兔颞下颌关节突缺损模型的建立和CFR-PEEK材料人造关节的修复效果评价

doi:10.13481/j.1671-587x.20170509

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (05): 903-909.doi: 10.13481/j.1671-587x.20170509

兔颞下颌关节突缺损模型的建立和CFR-PEEK材料人造关节的修复效果评价

韩明林¹, 李明贺¹, 及昕², 韩茹钰³, 张宁¹, 崔磊华¹, 孙兰芳¹, 韩成敏¹

1. 吉林大学口腔医院口腔颌面外科, 吉林长春 130021;
2. 吉林大学口腔医院消毒供应室, 吉林长春 130021;
3. 吉林大学口腔医院正畸科, 吉林长春 130021

收稿日期:2017-03-19 出版日期:2017-09-28 发布日期:2017-09-29
通讯作者: 韩成敏,教授,主任医师,硕士研究生导师(Tel:0431-85579361,E-mail:han-cm@sohu.com);李明贺,主治医师(Tel:0431-85579361,E-mail:87832900@qq.com) E-mail:han-cm@sohu.com;87832900@qq.com
作者简介:韩明林(1985-),男,云南省普洱市人,主治医师,在读医学硕士,主要从事口腔颌面外科肿瘤和颞下颌关节方面的研究。
基金资助:
吉林省科技厅自然科学基金资助课题（3D515V663431）；吉林省卫计委青年科研基金资助课题（3D514CP23431）

Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits

HAN Minglin¹, LI Minghe¹, JI Xin², HAN Ruyu³, ZHANG Ning¹, CUI Leihua¹, SUN Lanfang¹, HAN Chengmin¹

1. Department of Oral and Maxillofacial Surgery, Stomatology Hospital, Jilin University, Changchun 130021, China;
2. Department of Sterilization and Supply Center, Stomatology Hospital, Jilin University, Changchun 130021, China;
3. Department of Orthodontics, Stomatology Hospital, Jilin University, Changchun 130021, China

Received:2017-03-19 Online:2017-09-28 Published:2017-09-29

摘要/Abstract

摘要： 目的：探讨兔颞下颌关节（TMJ）关节突缺损模型建立后实现关节置换的方法，阐明碳纤维增强型聚醚醚酮（CFR-PEEK）材料制作的TMJ假体的置换修复效果，为临床应用CFR-PEEK人造关节置换TMJ提供实验依据。方法：13只健康成年日本大耳白兔按照随机数字法分为实验组（n=6）、阳性对照组（n=4）和阴性对照组（n=3）。实验组兔切除右侧TMJ关节突，建立关节缺损模型，同期植入CFR-PEEK人造关节；阳性对照组兔切除右侧TMJ关节突，建立关节缺损模型，不植入CFR-PEEK人造关节；阴性对照组兔不做任何处理。通过CT影像学检查评估人造关节植入后的固位和替代修复效果。连续记录13周各组兔体质量并进行比较。结果：建立的兔TMJ关节突缺损模型能够成功植入CFR-PEEK人造关节。CT影像学检查，经三维重建和体外显影处理后可见植入CFR-PEEK人工关节固位良好，代替正常关节发挥作用；13周兔体质量观察，与阳性对照组比较，实验组兔体质量增加（P < 0.05）；实验组和阴性对照组兔体质量均明显增加，但2组比较差异无统计学意义（P > 0.05）。实验组和阴性对照组兔体质量均正常增长，阳性对照组兔体质量增长较为缓慢，甚至停止增长或者负增长。结论：植入CFR-PEEK人造关节修复关节突缺损能够有效恢复兔正常咀嚼功能，CFR-PEEK人造关节成功应用于TMJ缺损修复，有望成为一种重建TMJ关节突的理想材料。

