重组人碱性成纤维细胞生长因子-自固化磷酸钙与医用胶原膜联合治疗牙周骨缺损的实验研究

目的:评价重组人碱性成纤维细胞生长因子(rh-bFGF)与自固化磷酸钙(CPC)复合物和医用胶原膜联合应用对家兔牙周组织再生的作用.方法:选用16只家兔,在双侧下颌中切牙远中手术制备3.5 mm×2.5 mm×2 mm的"U"型骨缺损,采用3种不同方法进行处理,实验组1:rh-bFGF和CPC复合物植入,胶原膜覆盖;实验组2:CPC植入,胶原膜覆盖;对照组:单纯胶原膜覆盖.根据影像学和组织学测量指标对治疗结果进行评价.采用SPSS 13.0统计软件进行方差分析处理.结果:术后8周,所有"U"型骨缺损均有数量不等的新生牙槽骨、牙骨质和结缔组织.其中2个实验组的新生牙槽骨与对照组相比有显著差异(P<0.01),实验组1与实验组2相比也有显著性差异(P<0.05).未出现根吸收和根固连等牙周再生治疗常见的不良结局.结论:应用rh-bFGF/CPC复合物更有利于牙槽骨再生.     

天然煅烧骨粉与碱性成纤维细胞生长因子联合对牙周骨缺损修复作用研究

目的    探讨天然煅烧骨粉（calcined natural bovine bone,CBB）植骨术和CBB植骨联合碱性成纤维细胞生长因子（basic fibroblast growth factor,bFGF）对牙周骨缺损修复作用和疗效。方法    选择2016年2—6月于海军军医大学第一附属医院全军口腔中心就诊,符合纳入条件的重症牙周炎患者10例（8例慢性牙周炎和2例侵袭性牙周炎）作为研究对象。在完成牙周基础治疗1个月后,对10例牙周炎患者的20个骨下袋分别行CBB植骨术（CBB组）和CBB植骨联合bFGF治疗（CBBbF组）,在术前及术后6、12个月分别测定两组菌斑指数（plaque index,PI）、出血指数（bleeding index,BI）、牙周袋深度（probing depth,PD）、临床附着丧失（clinical attachment loss,CAL）,并测定两组影像学差异。结果    CBBbF组术后1个月牙龈组织愈合良好者所占比率（90%）优于CBB组（40%）,术后12个月时骨缺损区骨充盈明显增强者所占比率（90%）大于CBB组（60%）。两组在术后6、12个月时的BI、PD和CAL均比术前明显减少（P < 0.05）,CBBbF组在术后6、12个月时BI、PD、CAL改善程度明显优于CBB组（P < 0.05）。两组在术后6、12个月时骨缺损区充盈程度均比术前明显增加,CBBbF组在术后6、12个月时骨充盈程度优于CBB组。结论    CBB骨移植与CBB植骨联合bFGF修复牙周骨缺损均有良好临床疗效,后者疗效优于前者。     

引导组织再生治疗术及碱性成纤维细胞生长因子促进牙周组织再生的实验研究

目的 了解引导组织再生治疗术(GTR)及碱性成纤维细胞生长因子(b-FGF)是否能够促进犬Ⅱ度根分叉病变牙周组织的再生。方法 将六只杂种犬的下颌双侧第二、三、四前磨牙制备慢性Ⅱ度根分叉病变模型后。随机分成两组，每组三只动物。每组中一只动物一侧进行GTR治疗，另一侧只进行翻瓣术治疗；另一只双侧都进行GTR b-FGF治疗；剩下的一只一侧进行GTR治疗，另一侧进行GTR b-FGF治疗。分别于术后第6、8周进行形态学和组织学观察。结果与翻瓣术组对比，GTR组和GTR b-FGF组都有明显的牙周组织再生；而GTR组和GTR b-FGF组之间牙周组织再生的量没有明显的差别。结论 GTR能够促进犬Ⅱ度根分叉病变牙周组织的再生，但单纯应用喷洒法使用b-FGF于牙周组织再生术中难以发挥其应有的疗效。     

