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بررسی هیستولوژیک و هیستومورفومتریک تأثیر کاربرد FDBA، PDFDB و Nanocrystalline hydroxyapatite silica gel در بازسازی نقائص استخوانی ایجاد شده در کالواریوم خرگوش

 

چكيده

سابقه و هدف

بازسازی ضایعات استخوانی از اهداف ایده آل درمان های پریو دنتال  و ایمپلنتهای دندانی می باشد.بیومتریالهای مختلفی به منظور دستیابی به این هدف استفاده شده و مطالعات زیادی سعی در مقایسه ومعرفی بهترین آن ها داشته است.  تحقیق حاضر با هدف بررسی هیستولوژیک و هیستومورفومتریک کاربرد nanocrystalline hydroxyapatite silica gel ، FDBA و PDFDB در بازسازی نقائص استخوانی کالواریای خرگوش انجام شد.

مواد و روش‌ها

در این مطالعه تجربی؛ چهار defect يك اندازه با قطر 8 میلی‌متر در استخوان كالواريوم 16 خرگوش سفید نیوزیلندی ايجاد گردید. حفرات با استفاده از مواد پیوندی FDBA و PDFDB (CenoBone) و nanocrystalline hydroxyapatite silica gel(NanoBone) پر شده و یک حفره هم به عنوان گروه كنترل با هيچ ماده‌اي پر نشد. کلیه نقایص توسط غشای کلاژن (cenomembrane) پوشانده شدند 6 و 12 هفته بعد؛ حیوانات قربانی و نمونه ها تحت بررسی هیستولوژیک و هیستومورفومتریک قرار گرفتند. درصد استخوان ساخته شده و درصد ماده پیوندی باقیمانده در گروه‌ها با آزمون آنالیز واریانس تکراری و فراوانی درجات شدت التهاب؛ نوع بافت همبند، الگوی شروع استخوان‌سازی و نوع استخوان با آزمون Friedman مورد قضاوت قرار گرفت.

يافته‌ها

بعد از 6 هفته؛ درصد استخوان‌سازی در گروه‌های FDBA؛ NanoBone؛ PDFDB و کنترل معادل 85/7±22/14؛ 91/6±57/21؛ 02/15±47/23 و 07/10±54/20 و بعد از 12 هفته؛ برابر 19/20±54/27؛ 27/6±86/23؛ 07/11±49/26 و 18/14±48/26 بوده است. تفاوت معنی‌داری از این جهت در گروه‌ها در نمونه‌های 6 و 12 هفته‌ای دیده نشد.در نمونه‌های 6 هفته‌ایی تفاوت‌های معنی‌داری از نظر فراوانی میزان التهاب در گروه‌های 4 گانه دیده شد (02/0p=). به گونه ای که تفاوت بین گروه‌های FDBA و PDFDB  با گروه‌های کنترل و NanoBone از لحاظ آماری معنی دار بود در حالی که در نمونه‌های 12 هفته‌ایی؛ تفاوت گروه‌های آزمایشی و کنترل از نظر میزان التهاب معنی‌دار نبوده است.

نتيجه‌گيري

استفاده از  FDBA ، PDFDB  ، nanocrystalline hydroxyapatite silica gel  به عنوان مواد جایگزین استخوان به طور مشابهی سبب ترمیم ضایعات استخوان کالواریوم خرگوش شدند.

كليد واژه‌ها

نقائص استخوانی، استخوان‌سازی، FDBA، PDFDB، Nano-hydroxyapatite

 

فهرست مطالب

عنوان                                                                                    شماره صفحه

چكيده

فصل اول: کلیات پژوهش

مقدمه و بيان مسأله                                                                 2

اهداف پژوهش                                                                     5

هدف اصلی                                                                         5

اهداف فرعی                                                                       5

پرسش های پژوهش                                                              7

پرسش اصلی                                                                       7

پرسش فرعی                                                                      7

جدول متغیرها                                                                      9                            فصل دوم: مبانی نظری و پیشینه‌ی پژوهش

مبانی نظری تحقیق                                                                 14

پیشینه در داخل کشور                                                             31

پیشینه در خارج از ایران                                                          38

فصل سوم: روش پژوهش

نوع مطالعه و روش انجام آن                                                      49