关键词: 缺损, 碳纤维增强型聚醚醚酮材料, 人造关节, 颞下颌关节

Abstract: Objective: To investigate the method of arthroplasty for reconstructing femporomandibular joint(TMJ) after the establishment of TMJ articular defect models in the rabbits, and to clarify the replacement and repair effects of carbon fiber reinforced polyetheretherketone (CFR-PEEK) material TMJ prostheses, and to provide an experimental basis for the clinical application of CFR-PEEK artificial joints to replace TMJ. Methods: Thirteen healthy adult Japanese rabbits were randomly divided into experimental group (n=6), positive control group (n=4) and negative control group (n=3). The right TMJ articular process of the rabbits in experimental group were resected to establish the joint defect models, and then the CFR-PEEK artificial joints were impanted. The right TMJ articular process of the rabbits in positive control group were resected, and the joint defect models were established without the CFR-PEEK artificial joint implantation. The rabbits in negative control group didn't receive any treatment.The body weights of the rabbits in each group were measured in 13 weeks. The effects of fixation and replacement after artificial joint implantation were assessed by CT imaging. Results: The TMJ articular process defect model was successfully implanted with the CFR-PEEK artificial joint. The CT imaging results after three-dimensional reconstruction and CT images by contrast in vitro showed that the CFR-PEEK-implanted artificial joint was fixed well, it could be instead of the normal joint function.Compared with positive control group, the weights of rabbits in experimental group were significantly increased(P<0.05) at 13 weeks; compared with positive control group, the weights of rabbits in experimental group and negative control group were both significantly increased (P>0.05) at 13 weeks,but there was no significant difference between them(P>0.05).The weights of rabbits in experimental group and negative control group kept normal growth; the weights of rabbits in positive control group was increased slowly, and even stopped growing or was negative. Conclusion: The CFR-PEEK artificial joint can be successfully implanted into the TMJ defect model and be used to repair the defect which help to restore chewing function. The CFR-PEEK is expected to be an ideal material for reconstructing TMJ.

Key words: temporomandibular joints, defection, artificial joints, carbon fiber reinforced polyetheretherketone

中图分类号:

R782

韩明林, 李明贺, 及昕, 韩茹钰, 张宁, 崔磊华, 孙兰芳, 韩成敏. 兔颞下颌关节突缺损模型的建立和CFR-PEEK材料人造关节的修复效果评价[J]. 吉林大学学报(医学版), 2017, 43(05): 903-909.

HAN Minglin, LI Minghe, JI Xin, HAN Ruyu, ZHANG Ning, CUI Leihua, SUN Lanfang, HAN Chengmin. Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits[J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 903-909.

