中国实用口腔科杂志

中国实用口腔科杂志 ›› 2023, Vol. 16 ›› Issue (6): 700-705.DOI: 10.19538/j.kq.2023.06.010

• 论著 • 上一篇    下一篇

利伐沙班对种植体早期骨结合影响研究

唐    越1，张    璇2，张雪健3，尹传荣3，林周兴1，邓    悦3   

  1. 1. 潍坊医学院口腔医学院，山东  潍坊  261053；2. 青岛西海岸新区中心医院口腔科，山东  青岛  266555；3. 青岛市口腔医院种植科，山东  青岛  266001
  • 出版日期:2023-11-30 发布日期:2023-12-20
  • 基金资助:
    山东省医药卫生科技发展计划项目（2017WS486）；青岛市口腔疾病临床医学研究中心项目（22-3-7-lczx-7-nsh）

  • Online:2023-11-30 Published:2023-12-20

摘要： 目的    研究新型口服抗凝药利伐沙班（rivaroxaban，RIV）对种植体早期骨结合的影响。方法    研究于2019年9月至2020年2月在青岛市口腔医院中心实验室进行。将12只新西兰大耳白兔随机分为空白对照组、阿司匹林（aspirin，ASP）组和RIV组，每组各4只。3组白兔分别用生理盐水、含ASP的生理盐水及含RIV的生理盐水灌胃，再检测3组白兔凝血功能的差异。手术植入种植体，每只白兔各植入4颗种植体，共48颗。种植术后第2、4周各选取每组的2只白兔的8颗种植体行后续研究。通过Micro-CT、三维模型重建图像及种植体-骨组织标本图像观察种植体及周围骨组织形态，并根据三维模型重建及种植体-骨组织标本图像比较3组种植体-骨结合率（bone-implant contact，BIC）的差异。结果    建模成功后3组白兔凝血功能的比较，差异无统计学意义（F = 0.034，P = 0.967）。Micro-CT、三维模型重建图像及种植体-骨组织标本图像观察发现第4周种植体周围新生骨较第2周增多。术后第2周和第4周，空白对照组及RIV组的BIC均大于ASP组，差异均有统计学意义（均P < 0.05）；而空白对照组与RIV组的BIC比较，差异均无统计学意义（均P > 0.05）；且3组第4周BIC均大于第2周，差异均有统计学意义（均P < 0.05）。结论    新型口服抗凝药物利伐沙班相较于传统抗凝药物阿司匹林，对种植体早期骨结合的抑制作用不明显。

关键词: 利伐沙班, 阿司匹林, 血小板抑制剂, 种植体, 骨结合

Abstract: Objective    To study the effect of new oral anticoagulant rivaroxaban （RIV） on early implant  osseointegration. Methods    The study was conducted in the central laboratory of Qingdao Stomatological Hospital from September 2019 to February 2020. 12 white rabbits were randomly divided into a blank control group，an aspirin（ASP）group，and an RIV group，with 4 rabbits in each group. Three groups of white rabbits were perfused with physiological saline，ASP dissolved in physiological saline，and RIV dissolved in physiological saline，and test the differences in coagulation function among the three groups of white rabbits. Totally 48 implants were placed by surgery，with 4 implants per white rabbit. At the 2nd and 4th weeks after implantation，8 implants from 2 white rabbits in each group were selected for subsequent research. Observe the morphology of the implant and surrounding bone tissue through Micro-CT，3D model reconstruction images，and implant-bone tissue specimen images. Compare the differences in bone-implant contact（BIC）among the three groups based on 3D model reconstruction and implant-bone tissue specimen images. Results    After successful modeling，there was no statistically significant difference in coagulation function among the three groups of white rabbits（F = 0.034，P = 0.967）. Micro-CT，3D model reconstruction images，and observation of implant bone tissue specimen images showed an increase in new bone formation around the implant at week 4 compared to week 2. At the 2nd and 4th week after surgery，the BIC of the blank control group and RIV group was higher than that of the ASP group，with statistical difference（all P < 0.05）；however，there was no statistically significant difference in BIC between the blank control group and the RIV group（all P > 0.05）. Moreover，the BIC of all three groups at week 4 was higher than that at week 2，and the differences were statistically significant（all P < 0.05）. Conclusion    Compared with the traditional anticoagulant drug-ASP，the new oral anticoagulant drug-RIV has no obvious inhibitory effect on the early implant osseointegration.

Key words: rivaroxaban, aspirin, platelet inhibitor, implants, osseointegration