جامعه‌ی مورد بررسی                                                                        49

حجم نمونه، شيوه‌ی محاسبه آن و روش نمونه‌گيري                                       49

 روش اجراي تحقيق                                                                        50

روش تجزيه و تحليل آماري                                                               58

 ملاحظات اخلاقي                                                                          59

فصل چهارم: یافته‌ها

 نتایج                                                                                         61

فصل پنجم: بحث و نتیجه‌گیری  

 بحث                                                                                         85

 نتيجه‌گيري                                                                                  95

محدوديت‌ها                                                                                 96

 پيشنهادات                                                                                             96                 منابع                                                                                           96

 

فهرست اشکال 

عنوان                                                                                        شماره صفحه

تصویر 1- تراشیدن موی حیوانات در محل ضایعات                                               52

تصویر2 –  برش ناحیه  تصویر تصویر                                                               53

تصویر 3 – کنار زدن فلپ                                                                              53

تصویر 4- استفاده از فرز ترفاین برای ایجاد ضایعه                                                           53

تصویر 5- برداشت قطعات استخوانی                                                                53

تصویر 6- جاگذاری بیومتریال‌ها در ضایعات ایجاد شده                                           55

تصویر 7- استفاده از ممبران برای پوشش بیومتریال‌ها                                              55

 تصویر 8-  سوچور پریوست                                                                           55

تصویر 9- سوچور پوست حیوانات در محل کالواریوم                                                55

تصویر 10- نمای هیستولوژیک استخوان‌سازی در ضایعات پر شده با FDBA                 80

تصویر 11- نمای هیستولوژیک استخوان‌سازی در ضایعات گروه NanoBone                   81

تصویر 12- نمای هیستولوژیک استخوان‌سازی در ضایعات گروه PDFDB                    82

فهرست جداول

عنوان                                                                                        شماره صفحه

جدول 1- درصد استخوان ساخته شده در گروه‌های کنترل و آزمایشی بعد از 6 هفته          62

جدول 2- درصد استخوان ساخته شده در گروه‌های کنترل و آزمایشی بعد از 12 هفته         62

جدول 3- درصد ماده پیوندی باقیمانده در گروه‌های آزمایشی بعد از 6 هفته                    64

جدول 4- درصد ماده پیوندی باقیمانده در گروه‌های آزمایشی بعد از 12 هفته                  65

جدول 5- مقایسه نوع استخوان ساخته شده در گروه‌های آزمایشی بعد از 6 هفته               67

جدول 6- مقایسه نوع استخوان ساخته شده در گروه‌های آزمایشی بعد از 12 هفته             68

جدول7-  الگوی شروع استخوان‌سازی در گروه‌های کنترل و آزمایشی بعد از 6 هفته                   70

جدول 8- الگوی شروع استخوان‌سازی در گروه‌های کنترل و آزمایشی بعد از 12 هفته           71     جدول 9- استخوان‌سازی در اطراف پارتیکل‌ها در گروه‌های کنترل و آزمایشی بعد از 6 هفته   73

جدول 10- استخوان‌سازی در اطراف پارتیکل‌ها در گروه‌های کنترل و آزمایشی بعد از 12 هفته74

جدول 11- فراوانی نوع بافت زمینه ای در گروه‌های کنترل و آزمایشی بعد از 6 هفته                   76

جدول 12- فراوانی نوع بافت زمینه ای در گروه‌های کنترل و آزمایشی بعد از 12 هفته       76

جدول 13- فراوانی میزان التهاب در گروه‌های کنترل و آزمایشی بعد از 6 هفته                78

جدول 14- فراوانی میزان التهاب در گروه‌های کنترل و آزمایشی بعد از 12 هفته               79

 

فهرست نمودارها

عنوان                                                                                        شماره صفحه

نمودار 1 درصد استخوان‌سازی در نمونه‌های گروه‌های مختلف بعد از 6 و 12 هفته (F: FDBA؛ N: NanoBone؛ P: PDFDB و C: کنترل)                                                                63

نمودار 2درصد جسم خارجی باقیمانده در گروه‌های مختلف در دو زمان 6 و 12 هفته‌ایی (F: FDBA؛ N: NanoBone؛ P: PDFDB)                                                                  65

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