牙髓再生的研究进展

活髓对于维持牙齿内稳态十分重要。理想的牙髓治疗方法应包括再生性牙髓治疗,即坏死或活力减退的牙髓被活髓所代替,最终牙齿活力恢复。随着组织工程的发展,牙髓再生成为可能,本文将从干细胞、支架、生长因子3个方面对牙髓再生相关的问题做一综述。     

3D打印技术在牙周病学领域的研究进展

3D打印技术具有精确、快速、易于成型的特点,近年来在牙周领域的研究应用也日益广泛。该文主要就3D打印技术在口腔牙周领域的应用现状、应用潜力与优势进行综述,介绍3D打印技术在在牙周病临床治疗中的应用效果,在牙周再生方面的研究进展,以及在牙周病教学和医患沟通中的应用。3D打印技术在牙周领域具有广阔的研究和应用前景。     

牙髓再生的研究进展

尽管目前的根管治疗手段可有效地保存牙髓病变的牙齿,但其仍然存在诸多术后并发症.随着分子生物学、细胞生物学、发育生物学等生命前沿科学的发展,牙髓治疗由物理充填治疗向生物学治疗转变成为可能.本文就成牙本质细胞再生、牙髓血运重建、神经再生和支架移植等方面对近年来的牙髓再生研究作一综述.     

3D打印技术制备颌骨组织工程支架的研究进展

骨组织工程具有创伤小,不受供体来源限制,个性化修复的优势,有望实现颌骨缺损后外形结构的恢复和相关功能的重建。目前,传统方法制备的骨组织工程支架尚无法实现个性化外形的构建和生物力学强度的精确调控。随着3D打印技术和计算机技术的迅速发展,应用3D打印技术制备颌骨组织工程支架的研究取得了较大进展,本文对其相关研究进行综述。     

3D干细胞培养在牙髓再生研究中的应用

3D细胞培养是一种模拟人体内细胞生长环境的体外培养方式,使细胞保持原有的立体形态,有利于细胞内基因的表达和信号转导.3D干细胞培养作为其中一个重要的研究方向,主要应用于器官体外培养和组织再生领域.在牙髓再生研究中,干细胞经2D培养后,存在细胞接触抑制、基因表达受限以及部分生物学功能缺失的局限性,而3D培养可增强干细胞自我更新和特异性分化的能力,再生神经血管化的牙髓-牙本质复合体,再生效果明显优于2D培养.本文将介绍3D细胞培养的研究现状,总结分析3D干细胞培养在牙髓再生研究中的优势、应用及展望,为牙髓再生中干细胞培养条件和再生效果的优化提供理论依据.     

3D生物打印技术在口腔颌面部骨组织缺损修复的研究进展

[提要] 3D生物打印是基于3D打印技术的基本原理,应用计算机辅助设计技术虚拟出待构建组织器官的三维立体结构,再利用相应的生物材料,逐层构建出实体的一种组织工程学技术。3D生物打印已在再生医学领域取得了一定成果,临床应用前景广阔。在口腔颌面部缺损修复中,3D生物打印技术可通过重建缺损部位的解剖结构,应用生物材料精确堆积出个性化植入物,使组织形态和功能得以恢复。本文对3D生物打印技术的发展及类别,3D生物打印应用于口腔颌面部骨缺损修复中的生物支架材料、细胞、生物活性因子等的研究进展进行简要综述。     

再生牙髓病学--牙髓再生的新方向

再生牙髓病学主要采用引导组织再生原理,通过组织工程学技术促进根管内牙髓再生,是牙髓再生治疗的新方向和新选择。在再生牙髓病学中,牙源性干细胞、生物支架以及生长因子是3个关键因素,逐渐成为学者们研究的热点。     

水凝胶用于牙髓再生的研究进展

水凝胶是一种柔软且生物相容性良好的高分子网络体系,可以作为组织工程研究中的支架材料.牙髓再生是运用组织工程学的原理,将牙髓干细胞在体外培养后植入生物相容性良好且可以被吸收降解的生物支架上,诱导牙髓干细胞形成牙髓-牙本质复合体和类牙髓样组织.水凝胶支架在牙髓再生中发挥着模拟微环境、传递信号分子等重要作用,具有良好的应用前...     

