微球在牙体组织再生领域应用的研究进展

随着组织工程技术和再生学科的发展,失去的牙体组织再生成为可能.微球作为组织工程中常用的载体形式,适用于小且形状不规则的牙体组织再生,同时还可利用微球的靶向性和缓释控释来运输各种生长因子、药物等到达指定区域.本文就微球在牙体组织再生领域应用的研究现状进行综述.     

富血小板纤维蛋白的研究及在组织修复中的应用

富血小板纤维蛋白(PRF)是含有丰富的细胞因子和生长因子等类似天然血凝块的浓缩体。因有助于修复组织缺损,在实验和临床应用研究中得到了广泛的认可。该文就PRF的制备、生理特性、组织修复的应用等研究进展作一综述。     

血管化在颞下颌关节骨组织工程中的研究

组织工程学是利用工程学和生命科学的原理和方法制造生物替代品来修复、维持或改善组织的功能。颞下颌关节易受创伤、肿瘤等破坏导致骨组织缺损,但又难于修复。组织工程学的兴起有望解决这个难题。     

Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta‐analysis

The present systematic review and meta‐analysis was carried out to determine the extent to which supracrestal tissue attachment (STA) thickness affects marginal bone loss (MBL) around dental implants. An electronic search was conducted in PubMed (MEDLINE), EMBASE, and complementary sources covering the period up to June 2018. The studies were meta‐analyzed based on implant position with respect to the alveolar bone crest (crestal/supracrestal). The MBL values were categorized according to STA width (thick/thin). Of the 1062 eligible titles, nine articles were included in the review. The implants were positioned crestal or supracrestal with respect to the alveolar ridge. The difference between (thin/thick) STA was statistically significant among analytical subsets in terms of lesser MBL (crestal‐positioned: weighted mean difference [WMD] = 0.52, 95% CI [0.03‐1.01]; P = 0.036; supracrestal‐positioned: WMD = 1.26; 95% CI [1.12‐1.39]; P = 0.00; pooled analysis: WMD = 0.73; 95% CI [0.033‐1.13]; P < 0.01). Implant positioning and patient age showed statistical significance in the meta‐regression analysis. The heterogeneity explained by age was R² = 39.8%. Despite its limitations, the present study demonstrates that implants with thin STA result in greater MBL. There is moderate certainty of the evidence for a large effect of MBL prevention “in favor” of a thick STA environment in crestal‐positioned implants and the pooled analysis, but lesser certainty when only supracrestal‐positioned implants are considered. No trials studying this topic in subcrestal‐positioned implants were found.     

A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan

Objective

The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan.

Patients and Methods

Approximately 10% of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study.

Results

In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5%) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5%), followed by the buccal mucosa (654, 23.4%) and the tongue (392, 14.2%). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases).

Conclusion

As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.     

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在口腔诸多的科研领域,都需要制作牙及牙周组织联合切片进行观察和研究。牙及牙周组织结构复杂,不同于一般组织。牙釉质、牙本质、牙骨质和牙槽骨内含有大量的无机盐成分,主要以磷酸钙和碳酸钙的羟基磷灰石晶体     

Long‐Term Results Comparing Xenogeneic Collagen Matrix and Autogenous Connective Tissue Grafts With Coronally Advanced Flaps for Treatment of Dehiscence‐Type Recession Defects

Background: Although connective tissue grafts with coronally advanced flaps (CTG + CAF) have been deemed the gold standard for recession defect treatment, to provide adequate recession coverage, the periodontal profession continues to pursue lower‐morbidity, patient‐preferred substitutes that are more convenient and of unlimited supply. Methods: Using a randomized, controlled, and masked contralateral comparison of matched‐pair, within‐patient recession defects, collagen matrix (CMX) + CAF therapy was compared with CTG + CAF at 6 months and 5 years. The primary efficacy endpoint was percentage of root coverage (RC). Secondary efficacy parameters included width of keratinized tissue (KTw), probing depth (PD), clinical attachment level (CAL), clinician rating of color and texture compared with surrounding tissues, and patient esthetic satisfaction. Results: Seventeen patients were available for the 5‐year recall. Mean RC between 6 months and 5 years changed from 89.5% to 77.6% for CMX + CAF test sites and 97.5% to 95.5% for CTG + CAF control sites. KTw averaged >3 mm for both test and control sites at 5 years. PD was equivalent at all time points. The 6‐month to 5‐year changes for RC, KTw, and PD were not significantly different between therapies. CAL change from 6 months to 5 years was greater for CTG + CAF (0.26 mm) than CMX + CAF (?0.21 mm). Tissue color match to surrounding tissues remained similar for both therapies throughout the study. There was a difference in tissue texture at both 6 months and 5 years, with CMX + CAF sites tending to be “equally firm” and CTG + CAF sites “more firm.” Patient satisfaction was high, with no statistical difference in satisfaction between therapies at any time point. Conclusion: When balanced with patient‐reported satisfaction, clinical rankings of esthetics, and control and historical RC results reported by other investigators, CMX + CAF appears to present a viable and long‐term alternative to traditional CTG + CAF therapy.     

