11
Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1 Tetsuya Yuasa,1Seiko Tatehara,1 Masaru Nagayama,1 and Kazuomi Suzuki3 1 First Department of Oral and Maxillofacial Surgery, School of Dentistry, Tokushima University 2 Department of Biomaterials, Faculty of Dental Science, Kyushu University 3 Division of Biomaterials, Department of Recovery and Reconstruction, Science of Functional Recovery and Reconstruction, Graduated School of Medicine and Dentistry, Okayama University Graduated School Received 24 September 2001; revised 11 February 2001; accepted 26 February 2002 指指指指 指指指 指指指 指指指指指指指指指指指

Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Embed Size (px)

Citation preview

Page 1: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Evaluation of Feasibility of Hydroxyapatite Putty as a Local

Hemostatic Agent for BoneYukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1 Tetsuya

Yuasa,1Seiko Tatehara,1 Masaru Nagayama,1 and Kazuomi Suzuki3

1 First Department of Oral and Maxillofacial Surgery, School of Dentistry, Tokushima University2 Department of Biomaterials, Faculty of Dental Science, Kyushu University3 Division of Biomaterials, Department of Recovery and Reconstruction, Science of Functional Recovery and Reconstruction, Graduated School of Medicine and Dentistry, Okayama University Graduated School

Received 24 September 2001; revised 11 February 2001; accepted 26 February 2002

指導老師:林鴻儒學 生:劉聿豐

民國九十九年八月十六日

Page 2: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

前言• 局部止血材料已廣泛應用於外科臨床,如氧化纖維素、凝膠、外用凝血酶。

• 骨蠟具有良好的止血能力,自 1800多年已被用於局部骨頭的止血劑。

• 骨蠟是由蜂蠟、杏仁油、水楊酸所製成• 據報導骨蠟的炎症會反應引起周圍組織有害影響骨組織,因此發展一個具有良好的生物相容性對骨頭是有利的。

Page 3: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

材料與方法• tetracalcium phosphate

• dicalcium phosphate anhydrous

• disodium hydrogen phosphate

• Sodium dihydrogen phosphate aqueous

• sodium alginate

Page 4: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

實驗方法tetracalcium phosphate

dicalcium phosphate anhydrous

powder phase

stored in a vacuumdesiccator at 60 °C

0.2- MOL/L disodium hydrogen phosphate

0.2 mol/l sodium dihydrogen phosphate aqueous solution

liquid phase

pH became 7.4 at 37 °C.

(0, 2, 4,6, 8, and 10 WT %) of sodium alginate

+ = 1 : 3.5

Page 5: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 2. Schematic illustration of the measurement of adhesive strength of HAP putty or bone wax to bone. The maximum load to separate the bone from HAP

putty after loading 78.4 N was used as an index of the adhesive strength.

Page 6: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 3. Effects of sodium alginate concentration of HAP putty on the adhesive strength of HAP putty to dry and wet bone. Open circles, wet bone; solid circles, dry bone. The bars in the figure denote standard deviation. Asterisks indicate significant

difference versus sodium alginate free specimens (n=5).

Page 7: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 4. Amounts of bleeding for each minute after hemostatic procedure.Open circles, HAP putty; solid circles, bone wax; triangles,shamoperation.The bars in the

figure denote standard deviation.Asterisks significant difference against sodium alginatebone wax groups (n=7).

Page 8: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 5. Powder X-ray diffraction patterns. T: TTCP, D: DCPA, H:HAP. (a) HAP putty, (b) the powder phases of HAP putty, that is, an

equimolar mixture of TTCP and DCPA, (c) bone apatite.

Page 9: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 6. Light micrograph of rabbit abdominal subcutaneous tissue surrounding HAP putty two weeks after implantation. H-E staining;

Magnification 31.

Page 10: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

Figure 7. Light micrograph of rabbit abdominal subcutaneous tissue surrounding bone wax two weeks after implantation. H-E staining;

Magnification 31.

Page 11: Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1

結論:從圖 3發現 8wt%的海藻酸鈉再濕骨與乾骨的黏合強度為較高。而骨蠟用於濕骨的黏合強度有非常小的黏合強度 8.3N , HAP Putty不管在濕骨或乾骨都明顯比骨蠟高出很多。

從圖 4可看出 HAPPUTTY 在 3分鐘內能停止出血,骨蠟停止出血時間為 8分鐘內。

從圖 6和圖 7可看出骨蠟的炎症反應明顯高於 HAP Putty。故 HAP Putty 是有效的做為止血、生物相容性好的修護材料。