Advances in regeneration of dental pulp – a literature review

This review summarizes the biological response of dentin–pulp complexes to a variety of stimuli and responses to current treatment therapies and reviews the role of tissue engineering and its application in regenerative endodontics. An electronic search was undertaken based on keywords using Medline/PubMed, Embase, Web of Science and Ovid database resources up to March 2012 to identify appropriate articles, supplemented by a manual search using reference lists from relevant articles. Inclusion criteria were mainly based on different combinations of keywords and restricted to articles published in English language only. Biological approaches based on tissue engineering principles were found to offer the possibility of restoring natural tooth vitality, with distinct evidence that regeneration of lost dental tissues is possible. Studies to formulate an ideal restorative material with regenerative properties, however, are still under way. Further research with supporting clinical studies is required to identify the most effective and safe treatment therapy.     

干细胞和支架与牙髓再生及其血运重建

在牙髓再生中,获取干细胞的方法包括干细胞移植、细胞归巢和诱导出血。干细胞移植可产生异位的牙髓样组织,可控制移植细胞的数量并选择对牙髓再生潜在效能最佳的细胞亚种。细胞归巢是指利用信号分子招募宿主内源性干细胞至需治疗的牙体根管中增殖和分化,形成牙髓-牙本质样组织。诱导根尖出血进入根管为年轻恒牙牙髓再生的一个重要步骤。支架是细胞在合成组织时的支撑结构,可促进细胞黏附,为牙髓再生提供有利的环境。牙髓再生离不开血运重建或者血管再生,感染控制、根管预处理、冠方封闭等操作,可为牙髓再生包括其血运重建提供适宜的环境。总之,组织工程技术在牙髓领域的应用发展为牙髓再生带来了新的希望。     

Dental pulp regeneration via cell homing

The typical treatment for irreversibly inflamed/necrotic pulp tissue is root canal treatment. As an alternative approach, regenerative endodontics aims to regenerate dental pulp‐like tissues using two possible strategies: cell transplantation and cell homing. The former requires exogenously transplanted stem cells, complex procedures and high costs; the latter employs the host's endogenous cells to achieve tissue repair/regeneration, which is more clinically translatable. This systematic review examines cell homing for dental pulp regeneration, selecting articles on in vitro experiments, in vivo ectopic transplantation models and in situ pulp revascularization. MEDLINE/PubMed and Scopus databases were electronically searched for articles without limits in publication date. Two reviewers independently screened and included papers according to the predefined selection criteria. The electronic searches identified 46 studies. After title, abstract and full‐text examination, 10 articles met the inclusion criteria. In vitro data highlighted that multiple cytokines have the capacity to induce migration, proliferation and differentiation of dental pulp stem/progenitor cells. The majority of the in vivo studies obtained regenerated connective pulp‐like tissues with neovascularization. In some cases, the samples showed new innervation and new dentine deposition. The in situ pulp revascularization regenerated intracanal pulp‐like tissues with neovascularization, innervation and dentine formation. Cell homing strategies for pulp regeneration need further understanding and improvement if they are to become a reliable and effective approach in endodontics. Nevertheless, cell homing currently represents the most clinically viable pathway for dental pulp regeneration.     

三维重建下3D打印技术在下颌骨缺损修复中的应用评价

目的:探讨三维重建下3D打印技术在下颌骨缺损修复手术中的应用效果.方法:选择在南京医科大学附属口腔医院行下颌骨缺损修复重建的84例患者作为研究对象,根据治疗方式不同分为3D组(42例)和对照组(42例),对照组行常规手术,3D组采用数字三维重建3D打印技术辅助手术.记录2组的手术情况、手术并发症发生率及面容、咬合关系恢...     