自体牙本质颗粒与Bio-Oss骨粉植入治疗牙周骨缺损的临床观察

目的观察应用引导组织再生术(GTR)结合植入自体牙本质颗粒治疗牙周骨缺损的临床效果。方法选择42例垂直性骨吸收的牙周骨缺损患者,经牙周基础治疗后,GTR结合植入骨移植材料,其中,试验组21例患者共21颗牙,用自体牙本质颗粒植入骨缺损区并覆盖胶原膜,对照组的21例患者共21颗牙,用Bio-Oss植入骨缺损区并覆盖胶原膜,术后3、6、12个月回访,临床检查牙周袋深度(PD)、附着丧失(AL)及X线片检查。结果两组术后牙周袋深度、附着丧失均明显减少,且有显著性差异(P<0.05),两组骨缺损处牙槽骨修复均明显。结论应用自体牙本质颗粒治疗牙周骨缺损与应用Bio-Oss植入的临床效果无明显差异。     

引导组织和骨组织再生术及其生长因子在牙周骨缺损治疗中的应用

引导组织再生术和引导骨再生术广泛用于牙周骨缺损的治疗中,给牙周组织再生开辟了广泛的空间,但二者单独使用却存在一定的局限性。因此,目前的研究多趋向于将骨移植材料和膜材料与多肽生长因子联合应用于牙周骨缺损的修复。下面就引导组织再生膜材料、引导骨再生支架材料和碱性成纤维细胞生长因子的理化性质、生物学功能,以及三者联合应用于牙周骨缺损治疗中的作用作一综述。     

骨形态蛋白复合物联合引导组织再生技术修复牙周骨缺损的实验研究

目的评价骨形态蛋白复合物联合引导组织再生技术修复牙周骨缺损的效果。方法选择6只新西兰兔，制备下前牙牙周骨缺损模型，将其分为3组：GTR组(牙周骨缺损处植入胶原膜)、BMP组(牙周骨缺损处植入骨形态蛋白复合物和胶原膜)和OFD组(牙周骨缺损处未植入任何物，对照组)。术后12周分别观察各组缺损处的组织学变化。结果BMP组骨缺损处只见少量的软组织，新生骨组织的量及其成熟程度明显优于GTR组和OFD组，显示骨组织修复良好。结论骨形态蛋白复合物联合GTR技术修复牙周骨缺损，与传统的GTR术和牙周翻瓣术相比，更能有效促进牙周骨组织再生与修复。     

屏障膜放置时间与牙周再生量关系的动物实验研究

目的：探讨行引导组织再生术时,达到最大量牙周再生所需屏障膜在体内保留的最短时间。方法：在杂种犬下颌第3、4前靡牙近中根颊侧制备“U”型牙周缺损,表面覆盖ePTFE膜,置留时间分别为2、3、4、8周,以不放膜组（右下第2前磨牙）为空白对照,术后8周处死动物,标本作组织学分析。结果：膜3且的牙槽骨、牙骨质再生量显著大于空白对照组,上皮根移被明显抑制,但放膜3、4、8周3组之间的牙周再生量无显著性差异。结论：达到最大量牙周再生所需屏障膜放置的最短时间为3周。     

自体牙本质颗粒与Bio-Oss骨粉植入引导骨再生治疗牙周骨缺损效果比较

目的: 评价自体牙本质颗粒与Bio-Oss骨粉植入引导骨再生治疗牙周骨缺损的效果。方法: 选择2018年5月—2020年5月张掖人民医院收治的82例行引导骨再生治疗的牙周骨缺损患者,依照随机数表法分为实验组和对照组,每组41例。对照组植入Bio-Oss骨粉,实验组植入自体牙本质颗粒。比较2组患者牙周袋深度和附着丧失,颊侧软组织剖面、颊侧软组织厚度,红色美学评分,修复成功率及并发症。采用SPSS 22.0软件包对数据进行统计学分析。结果: 术后1个月和术后1年,2组患者牙周袋深度和附着丧失均显著降低（P<0.05）;且术后1年,2组患者牙周袋深度和附着丧失均低于术后1个月（P<0.05）。术后1个月和术后1年,实验组患者牙周袋深度和附着丧失显著低于对照组（P<0.05）。术后1个月和术后1年,2组患者颊侧软组织剖面显著高于术前（P<0.05）;术后1年,2组颊侧软组织剖面显著低于术后1个月（P<0.05）。术后1年,实验组患者颊侧软组织剖面显著高于对照组（P<0.05）。术后1个月和术后1年,2组患者颊侧软组织厚度显著高于术前。各时间点,2组患者颊侧软组织厚度相比,差异无统计学意义（P>0.05）。术后1个月和术后1年,2组患者红色美学评分显著高于术前（P<0.05）;且术后1年2组红色美学评分显著高于术后1个月（P<0.05）。术后1个月和术后1年,实验组患者红色美学评分显著高于对照组（P<0.05）。术后1年,实验组和对照组修复成功率分别为90.24%（37/41）和85.37%（35/41）,2组修复成功率相比,差异无统计学意义（P>0.05）。2组患者并发症发生率无统计学差异（P>0.05）。结论: 自体牙本质颗粒引导骨再生治疗牙周骨缺损患者,能够降低牙周袋深度和附着丧失,提高颊侧软组织剖面和红色美学评分,且修复成功率与Bio-Oss骨粉植入相当,是一种安全可靠的治疗方法。     