Candida albicans colonization of surface-sealed interim soft liners

PURPOSE: This in-vivo investigation evaluated the effect of 2 denture sealer agents on the microbial colonization of a newly placed soft interim denture liner during a period of 14 days. MATERIALS AND METHODS: An interim soft denture liner (Coe-Soft; GC America, Alsip, IL) was coated with 2 different denture surface sealants (Palaseal [Heraeus Kulzer, Irvine, CA] and Mono-Poly [Plastodent, New York, NY]). Three rectangular wells of 1 cm wide x 2 cm long x 2 mm deep were placed in the intaglio of 10 maxillary complete dentures and filled with the soft liner material. The soft liner surface was treated with Palaseal (first well) and Mono-Poly (second well), and the unsealed (third well) was used as a control. These were exposed to the oral cavity for 14 days. The effect the sealant had in the prevention of Candidal colonization in vivo of the soft liner material was evaluated. Microbiological specimens were recovered from all samples and cultivated. Microbiological data from the control and 2-test samples in each denture were tabulated, and statistical analyses were performed. RESULTS: This investigation showed clear differences (p <.001) between the sealed and unsealed soft liners. The sealed material showed significantly less colonization by yeast and bacteria. Intercomparison of the surface denture sealers, Palaseal versus Mono-Poly, showed no statistically significant differences (p < .005) in total yeast or bacterial colonization. CONCLUSION: Coating of Coe-Soft denture liner with either Palaseal or Mono-Poly significantly decreased yeast and bacterial colonization. .     

植体周角化龈研究进展

种植牙周围角化龈对抵抗菌斑刺激及机械创伤起到屏障作用,无论从功能还是美观角度,对最终种植修复成功有着重要意义.早期研究表明,至少2 mm的角化龈(其中附着龈至少1mm)才能维护牙周健康.角化龈的存在有利于植体周围菌斑控制及后期维护,但关于角化龈确切的量与种植体周围感染的关系尚有争议.文章就近年来植体周角化龈的研究做一综...     

Management of the flabby ridge using a modified window technique and polyvinylsiloxane impression material

Flabby ridge is a common clinical finding affecting the alveolar ridges of the mandibular or maxillary arches. The anterior region of maxilla is the most affected area in edentulous patients. Dentures on flabby ridges have compromised stability, support, and retention unless adequate measures for its management are employed. Methods applied for flabby ridge management, include surgical removal and augmentation, special impression techniques, balanced distribution of occlusal loads and implant therapy. Special impressions often involve window technique for static impression of flabby area, which present multiple challenges. The purpose of this technique report is to present a modified window technique for the impression of anterior maxillary flabby tissues for improved and controlled application of polyvinylsiloxane impression material that are routinely available in dental practice.     

Enhancing Guided Tissue Regeneration of Periodontal Defects by Using a Novel Perforated Barrier Membrane

Background: The present study was designed to determine whether exclusion of the gingival connective tissue (CT) and periosteum with contained stem cells has a positive or negative effect on periodontal regeneration by comparing the use of a novel modified perforated collagen membrane with a traditional cell occlusive barrier membrane. Methods: Twenty non‐smoking patients with severe chronic periodontitis were included in the study. Single deep intrabony defects from each of the patients were randomly divided into two groups, as follows: occlusive bovine collagen membranes (OM control group, 10 sites) and modified perforated bovine collagen membranes (MPM test group, 10 sites). Plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), defect base level (DBL), and crestal bone level (CBL) were measured at baseline and were reassessed at 6 and 9 months after therapy to evaluate the quantitative changes in the defect. Results: At 6‐ and 9‐month observation periods, the MPM‐treated sites showed a statistically significant improvement in PD reduction and CAL gain compared with the OM control group. DBL was significantly reduced with no significant difference between the two groups at 6‐ and 9‐month observation periods. CBL was significantly higher in the MPM group when compared with that of the OM group at both observation periods. The postoperative differences between the two groups were 2 and 1.7 mm at 6 and 9 months, respectively, in favor of the MPM‐treated sites. Conclusions: The present study demonstrated enhanced clinical outcomes when using novel MPMs compared to OMs in guided tissue regeneration procedures. These results may be affected by the penetration of gingival CT contained stem cells and periosteal cells and their differentiation into components of the attachment apparatus.     

牙槽外科中采用异种脱细胞真皮基质修复口腔软组织浅层缺损的效果

目的:评价在牙槽外科中采用正海生物膜(一种异种脱细胞真皮基质)修复口腔软组织浅层缺损的效果.方法:选择28例口腔软组织浅层缺损患者应用正海生物膜进行治疗,术后进行随访,观察生物膜成活情况,颜色、质地以及对患者的影响等,并进行统计分析.结果:术后生物膜全部成活,术后2周成活面积达(97.10±6.20)%;1个月生物膜收缩率为(9.68±11.16)%.受植床表面颜色多为粉红,质地柔软,瘢痕轻微;患者进食不受影响,未出现明显局部或全身反应.术前术后实验室检查项目无显著性差异.结论:应用正海生物膜治疗牙槽外科中常见口腔内软组织浅层缺损安全有效,值得临床推广使用.     

