自固化磷酸钙人工骨复合骨形成蛋白在牙槽骨缺损修复中的应用

目的探讨自固化磷酸钙人工骨(autosolidification calcium phosphate cement,ACPC)复合骨形成蛋白(bone morphogenetic protein,BMP)对牙槽骨缺损修复的生物学作用.方法将ACPC/BMP即刻植入拔牙术后患者牙槽创口,随访24周,通过临床检查和CCD数字化摄片观察牙槽骨缺损修复情况.结果实验位点无炎症、过敏和毒性反应发生,实验组患者牙槽嵴骨量吸收较空白对照组少,外形维持较好.结论BMP/ACPC复合骨兼具骨的引导性和诱导性,可促进新骨沉积钙化,即刻植入拔牙创利于增加牙槽骨量,维持牙槽外形,但材料降解性存在不足.     

上前牙区延期即刻种植后的骨量变化及美学影响

背景：拔牙后牙槽骨伴有冠根向和颊舌向大量的骨吸收,导致失牙区牙槽骨骨量明显不足;对种植初期的稳定性及修复后美学效果均有一定影响,严重影响种植义齿的远期成功率。因此,即刻种植技术可以缩短种植修复时间。 目的：评价上颌前牙区行延期即刻种植及引导骨再生技术后种植修复效果。 方法：选择19例(28颗缺牙)上颌前牙缺失伴唇侧单壁骨缺损患者,分别于拔牙后4周植入奥齿泰种植体28枚,唇侧骨缺损区种植同期采用引导骨再生技术,6个月后行二期修复。 结果与结论：28枚种植体在24个月后,存留率100%。6个月后平均种植体周边缘骨高度丧失为0.1 mm,   1年平均骨高度丧失为0.6 mm,2年平均骨高度丧失为0.11 mm。红色美学分值评分满意。在上颌前牙缺失伴轻度骨缺损延期即刻种植中采用引导骨再生技术可较好的恢复种植体周围骨高度和宽度,垂直向骨吸收稳定,牙龈美学效果满意。  中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

异种煅烧骨材料修复骨缺损：特点、优势与问题

文题释义： 拔牙位点保存：当由于各种原因拔除牙齿后,其周围的牙槽骨在前6个月将会发生水平向和垂直向上的严重吸收,导致种植手术时骨量不足,严重影响种植修复的成功率。许多学者建议在彻底拔除牙齿的同时,于拔牙窝内放置骨粉和骨膜进行保护和修复性干预,将会显著减少周围牙槽嵴生理或病理性的骨吸收、阻断周围龈缘和龈乳头的退缩,保存牙槽窝周围软硬组织的高度和形态,并改善新生软硬组织的质量,为后期的种植美学修复创造良好条件。 爬行替代：在具有良好血供的骨损伤区域植入骨移植材料后,将会激活骨再生程序：破骨细胞开始活动,并在植骨材料上进行骨吸收,形成一条条“沟”状缺损,引导骨原细胞进入,随之分化为成骨细胞,成骨细胞分泌大量的类骨质,钙化成骨基质,成熟为骨单位。即在骨移植材料逐渐吸收的部位新生骨组织逐渐形成,充填骨吸收的凹陷。 背景：牙种植区域的牙槽骨骨量不足增加了种植手术难度,植骨材料的出现成功解决了此类难题。在所有单一植骨材料中,异种煅烧骨被广泛用于治疗骨缺损,但单独使用煅烧骨时仍然存在一些缺点。 目的：结合最新的相关研究动态,对异种煅烧骨材料修复骨缺损的相关研究进展作以综述。 方法：第一作者以“calcined bone,xenogeneic bone,bone augmentation,bone substitute”为英文检索词,以“煅烧骨、异种骨、骨增量、骨替代材料”为中文检索词,应用计算机检索 PubMed、维普、万方、知网数据库中1986年1月至2019年11月已发表的相关文献,并进行筛选、归纳与总结,最终纳入69篇相关文献进行综述。 结果与结论：在所有骨移植材料中,异种煅烧骨的结构与人类骨骼相似,具有良好的互连孔性,便于血管因子和骨原细胞进入,为新骨形成提供了通道和支架作用,同时具有良好的生物相容性及一定的降解作用,受到临床医生们的青睐。但其本身仍然存在溶解度较低、吸收缓慢、机械性能较差等不足,这就促使研究者们研发出将煅烧骨与陶瓷、聚合物、骨诱导因子及金属离子等其他材料复合,发挥出所参与材料的优点,从而使复合材料成为骨增量材料的首选。 ORCID: 0000-0002-0313-7462(李芳) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

