (Biphasic) and highly purified HA (hydroxyapatite) (Algipore) by add-in BMSCs in reconstructing peri-implant bone defect.
In the experiment, male New Zealand white rabbits were used in this study. Four experimental groups with different bone-filling materials with and without BMSCs were designed. Implant stability parameters (ISQ) were measured immediately after implant insertion and at 4 and 8 weeks after the operation. After 4 and 8 weeks of healing, those experimental animals were sacrificed, and the bone block with an implant embedded in a methyl methacrylate fixture for micro-CT and histomorphometric analysis for evaluating bone-implant contact (BIC). Statistical analyses were performed using SPSS (Statistical Package for the Social Sciences) with one-way analysis of variance (ANOVA).
The results of this study provide evidence that the initial ISQ (implant stability quotient) value after implant surgery was demonstrated at approximately 40, and at 8 weeks, it was 80, which gradually increased. Moreover, the PTV (periotest value) after implant surgery demonstrated approximately 5 and at 4 weeks was -0.9, which gradually decreased. The four experimental groups present a similar healing tendency in micro-CT analysis.
The results of histomorphometric analysis revealed in this study demonstrated that the groups that contain the BMSCs, the BIC increased slightly; thus, there is no significant difference in BIC values among of four groups at 4 weeks; however, in 8 weeks, the BIC is significant between Algipore with BMSCs and Biphasic (P<0.05). Interestingly, Algipore revealed more Ca/P ratio (1.67) than Biphasic (1.44) in the Energy-dispersive X-ray spectroscopy (EDS) experiment.
In conclusion, our results demonstrated that Algipore and Biphasic can efficiently reconstruct peri-implant bone defects. Algipore with BMSCs showed the best performance in enhancements of implant stability and osseointegration potentials. |