参考文献

[1] Kurtz SM, Devine JN. PEEK biomaterials in trauma, orthopedic, and spinal implants[J]. Biomaterials, 2007, 28(32):4845-4869.
[2] Ponnappan RK, Serhan H, Zarda B, et al. Biomechanical evaluation and comparison of polyetheretherketone rod system to traditional titanium rod fixation[J]. Spine J, 2009, 9(3):263-267.
[3] Nieminen T, Kallela I, Wuolijoki E, et al. Amorphous and crystalline polyetheretherketone:Mechanical properties and tissue reactions during a 3-year follow-up[J]. J Biomed Mater Res A, 2008, 84(2):377-383.
[4] Steinberg EL, Rath E, Shlaifer A, et al. Carbon fiber reinforced PEEK Optima-a composite material biomechanical properties and wear/debris characteristics of CF-PEEK composites for orthopedic trauma implants[J]. J Mech Behav Biomed Mater, 2013, 17:221-228.
[5] Deng Y, Liu X, Xu A, et al. Effect of surface roughness on osteogenesis in vitro and osseointegration in vivo of carbon fber-reinforced polyetheretherketone-nanohydroxyapatite composite[J]. Int J Nanomed, 2015, 10:1425.
[6] Banks R, Keith D. Optomising the design of two piece peek implants in orbito-zygomatic reconstruction-the jigsaw technique[J]. J Oral Maxil Surg, 2014, 72(9):e202.
[7] Abdullakutty A, Madhavarajan S, Collyer J, et al. Uses of PEEK in maxillofacial reconstruction:a 6 year review of cases[J]. Brit J Oral Max Surg, 2012, 50:S39-S40.
[8] Shen G, Darendeliler MA. The adaptive remodeling of condylar cartilage-a transition from chondrogenesis to osteogenesis[J]. J Dent Res, 2005, 84(8):691-699.
[9] Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders[J]. New Engl J Med, 2008, 359(25):2693-2705.
[10] Hahnel S, Scherl C, Rosentritt M. Interim rehabilitation of occlusal vertical dimension using a double-crown-retained removable dental prosthesis with polyetheretherketone framework[J]. J Prosthet Dent, 2017.doi:org/10.1016/j. prosdent.2017.02.017.
[11] Zoidis P. The all-on-4 modified polyetheretherketone treatment approach:A clinical report[J]. J Prosthet Dent, 2017.doi:org/10.1016/j.prosdent.2017.04.020.
[12] Yamane S, Kyomoto M, Moro T, et al. Wear resistance of poly (2-methacryloyloxyethyl phosphorylcholine)-grafted carbon fiber reinforced poly (ether ether ketone) liners against metal and ceramic femoral heads[J]. J Biomed Mater Res B, 2017.DOI:10.1002/jbm.b.33918.
[13] Grupp TM, Utzschneider S, Schwiesau J, et al. Biotribology of alternativ bearing materials for knee arthroplasty[C]//World Congress on Medical Physics and Biomedical Engineering, September 7-12, 2009, doi:org/10.1007/978-3-642-03882-2_93.
[14] Nieminen T, Kallela I, Wuolijoki E, et al. Amorphous and crystalline polyetheretherketone:Mechanical properties and tissue reactions during a 3-year follow-up[J]. J Biomed Mater Res A, 2008, 84(2):377-383.
[15] Wang L, He S, Wu X, et al. Polyetheretherketone/nano-fluorohydroxyapatite composite with antimicrobial activity and osseointegration properties[J]. Biomaterials, 2014, 35(25):6758-6775.
[16] Huiskes R, Weinans H, van Rietbergen B. The relationship between stress shielding and bone resorption around total hip stems and the effects of flexible materials[J]. Clin Orthop Relat R, 1992(274):124-134.
[17] Niki Y, Matsumoto H, Otani T, et al. Metal ion concentrations in the joint fluid immediately after total knee arthroplasty[J]. Mod Rheumatol, 2001, 11(3):192-196.
[18] Sarot JR, Contar CMM, da Cruz ACC, et al. Evaluation of the stress distribution in CFR-PEEK dental implants by the three-dimensional finite element method[J]. J Mater Sci Mater Med, 2010, 21(7):2079-2085.
[19] Hak DJ, Fader R, Baldini T, et al.Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates[J]. Int Orthop, 2017, 41(9):1735-1739.
[20] 刘瑞, 李明贺, 及昕, 等. 碳纤维增强型聚醚醚酮植入下颌骨单层骨皮质缺损模型白兔体内后的生物相容性评价[J]. 吉林大学学报:医学版, 2014, 40(3):569-573.
[21] 王栋, 田卫东, 李逸松, 等. 兔颞下颌关节腔穿刺定位及滑液抽取方法的研究[J]. 华西口腔医学杂志, 2003, 21(1):64-66.
[22] Kraft M, Koch DK, Bushelow M. An investigation into PEEK-on-PEEK as a bearing surface candidate for cervical total disc replacement[J]. Spine J, 2012, 12(7):603-611.
[23] 李兴华.人工关节置换术后深静脉血栓的形成及其影响因素[J].解放军医学杂志,2016,41(8):701-702.

兔颞下颌关节突缺损模型的建立和CFR-PEEK材料人造关节的修复效果评价

Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits

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