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標題: | 利用快速列印三維空間羥基磷灰石支架促進齒槽骨再生 Acceleration of Alveolar Ridge Regeneration Using a Rapidly Prototyped Three-Dimensional Hydroxyapatite-Based Scaffold |
作者: | Hui-Ting Luo 羅蕙廷 |
指導教授: | 張博鈞(Po-Chun Chang) |
關鍵字: | 三維空間列印,齒槽骨再生,骨再生,羥基磷灰石, 3D-printed,alveolar ridge regeneration,bone regeneration,hydroxyapatite, |
出版年 : | 2020 |
學位: | 碩士 |
摘要: | 重建嚴重受損缺牙脊的型態為當今植牙重建治療的一大挑戰,本實驗旨在齒槽脊增加術的過程中使用一種羥基磷灰石為基底的三維旭翔空間列印支架來促進骨組織再生。 本實驗使用的三維空間列印支架利用以羥基磷灰石為基底的生物墨水,透 過微擠出法的列印方式進行製作。動物實驗驗證分為兩部分,第一部分透過大 鼠齒槽骨內相通缺損(intrabony through-and-through defect)模式探討此支架在 骨面較完備的缺損區域中對於骨再生效果的影響。實驗方式為在大鼠下頷角處 利用環鑽工具製備一個直徑 4 公分的圓型缺損,於此缺損中放置列印好的直徑 4 公分圓盤型三維空間支架作為測試組(group HA),對側下頷骨同樣缺損處則 不放置任何材料作為控制組(group Control)。動物於 4 週後犧牲,透過微電腦 斷層影像(micro-CT)以及組織切片進行骨再生的比較。 第二部分則是透過大鼠齒槽骨上再生(supracrestal ridge augmentation)模 式探討羥基磷灰石三維空間支架對於促進齒槽骨垂直方向骨再生以及與植體骨整合的表現。手術方式為將直徑 5 mm 高度 2.5mm 的圓柱形支架利用鈦金屬迷 你植體(titanium mini-implant)固定在下頷骨角頰側處作為測試組(group HA), 另外設計鈦金屬迷你植體周圍放置去礦物質化牛骨顆粒(group Graft),控制組 則單純放置迷你植體(group Control)。動物於四週及八週犧牲,透過微電腦斷 層影像(micro-CT)以及組織切片進行骨再生比較。 印製出的羥基磷灰石三維空間支架的孔洞直徑(pore size)為 420 ± 28 μm 及 328 ± 5 μm,纖維直徑為 449± 101 μm。在第一部分的動物實驗中,micro-CT 影像分析顯示 group HA 相對於 group Control 有顯著較多的礦化組織百分比, 在組織學切片分析上也可以在 group HA 中看到較明顯的骨缺損填補率,且有較 多的新生骨比例。第二部分的動物實驗中,micro-CT 影像可看到 Group HA 在 8 週的礦化組織比例上顯著較 4 週高;在四週及八週的 group HA 以及 group Graft 均有拱門狀(dome-shape)的新生骨再生痕跡,礦化組織百分比皆顯著高 於 group Control。在硬組織切片組織學觀察中可發現新生成骨小梁結構可在四 週及八週的 group HA 中觀察到,且新生骨與植體以及羥基磷灰石支架間的骨整 合也清楚可見。 本實驗的結果結果顯示利用三維空間印製的羥基磷灰石支架對於齒槽骨再生有正向的幫助,可進一步促進骨新生及植體骨整合。 Purpose:Alveolar ridge regeneration is a frequently required but challenging procedure for implant site preparation. The aim of this study was to investigate the potential of a novel 3D-printed hydroxyapatite scaffold for accelerating alveolar ridge regeneration. Materials and Methods:Three-dimensional hydroxyapatite-based scaffolds with evenly distributed orthogonal pores were designed on a computer and printed using the microextrusion technique. Two animal models were investigated in this study. The first was the intrabony through-and-through defect model. On the mandibles of Sprague-Dawley rats, 4-mm-diameter through-and-through bony defects were surgically created and left unfilled (control group) or filled with the 4-mm-diameter and 0.5-mm-thick scaffold (HA group) for 4 weeks. The second model involved supracrestal ridge augmentation with 3 experimental groups. Cylindrical scaffolds 5 mm in diameter and 2.5 mm in height were fixed with titanium mini-implants in one group (HA group). Another group was grafted with DBBM particles around the fixed implants (Graft group) and the other group was left ungrafted (control group). The observation periods were 4 weeks and 8 weeks. The therapeutic potential was evaluated using micro-computed tomography (micro-CT) and histology. Results:The mean pore size of the scaffold was 0.42±0.028 mm by 0.328±0.005 mm, and the mean thickness was 0.449±0.101 mm. In the first animal experiment, the micro- CT images revealed greater mineralized tissue deposition within the defects in the HA group, and the mean bone volume/defect volume ratio was 14.21±2.57% in the control group and 29.38±1.94% in the HA group (p < 0.001). The histologic slides showed good scaffold-tissue and scaffold-bone integration, and the mean defect fill was 38.25±12.69% in the control group and 69.94±19.42% in the HA group (p < 0.001). The micro-CT result of supracrestal ridge augmentation showed mineralized tissue ingrowth in the HA and control groups at both 4 weeks and 8 weeks and the bone volume/total volume ratio was significantly greater in the HA group than in the control group. The histologic slides showed new trabecular bone bridging between the remaining scaffolds and osseointegration was observed on the implant surface. Conclusion:The 3D-printed HA scaffold demonstrated good osteoconductivity, was effective at promoting the repair of jawbone defects in rats, and showed potential for accelerating alveolar ridge regeneration. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/51909 |
DOI: | 10.6342/NTU202002673 |
全文授權: | 有償授權 |
顯示於系所單位: | 臨床牙醫學研究所 |
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