牙周引导组织再生技术在牙周病治疗中的应用

牙周引导组织再生技术是近年来兴起的诱导牙周组织再生疗法,给牙周病治疗开辟了广泛的前景。该文旨在对牙周引导组织再生术在牙周病治疗中的应用及应用前景作一综述。     

自体牙周膜细胞移植对狗牙周组织再生的影响

目的　对应用自体牙周细胞移植结合e PTFE膜引导的牙周组织再生的动物实验进行评价。方法　将 6只成年狗的 36颗牙分为实验组和对照组 ,每组 18颗牙。在人工制造的牙周缺损中 ,进行体外培养的自体牙周细胞移植结合GTR法为实验组 ,单纯应用GTR法为对照组。 6周后切片行牙周组织学观察。结果　实验组新生牙槽骨、牙周膜组织及牙骨质的修复再生效果明显好于对照组 (P <0 0 5 ) ;实验组牙槽骨再生高度平均为 (4 0 0± 0 13)mm ,对照组为 (3 0 9± 0 2 8)mm。结论应用自体牙周膜细胞移植结合e PTFE膜引导牙周组织再生可促进狗牙周组织的再生     

Significance of the platelet-derived growth factor in periodontal tissue regeneration

Aim

The aim was to review the significance of the platelet derived growth factor (PGDF) in periodontal tissue regeneration.

Methods and results

Databases were searched using the following terms in different combinations: “growth factors”, “guided bone regeneration”, “guided tissue regeneration”, “periodontal”, “platelet rich plasma” and “platelet derived growth factor”. Titles and abstracts of articles obtained using the above-described criteria were then screened by the authors and checked for agreement. The next step was to hand-search the reference lists of original and review studies that were found to be relevant in the previous step. PDGF has a stimulatory effect on the DNA replication and chemotaxis of osteoblasts, fibroblasts, leukocytes, monocytes, neutrophils periodontal and alveolar bone cells. Proliferation of mesenchymal stem cells is also promoted by supplement treatment with PDGF. PDGF in combination with other growth factors enhances periodontal tissue repair.

Conclusions

The PDGF plays a significant role in periodontal bone and tissue regeneration.     

人釉原蛋白真核表达载体体外表达产物生物学活性的检测

目的探讨人釉原蛋白基因重组质粒PcDNA3．1-AMG的真核细胞转染表达产物是否具有促进牙周组织再生的作用。方法脂质体介导PcDNA3．1-AMG体外转染COS1细胞．ELISA法检测转染细胞内及其培养上清液中重组釉原蛋白的表达：建立犬牙周组织缺损模型．局部使用转染表达产物冻干粉．8周后通过组织学观察牙周组织再生的情况。结果PcDNA3．1-AMG转染的COS1细胞内重组釉原蛋白浓度为（0．253±0．075）μg／ml。培养液中浓度为（0．065±0．011）μg／ml；使用转染表达产物8周后．牙周缺损区牙骨质、牙槽骨均有显著再生，并且新生牙骨质为有胶原纤维穿通的无细胞牙骨质。结论重组质粒PcDNA3．1－AMG在体外转染哺乳动物细胞后能够表达重组人釉原蛋白．并且表达产物具有促进牙周组织再生的生物学活性。     

自体骨髓干细胞移植狗牙周缺损处引导组织再生的实验观察

目的本文对应用自体骨髓干细胞移植引导组织再生的动物实验的观察进行评价。方法6只成年狗,实验组,对照组各18颗牙。分别在每条狗抽取骨髓1ml,在实验室内进行原代骨髓干细胞培养,培养液为内含15%小牛血清(FCS)和0.5%青-链霉素抗生素的a-MEM培养液。第1代细胞转移到18块大小为6×2mm2胶原膜上,约每张胶原膜上1×107个细胞,培养24小时后相差显微镜下观察细胞在膜上附着情况。在人工制造的牙周缺损中进行体外培养的自体骨髓干细胞移植结合GTR方法(实验组)和单纯GTR方法(对照组)。在6周后切片行牙周组织学观察。结果实验组新生牙槽骨新生牙周膜组织及新生牙骨质的修复再生的效果明显好于对照组(P<0.05),形成了的牙周结构,只是引导再生的牙周组织基本恢复到正常的牙周组织高度。实验组牙槽骨再生高度平均为4.50±0.13mm;对照组为3.09±0.28mm。结论应用自体骨髓干细胞移植结合e-pTFE膜引导牙周组织再生可促进牙周组织的再生、加快正常骨结构组织的建立并缩短修复再生时间。     