不同测量方法评估位点保存术后牙槽嵴高度变化

目的 采用锥形束CT（CBCT）结合3D打印数字导板、直接观测、平行投照根尖片测量三种方法评估拔牙后位点保存6个月后牙槽骨高度的变化,比较各方法的测量效果。方法 选择我院2015年7月~2017年5月收治的20例患者,共20颗需拔除的患牙,微创拔除患牙后即刻行位点保存术。术中行临床直接测量记录牙槽骨高度,术后即刻及6个月拍摄根尖片并佩戴数字导板行CBCT检查,种植术中翻瓣再次测量牙槽骨高度,比较三种方法检测牙槽嵴高度的变化。结果 术后6个月颊侧中点牙槽嵴及近、远邻面牙槽嵴高度均有降低,非磨牙区分别为（0.85±1.56）mm、（0.15±0.44）mm、（0.16±0.53）mm,磨牙区分别为（0.82±1.20）mm、（0.14±0.25）mm、（0.15±0.89）mm。直接探查与CBCT结合3D打印数字导板测量的牙槽嵴高度结果比较,差异无统计学意义( P＞0.05) ;平行投照根尖片检测结果与另外两种方法比较,差异有统计学意义（P＜0.05）。结论 直接测量与CBCT结合3D打印数字导板对牙槽骨高度变化的评估基本一致,3D打印数字导板结合CBCT检测具有无创、精准且可重复的特点,可用于临床其他环境下的牙槽骨各水平变化的评估中。     

β-磷酸三钙支架材料即刻植入对保存剩余牙槽嵴的影响

背景：拔牙后在牙槽窝内即刻植入成骨材料,如脱蛋白小牛骨、羟基磷灰石、硬组织代用品、人脱钙冻干骨等,可防止或延缓牙槽嵴在拔牙后的快速、持续吸收。 目的：观察β-磷酸三钙支架材料即刻植入对剩余牙槽嵴保存的影响。 方法：完整拔除18只新西兰大白兔双侧下颌中切牙,一侧牙槽窝内即刻植入β-磷酸三钙作为实验组,另一侧不处理作为对照组。术后4,8,12周测量剩余牙槽嵴长度、宽度、高度;甲苯胺蓝染色观察术区牙槽嵴愈合过程中的组织病理改变,X射线观察术区牙槽嵴骨密度改变,扫描电镜观测β-磷酸三钙与拔牙窝骨小梁的结合界面。 结果与结论：术后8,12周时,实验组牙槽嵴高度、宽度及长度均高于对照组(P < 0.05)。随着时间的延长,实验组拔牙窝内可见成骨细胞散在分布,新生骨小梁逐渐增多,血管网由稀疏变得丰富,新生骨与β-磷酸三钙结合日益紧密,并且β-磷酸三钙不断降解,与拔牙窝牙槽骨交界处有新生骨组织形成。说明β-磷酸三钙具有良好的骨传导特性及生物相容性,拔牙后即刻植入β-磷酸三钙材料可有效保存剩余牙槽嵴解剖形态,防止牙槽嵴的进一步吸收。     

