ウサギの上顎洞形成術における自己修復性α-リン酸三カルシウムの使用について

Use of self-setting α-tricalcium phosphate for maxillary sinus augmentation in rabbit.

抄録

目的:

本研究の目的は、ウサギを用い、自己修復型α-リン酸三カルシウム（BIOPEX(®)-R）を用いた骨ネジ移植および上顎洞補強術後の上顎洞の組織変化を組織学的および免疫組織化学的に評価することである。

PURPOSE: The purpose of this study was to histologically and immuno-histochemically evaluate tissue changes in the maxillary sinus after bone screw implantation and maxillary sinus augmentation using self-setting α-tricalcium phosphate (α-TCP; BIOPEX(®)-R) in rabbit.

研究デザイン:

日本白色成熟雄ウサギ（n=15、12～16週、2.5～3kg）を使用した。サイナスリフトはウサギの鼻骨から作製した。骨ネジ（Dual top auto-screw(®)）を鼻骨に埋め込み、BIOPEX(®)-Rを左挙上腔（手術側）に埋め込んだ後、アテロコラーゲンスポンジ（ACS:Teruplug(®)）を移植した後、右側の高架下に移植した（コントロール側）。術後4，12，24週目にウサギを屠殺し，ホルマリン固定した標本をアクリル樹脂に包埋した．標本はヘマトキシリン・エオジンで染色した。免疫組織化学的解析のために，骨形成タンパク質-2（BMP-2）抗体で標本を処理した．最後に、これらを顕微鏡的に評価した。

STUDY DESIGN: Adult male Japanese white rabbits (n=15, 12-16 weeks, 2.5-3 kg) were used. The sinus lift was made from the nasal bone of a rabbit. Bone screws (Dual top auto-screw(®)) were implanted into the nasal bone, and after BIOPEX(®)-R was implanted into the left elevated space (operated side) an atelocollagen sponge (ACS: Teruplug(®)) was implanted into the right elevated space (control side). The rabbits were sacrificed at 4, 12 and 24 weeks postoperatively, and formalin-fixed specimens were embedded in acrylic resin. The specimens were stained with hematoxylin and eosin. For immune-histochemical analysis, the specimens were treated with bone morphogenetic protein-2 (BMP-2) antibodies. Finally, these were evaluated microscopically.

結果:

骨ネジとBIOPEX(®)-Rの間には繊維組織のない強固な結合が持続し、骨ネジの鼻骨内での剛性は全例で24週間保持された。新生骨形成面積は両側とも徐々に増加したが，4，12，24週では両側とも有意差はなかった．BMP-2染色細胞数は4週間後に実験側が対照側より有意に多かった（P=0.0361）。

RESULTS: Tight bonding without fibrous tissue continued between the bone screw and BIOPEX(®)-R, and the rigidity of the bone screw in the nasal bone was retained for 24 weeks in all cases. The area ofnew bone formation increased gradually on both sides; however, there was no significant difference between both sides at 4, 12 and 24 weeks. The number of BMP-2-stained cells on the experimental side was significantly larger than that on the control side after 4 weeks (P=0.0361).

結論:

本研究は、自己硬化型α-TCP（BIOPEX(®)-R）が早期から埋入骨ネジの剛性を維持する有用性を示唆し、BMP-2発現の結果からBIOPEX(®)-Rが上顎洞補強術において骨伝導活性を有する可能性が示唆された。

CONCLUSION: This study suggested the usefulness of self-setting α-TCP (BIOPEX(®)-R) to maintain the rigidity of implanted bone screws from an early period, and the result of BMP-2 expression suggested that BIOPEX(®)-R could have bone-conductive activity in the maxillary sinus augmentation.