Combination of bone allograft,barrier membrane and doxycycline in the treatment of infrabony periodontal defects: A comparative trial

Aim

The purpose of the present study was to compare the regenerative potential of noncontained periodontal infrabony defects treated with decalcified freeze-dried bone allograft (DFDBA) and barrier membrane with or without local doxycycline.

Methods

This study included 48 one- or two-wall infrabony defects from 24 patients (age: 30–65 years) seeking treatment for chronic periodontitis. Defects were randomly divided into two groups and were treated with a combination of DFDBA and barrier membrane, either alone (combined treatment group) or with local doxycycline (combined treatment + doxycycline group). At baseline (before surgery) and 3 and 6 months after surgery, the pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF), and alveolar height reduction (AHR) were recorded. Analysis of variance and the Newman–Keuls post hoc test were used for statistical analysis. A two-tailed p-value of less than 0.05 was considered to be statistically significant.

Results

In the combined treatment group, the PPD reduction was 2.00 ± 0.38 mm (32%), CAL gain was 1.25 ± 0.31 mm (17.9%), and RBF was 0.75 ± 0.31 mm (20.7%) after 6 months. In the combined treatment + doxycycline group, these values were 2.75 ± 0.37 mm (44%), 1.5 ± 0.27 mm (21.1%), and 1.13 ± 0.23 mm (28.1%), respectively. AHR values for the groups without and with doxycycline were 12.5% and 9.4%, respectively.

Conclusion

There was no significant difference in the regeneration of noncontained periodontal infrabony defects between groups treated with DFDBA and barrier membrane with or without doxycycline.     

Effect of Bio-Oss with or without platelet-derived growth factor on bone formation by "guided tissue regeneration": a pilot study in rats

Aim: To investigate the effect of Bio‐Oss^® with and without the local application of recombinant human platelet‐derived growth factor (rhPDGF‐BB) on bone formation under Teflon capsules. Materials and Methods: Eight male, 6‐month‐old, Wistar strain rats were used in the study. In each animal, the lateral aspect of the mandibular ramus was exposed and small perforations were produced in the bone. A rigid, non‐porous hemispherical teflon capsule (diameter 7 mm) was placed on the ramus in both sides of the animals. The capsule placed on the one side of the jaw was filled with Bio‐Oss^® granules soaked in a solution of PDGF‐BB (20 μg/capsule) and autogenous blood prior to placement. The capsules placed on the other side of the jaw were filled with Bio‐Oss^® granules soaked in autogenous blood only (controls). Four rats were sacrificed after 3 months and the remaining four after 5 months. Undecalcified sections containing the capsule and surrounding tissues were prepared and analysed in the microscope. Results: Histologic analysis revealed limited amounts of bone formation. Most of the space underneath the capsules was occupied by Bio‐Oss^® particles surrounded by fibrovascular connective tissue. Given the small sample size statistical analysis was not possible, however, the mean amount of mineralized new bone in the control group (20.8%) appeared to be larger than that in the test group (6.7%). After 5 months the amount of newly formed bone appeared similar in the two groups (23.0% test, 26.0% controls). The Bio‐Oss^® particles occupied between 31.4% and 41.1% of the capsule area at 3 months and between 34.0% and 34.7% at 5 months. Only particles adjacent to the mandibular ramus were incorporated in newly formed bone. Conclusion: Limited bone formation was present in the capsules grafted with Bio‐Oss^® with or without the growth factor.     

Development of layered PLGA membranes for periodontal tissue regeneration

Objective

Various commercial products are available for guided tissue regeneration (GTR) therapy; however, they do not combine biosafety with the ability to control cell function. The purpose of this study was to evaluate the physicochemical and biological characteristics of the novel bilayer biodegradable poly(lactic-co-glycolic acid) (PLGA) membrane, and to assess whether the bilayer PLGA membrane could be used for periodontal tissue regeneration.