活性短肽修饰纳米晶胶原基骨修复拔牙后剩余牙槽嵴

背景：各种原因导致的牙齿拔除后都会造成剩余牙槽嵴的吸收,导致颌骨骨量不足,不利于患者后期接受义齿和种植牙的修复治疗。 目的：通过建立大鼠拔牙后剩余牙槽嵴模型,观察纳米晶胶原基骨/活性肽P17-骨形态发生蛋白2对拔牙窝修复及牙槽嵴吸收的影响。 方法：将36只健康SD大鼠随机分为实验组、对照组和单纯材料组,均拔除右侧下颌中切牙,实验组在拔牙窝内即刻植入纳米晶胶原基骨/活性肽P17-骨形态发生蛋白2材料,对照组在拔牙窝内植入纳米晶胶原基骨/骨形态发生蛋白2材料,单纯材料组在拔牙窝内植入纳米晶胶原基骨材料。 结果与结论：①牙槽嵴的相对长度：术后2,4,8周,实验组与对照组均大于单纯材料组(P < 0.05),实验组与对照组比较差异无显著性意义(P > 0.05)。②组织学观察结果：术后2,4,8周,实验组与对照组新生血管和新骨形成的速度和质量均优于单纯材料组。③新生骨面积占骨缺损面积的百分比：术后2,4,8周,各组随时间增长不断增加,实验组与对照组大于单纯材料组(P < 0.05),对照组大于实验组。表明纳米晶胶原基骨/活性肽P17-骨形态发生蛋白2具有良好的骨诱导能力,拔牙后即刻植入可促进拔牙创的愈合,延缓剩余牙槽嵴的吸收。     

下颌切牙牙槽骨骨吸收前后三维有限元应力分析

主要利用三维有限元应力分析的方法研究观察下颌切牙牙槽骨骨吸收前后在垂直载荷、15°斜向载荷、30°斜向载荷分别作用下牙槽骨骨组织表面的vonMises应力分布特点及牙齿的舌向位移值。在垂直载荷、15°斜向载荷作用下,牙周健康的下颌切牙牙槽骨骨组织表面vonMises应力最大值分别是13.171和14.315MPa,均位于根尖处牙槽骨,舌向位移值分别是0.056和0.197mm;在30°斜向载荷作用下vonMises应力最大值是15.262MPa,分布于根尖处牙槽骨和牙槽嵴顶,舌向位移值为0.324mm。而牙槽骨骨吸收达根长1/2时,在垂直载荷作用下vonMises应力明显增加,最大值位于根尖处牙槽骨;在不同的斜向载荷作用下,所产生应力继续显著增加,vonMises应力最大值可达牙周健康的下颌切牙的3～5倍,分布部位完全由根尖处牙槽骨转移到牙槽嵴顶,分布的面积也越来越小,发生了由面分布到点分布的转变,应力越来越集中于某一点。且牙齿已发生明显的舌向位移,可高达2.850mm。提示当牙槽骨骨吸收接近根长1/2或以上时,在牙周基础治疗过程中,应考虑进行调牙合、松牙固定术等治疗,分散牙合力以避免过大应力的产生和应力分布的改变,减轻对牙周组织的损伤。     

种植体周围骨吸收的时间因素

背景：目前,对种植体周骨吸收速度随时间的变化趋势判断尚缺乏临床实验数据支持。 目的：观察种植体植入后周围牙槽骨吸收的情况,评价时间因素对种植体周围骨吸收的影响。 方法：收集2003/2010接受种植义齿修复治疗病例的所有直接数字化全景片,筛选出其中可供分析的全景片,并将其分为种植后即刻,1,3,6和12个月片,对所有全景片进行测量,比较种植体植入后不同时间种植体周围骨吸收速度的差异性。 结果与结论：种植体植入后1个月和6个月之间,3个月和6个月之间,1个月和12个月之间,3个月和12个月之间的种植体周骨吸收速度的差异有非常显著性意义(P < 0.01)。提示种植体植入后1~3个月内种植体周围骨吸收最显著。     