Clinical evaluation of a new collagen matrix (Mucograft® prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial

Aim: The aim of this study was to test a new collagen matrix (CM) aimed to increase keratinized gingiva/mucosa when compared with the free connective tissue graft (CTG).
Material and Methods: This randomized longitudinal parallel controlled clinical trial studied 20 patients with at least one location with minimal keratinized tissue (1 mm).
Main Outcome Measure: The 6-month width of keratinized tissue. As secondary outcomes, the aesthetic outlook, the maintenance of periodontal health and the patient morbidity were assessed pre-operatively at 1, 3 and 6 months.
Results: At 6 months, the CTG attained a mean width of keratinized tissue of 2.6 (0.9) mm, while the CM was 2.5 (0.9) mm, these differences being insignificant. In both groups, there was a marked contraction (60% and 67%, respectively) although the periodontal parameters were not affected. The CM group had a significantly lower patient morbidity (pain and medication intake) as well as reduced surgery time.
Conclusions: These results prove that this new CM was as effective and predictable as the CTG for attaining a band of keratinized tissue, but its use was associated with a significantly lower patient morbidity.     

种植体周角化组织增宽的临床意义和研究进展

种植体周角化组织宽度不足是种植修复过程中常见的问题.已有研究表明,充足的角化组织宽度不仅利于菌斑控制,还可提高种植体的长期稳定性.目前,临床中用于角化组织增宽的术式主要有:根向复位瓣术、自体组织移植和异体组织移植等.本文就种植体周角化组织宽度的意义及各类角化组织增宽术的研究进展作一综述,以期为临床诊疗提供借鉴.     

Soft Tissue Attachment to Titanium Implants Coated with Growth Factors

Background: Enhancing the connective tissue seal around dental implants may be an important factor in implant survival. Purpose: The objective of the study was to investigate the effect of implant surface modification with either platelet‐derived growth factor (PDGF) or enamel matrix derivative (EMD) on connective tissue attachment to titanium implants. Materials and Methods: Eighteen implants (Branemark® Mk III Groovy NP (3.3 mmØ × 10 mm, Nobel Biocare) were implanted subcutaneously into 12 rats. Six implants each were coated with either PDGF or EMD immediately prior to implantation and six implants were left uncoated. Implants were retrieved at 4 and 8 weeks and assessed histologically to compare the soft tissue adaptation to the implant surfaces. Results: Ingrowth by soft connective tissue into the threads of all implants was noted at 4 and 8 weeks. Coating with growth factors did not alter the orientation of fibroblasts and collagen fibers. The depth of connective tissue penetration into the implant grooves was significantly greater for the implants coated with PDGF at 4 weeks. The thickness of the connective tissue in growth was significantly less for the implants coated with PDGF at 8 weeks. Conclusion: Coating of the implant surface with rhPDGF‐BB or EMD can increase the speed and quantity of soft tissue healing around the implant surface.     

骨形成蛋白促进牙周组织再生的动物实验研究

目的将骨形成蛋白（ｂｏｎｅｍｏｒｐｈｏｇｅｎｅｔｉｃｐｒｏｔｅｉｎ，ＢＭＰ）联合应用于牙周引导组织再生（ｇｕｉｄｅｄｔｉｓｓｕｅｒｅｇｅｎｅｒａｔｉｏｎ，ＧＴＲ）技术中，观察和比较其对牙周组织再生修复的影响和意义。方法制备狗下颌后牙区人工骨缺损，于清创后分组置入引导膜材料和ＢＭＰ，以常规翻瓣术为对照；分不同时期取材做组织学观察和评价。结果实验组较对照组新生组织量多，而以复合ＢＭＰ组效果最为显著；膜材料在早期有一定抑制结合上皮根向迁移的作用。结论利用外源性ＢＭＰ的主动生物诱导活性，可望应用于临床促进牙周硬组织成分的新生修复。     

Begg技术第三期治疗前后牙颌面硬软组织的变化

本文对３２例拔除第一双尖牙、采用Ｂｅｇｇ技术矫正的ＡｎｇｌｅⅡ类１分类患者，比较分析Ｂｅｇｇ技术第三期治疗前后其面部硬软组织的变化。结果显示：Ｂｅｇｇ技术第三期治疗对上齿槽座点和切牙均可产生有效的移动，而对软组织外观甚微。提示了面部硬软组织对治疗反应的另一侧面－非同步性。文中探讨了Ｂｅｇｇ技术在第三期治疗中所起的作用。     

上颌尖牙阻生患者牙龈组织的转录组特征分析

目的:采集和分析上颌尖牙阻生患者牙龈组织的转录组信息,为其地域差异和病因基因理论奠定基础.方法:使用Resequencing Illumina HiSeq 2000测序平台,采集遵义地区5例成人(25～35岁)上颌尖牙阻生患者牙龈组织的转录组信息,并采用FPKM方法计算基因在牙龈组织中的表达量.通过转录组比对,将基因映...