3D打印技术在口腔颌面修复中的应用

3D打印及其相应计算机辅助医疗模拟技术能根据患者需要,快速制备适合不同患者个性化要求的生物医用材料,并能对材料的微观结构进行精确控制,以精确修复病变组织或器官,并可通过相应的计算机软件辅助进行口腔颌面外科手术模拟操作等,改进治疗方法,提高医疗质量。因此,这种新兴技术在生物医学领域中的应用,尤其在生物医用材料开发、生物组织工程技术中的应用具有独特的优势。本文通过查阅近年来3D打印技术在口腔颌面修复领域中的相关文献,以综述3D打印技术在该领域的应用动态及其进展。     

3D打印辅助手术治疗下颌骨缺损疗效的Meta分析

目的分析研究3D打印技术应用于下颌骨缺损治疗的文献,评价3D打印技术对下颌骨缺损重建治疗效果的影响。方法检索PubMed、MEDLINE、Cochrane图书馆、Embase、中国生物医学文献数据库、CNKI、万方数据库、维普资讯数据库正式发表的文献,检索起止时间为从建库至2019年1月,收集应用3D打印技术于下颌骨缺损重建的临床对照试验,严格评价纳入研究的质量并提取数据,采用RevMan5.3软件进行Meta分析。结果共纳入10篇临床对照研究,受试者共268例,其中3D打印组124例,非3D打印组144例;Meta分析显示,与传统的非3D打印技术辅助手术重建下颌骨相比,3D打印辅助技术组的术中组织缺血时间短(SMD=-39.78,95%CI为-57.85至-21.71,P<0.01)、重建时间短(SMD=-31.90,95%CI为-43.12至-20.68,P<0.01)、手术时间短(SMD=-76.93,95%CI为-106.93至-46.92,P<0.01),下颌骨重建精确性高。结论下颌骨重建手术中应用3D打印技术具有缩短术中组织缺血与重建时间、手术时间短等优点,且能够提高下颌骨重建的精确性,提高手术效率和质量。     

Towards resorbable 3D-printed scaffolds for craniofacial bone regeneration

This review will briefly examine the development of 3D-printed scaffolds for craniofacial bone regeneration. We will, in particular, highlight our work using Poly(L-lactic acid) (PLLA) and collagen-based bio-inks. This paper is a narrative review of the materials used for scaffold fabrication by 3D printing. We have also reviewed two types of scaffolds that we designed and fabricated. Poly(L-lactic acid) (PLLA) scaffolds were printed using fused deposition modelling technology. Collagen-based scaffolds were printed using a bioprinting technique. These scaffolds were tested for their physical properties and biocompatibility. Work in the emerging field of 3D-printed scaffolds for bone repair is briefly reviewed. Our work provides an example of PLLA scaffolds that were successfully 3D-printed with optimal porosity, pore size and fibre thickness. The compressive modulus was similar to, or better than, the trabecular bone of the mandible. PLLA scaffolds generated an electric potential upon cyclic/repeated loading. The crystallinity was reduced during the 3D printing. The hydrolytic degradation was relatively slow. Osteoblast-like cells did not attach to uncoated scaffolds but attached well and proliferated after coating the scaffold with fibrinogen. Collagen-based bio-ink scaffolds were also printed successfully. Osteoclast-like cells adhered, differentiated, and survived well on the scaffold. Efforts are underway to identify means to improve the structural stability of the collagen-based scaffolds, perhaps through mineralization by the polymer-induced liquid precursor process. 3D-printing technology is promising for constructing next-generation bone regeneration scaffolds. We describe our efforts to test PLLA and collagen scaffolds produced by 3D printing. The 3D-printed PLLA scaffolds showed promising properties akin to natural bone. Collagen scaffolds need further work to improve structural integrity. Ideally, such biological scaffolds will be mineralized to produce true bone biomimetics. These scaffolds warrant further investigation for bone regeneration.     

3D打印技术在眶底缺损修复重建中的应用

目的 探讨3D打印技术和镜像求反在口腔颌面部创伤和肿瘤导致的眶底缺损修复重建中的应用价值。方法 选择眶底缺损患者7例,以DICOM格式文件保存所有患者的上颌骨CT扫描数据,转换为STL格式后,打印疾病模型和镜像模型。钛网和可吸收眶底板依托镜像模型进行精确塑形,手术中将预成型的钛网或可吸收眶底板植入眶底缺损部位,修复缺损。结果 7例患者均按术前设计和钛网预成型,术中实现了眶底缺损的精准修复、重建。术后患者眼球内陷、复视和眼球突出等症状消失,面部对称性恢复良好。结论 3D打印技术可以实现术前设计、手术模拟和植入物精确塑形,有效提高眶底缺损修复重建的精确性和安全性。