神经支配与拔牙窝的骨愈合*

背景：拔牙窝的新骨形成与骨量保持受体内外多种因素调控,神经系统通过介导成骨细胞和破骨细胞调节骨代谢。 目的：观察神经支配对拔牙窝骨愈合的调节作用,探讨神经支配与拔牙窝骨愈合的相互关系。 方法：切除犬一侧下牙槽神经建立失神经支配动物模型,以未切除侧为对照,拔除失神经支配侧和正常侧前磨牙,放射影像学方法检测术后2,4,8,12周拔牙窝新骨形成和骨量保持。 结果与结论：失神经支配组拔牙窝骨缺损区牙槽嵴高度、宽度和CT值明显低于对照组(P < 0.01);实验组拔牙窝唇颊侧牙槽嵴高度明显低于对照组(P < 0.05或0.01),舌侧牙槽嵴高度差明显高于对照组(P < 0.05或0.01)。提示失下牙槽神经支配影响拔牙窝的新骨形成及骨量保持,二者之间存在密切相关性。     

纳米晶胶原人工骨用于新疆维吾尔自治区塔城地区哈萨克族人的牙槽嵴保存

背景：拔牙后牙槽嵴的保存是一个重要的课题。新疆维吾尔自治区塔城地区边疆各县少数民族牙齿拔出后,由于就诊条件、地理条件等限制以及当地居民缺乏口腔保健意识等诸多因素,缺牙区长时间未及时修复导致牙槽嵴条件较差,因此寻找一种适合当地的且更有效的保存剩余牙槽嵴的方法,在当地有着较实用的临床价值。 目的：探索纳米晶胶原人工骨用于新疆维吾尔自治区塔城地区哈萨克族人牙槽嵴保存的可行性。 方法：采用自身配对设计,选取68例新疆维吾尔自治区塔城地区哈萨克族双侧拔牙患者,对就诊的双侧拔牙患者实验侧和对照侧的确定按“不平衡指数最小的分配原则”分组,实验侧拔牙窝植入纳米晶胶原人工骨,对照侧拔牙窝常规处理。植入后即刻及植入后3个月应用螺旋CT对植入区感兴趣区扫描,测量骨密度。 结果与结论：植入后即刻,患者实验侧和对照侧CT图像可见拔牙窝清晰的轮廓,牙槽间隔可见;植入后3个月,患者实验侧和对照侧CT图像显示拔牙窝牙槽间隔影像模糊,CT值与周围牙槽突CT值接近,但实验侧植骨区骨充盈;且植入后3个月患者实验侧骨密度高于对照侧。说明纳米晶胶原人工骨用于新疆维吾尔自治区塔城地区哈萨克族患者牙槽嵴保存的临床效果较好。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

应用羟基磷灰石生物陶瓷及口腔膜引导骨再生修复牙周骨缺损

背景：羟基磷灰石生物陶瓷以天然优质海洋珊瑚为原料,在珊瑚骨架上形成羟基磷灰石薄层,保留珊瑚天然孔孔相同的支架结构,为组织生长提供了良好空间。 目的：观察羟基磷灰石生物陶瓷膜引导骨再生修复牙周骨缺损的临床效果。 方法：将42例下颌第一磨牙牙周病致骨缺损患者随机分组：实验组采用羟基磷灰石生物陶瓷结合口腔修复膜充填修复骨缺损,对照组采用单独羟基磷灰石生物陶瓷充填修复。 结果与结论：临床随访观察12个月,两组牙周组织附着丧失、牙周探诊深度较治疗前明显改善(P < 0.05),且实验组牙周组织附着丧失、牙周探诊深度改善优于对照组(P < 0.05);实验组骨缺损区新骨形成密度和骨量均优于对照组(P < 0.05)。表明采用羟基磷灰石生物陶瓷充填骨缺损区同时覆盖生物膜的引导骨再生技术可获得良好的骨引导再生效果,修复骨缺损。     

牙周膜干细胞与牙周组织的再生

背景：牙周组织再生过程中再生细胞数量和生物学功能的不足是造成组织再生困难的主要原因。 目的：就近年来牙周膜干细胞在牙周组织再生中的研究进展及未来展望作一综述。 方法：由第一作者检索Pubmed 数据库(http://www.ncbi.nlm.nih.gov/pubmed)、中国知网数据库(http://www. cnki.net/)2000年1月至2012年7月 有关牙周膜干细胞分离、鉴定、相关细胞因子等方面的文献,英文检索词为“periodontal ligamentstem cell”,中文检索词为“牙周膜,干细胞”。排除重复性研究,最终纳入26 篇文献进行综述。 结果与结论：利用组织工程的方法,将牙周膜干细胞作为牙周组织再生的种子细胞,在体外培养扩增后移植至缺损区,可有效增进牙周附着结构的再生并缩短愈合周期。对牙周膜干细胞的研究已成为目前牙组织工程领域中的重点课题。     

人牙周韧带细胞-聚羟基乙酸支架复合体修复牙周组织缺损

BACKGROUND: In recent years, tissue engineering technology as a new model for tissue regeneration has provided new ideas and methods for the repair of periodontal tissue defects. OBJECTIVE: To investigate the effect of human periodontal ligament cells-polyglycolic acid scaffold complex for repair of periodontal tissue defects. METHODS: Passage 4 human periodontal ligament cells at a density of 1.5×109/L were seeded onto the polyglycolic acid scaffold to prepare cell-scaffold complex. Then mongrel dogs were selected to make animal models of periodontal tissue defects and then randomly assigned into experimental group subjected to cell-scaffold complex implantation or control group subjected to direct coronal reset and suture of the gingival flap. Collagen content, new blood capillaries, new cementum, new alveolar bone and new periodontal ligament were detected within 4 weeks after operation; hematoxylin-eosin staining of periodontal tissue defects was done at 8 weeks after operation. RESULTS AND CONCLUSION: In the experimental group, the collagen content, number of newborn capillaries, amount of new cementum, new alveolar bone and new periodontal ligament tissues were significantly higher than those in the control group at postoperative 1, 2, 3, 4 weeks (P < 0.05). At 8 weeks after operation, in the experimental group, there were more vessels arranging on the connective tissue surface of new alveolar bone, the alveolar bone showed a sawtooth-like interlinking with the periodontal tissues in the presence of a thin layer of cementum; in the control group, only new alveolar bone and cementum formed below the incisure. These findings indicate that human periodontal ligament cells-polyglycolic acid scaffold complex can promote periodontal tissue regeneration.      

Preservation and regeneration of alveolar bone by tissue-engineered implants

Bone maintenance after dental extraction has a significant impact on the success of future treatment. The purpose of this study was to regenerate bone by implanting an engineered porous scaffold seeded with bone marrow mesenchymal stem cells (BMSCs) in a socket created by extraction of the lower left central incisor in rabbits, utilizing the principles of tissue engineering. It involved preparation and characterization of three-dimensional porous hollow root form scaffolds consisting of a poly-L-lactic acid:polyglycolic acid composite (PLG, 50:50), using a solvent casting/compression molding/particulate leaching technique. Porosity of the scaffolds was 83.71% with good interconnectivity and uniform distribution of the various pore sizes. The degraded scaffolds maintained their porosity and form for the first 2 weeks and their mass loss continued up to 6 weeks. The scaffolds developed viscoelastic behavior under dynamic compression; yet they lost their mechanical characteristics as they degraded. The scaffolds were seeded with BMSCs and examined by scanning electron microscopy. Cell proliferation and scaffold degradation were shown up to 2 weeks in vitro. The cultivated scaffolds were implanted in empty extraction sockets immediately after tooth removal. Four weeks later, bone regeneration was evaluated histologically in the healed sockets in three experimental groups: sockets left empty, sockets that received PLG without cells, and sockets that received PLG with cells. Radiographic evaluation, performed 4 weeks later for the three experimental groups, demonstrated preservation of alveolar bone walls in the extraction sockets that received PLG with cells as compared with the other two groups. The bone density profile for the healed sockets confirmed both histological and radiographic findings. The results of this study show promise in the area of dentoalveolar surgery, yet longitudinal studies under variable clinical situations would encourage the current application.     

Transplantation of labeled periodontal ligament cells promotes regeneration of alveolar bone

Regeneration of damaged periodontal tissues is mediated by periodontal cells, but a major sub-population comprises highly differentiated cells that do not renew. To overcome the loss of specialized cell types caused by disease, various therapeutic approaches including cell transplants have been developed to promote cell re-population in periodontal tissues. As previous transplantation studies used unlabeled cells, that are indistinguishable from host cells, it has been difficult to assess the contributions of transplanted cells to the healing processes. To track the fate and differentiation of rat periodontal cells transplanted into periodontal wounds, we used collagen-coated fluorescent beads as a permanent endocytosed marker, or cells constitutively expressing beta-galactosidase. We assessed osteogenic cell differentiation with immunohistochemical staining for osteopontin and bone sialoprotein. Cells were transplanted into periodontal wounds created in Sprague--Dawley male rats that are null for beta-galactosidase. Defects were allowed to heal spontaneously (controls), or were closed with collagen implants mixed with beta-galactosidase-positive (Lac-Z) periodontal cells, or closed with collagen implants mixed with periodontal cells loaded with fluorescent beads. Animals were killed at 1 and 2 weeks after surgery and tissues were prepared for morphometric assessment and immunostaining for osteopontin (OPN) and bone sialoprotein (BSP). Transplanted cells were easily distinguished by fluorescent beads or by beta-galactosidase-positive expression and were distributed throughout the regenerating periodontal ligament (PL) and alveolar bone. At 1 week after wounding, animals treated with beta-galactosidase-positive cells exhibited a slightly higher percentage of labeled cells in the PL compared with the fluorescent bead-labeled cell implant group (2% vs. 1% respectively; P > 0.2). At Week 2 percentages of labeled cells were slightly increased in the regenerating PL (approximately 3% for both groups, P > 0.2). In regenerating alveolar bone at 1 week, animals that were treated with beta-galactosidase-positive cells and fluorescent bead-loaded cells exhibited approximately 30% and 25% of labeled cells respectively. At 2 weeks after wounding there was an increase in the percentage of transplanted beta-galactosidase-positive cells (approximately 39% at week 2; P < 0.05), but not of transplanted cells with fluorescent beads (approximately 25% at week 2). In sites with transplanted cells there were higher percentages of OPN positive and BSP positive cells in nascent bone and more newly formed bone than in controls (>40%; P < 0.05). Transplantation of beta-galactosidase-positive cells or cells loaded with fluorescent beads is a useful method for assessing the fate and differentiation of periodontal cells in vivo. Fluorescent beads, however, are diluted at mitosis and this method underestimates the percentage of transplanted cells. As transplanted periodontal cells in both groups promoted regeneration of alveolar bone, cell transplantation could improve the restoration of periodontium destroyed by periodontitis.     

骨保护素和碱性成纤维细胞生长因子在牙周组织再生中的应用

背景：利用组织工程和基因治疗技术,联合应用骨保护素和碱性成纤维细胞生长因子可以促进牙周组织修复再生,是治疗重症牙周病的新方法。 目的：探讨联合应用骨保护素和碱性成纤维细胞生长因子以促进牙周组织修复再生的理论依据。 方法：应用计算机检索PubMed数据库(1996/2009)和中国知网数据库(1999/2009),分别以“osteoprotegerin,basic fibroblast growth factor,tissue engineering, gene therapy,periodontal regeneration”和“骨保护素、碱性成纤维细胞生长因子、组织工程、基因治疗、牙周组织修复再生”为检索词,通过阅读标题和摘要进行初筛,排除较陈旧和重复研究文献,保留符合纳入标准的文献29篇。 结果与结论：使牙槽骨、牙周膜和牙骨质获得再生,形成牙周新附着一直是口腔医学研究的热点。骨保护素是一种能阻止破骨细胞分化、促进骨形成的关键因子。碱性成纤维细胞生长因子在胚胎发育,血管生成,骨的形成和修复,促进细胞增生等有广泛的作用。2者都可促进牙周组织的修复和再生。组织工程技术和基因治疗技术的出现显著促进了牙周组织修复再生研究的发展,有选择地复合这2种生长因子促进牙周支持组织的再生和修复可成为治疗牙周病的一种新方法。     

脂肪干细胞和生物支架应用于牙槽骨修复

背景：各种生理或病理因素导致的牙槽骨的吸收、缺损是口腔临床医学中的常见问题,但目前较常用的修复缺损牙槽骨的方法不能完全满足临床需要。骨组织工程的出现成为修复骨缺损的研究热点。  目的：就脂肪干细胞的来源和应用价值、生物支架的种类及特性、生物支架对种子细胞的影响及脂肪干细胞复合支架用于动物实验的研究等方面作一总结。 方法：应用计算机检索CNKI和Pubmed数据库中1995年1月至2013年4月关于脂肪干细胞、生物支架及骨修复的文章,在标题和摘要中以“脂肪干细胞,分化、增殖和成骨生物支架,牙槽骨,骨组织工程”或“Adipose stem cells,Differentiation、proliferation and Osteogenesis,Biological scaffold,alveolar bone,bone tissue engineering”为检索词进行检索。选择文章内容与脂肪干细胞和生物支架应用于修复骨缺损有关者,同一领域文献则选择近期发表或发表在权威杂志文章。初检得到163篇文献,根据纳入标准选择关于脂肪干细胞和生物支架应用于修复骨缺损的40篇文献进行综述。 结果与结论：脂肪干细胞具有与骨髓基质干细胞相似的分化潜能,因其来源广、易采集、易培养低衰老,成骨分化好和风险小等特点被广泛关注,尤其和生物支架应用于骨修复表现出更好的成骨效果。随着有关各科学的发展牙槽骨缺损的修复有关问题都可以解决,脂肪干细胞和生物支架构建工程骨将是实现真正意义上牙槽骨再生的发展趋势且具有良好的发展前景。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程全文链接：     

Periodontal tissue regeneration with adipose-derived stem cells

A number of surgical techniques have been developed to promote periodontal tissue regeneration. Bone marrow-derived stem cells have also been shown to promote periodontal tissue regeneration. In this study, we sought to determine whether adipose-derived stem cells (ASCs) can promote periodontal tissue regeneration as well. ASCs were isolated from a Wistar rat, passaged twice, mixed with platelet-rich plasma (PRP) obtained from inbred rats, and implanted into the periodontal tissue defect that had been generated in the test rats. Tissue specimens were harvested after 2, 4, and 8 weeks for histological analysis. Rats that received PRP only or were not implanted served as controls. A small amount of alveolar bone regeneration was observed 2 and 4 weeks after ASC/PRP implantation. Moreover, 8 weeks after implantation, a periodontal ligament-like structure was observed along with alveolar bone. These observations suggest that ASCs can promote periodontal tissue regeneration in vivo. Because large amounts of human lipoaspirates are readily available, and their procurement induces only low morbidity, ASCs may be useful in future clinical cell-based therapy for periodontal disease.     

生物膜引导骨再生在上颌窦提升中的成骨效果

背景：利用生物膜引导骨再生技术在上颌窦提升中成骨是牙种植的研究热点。 目的：探讨引导骨再生技术在上颌窦提升中的成骨效果。 方法：9只比格犬进行双侧上颌窦底提升同期牙种植,实验侧行胶原膜覆盖颊侧创口,对照侧无胶原膜覆盖。术后4,12,24周分别处死实验犬,行大体标本、力学测试及组织学检查。 结果与结论：术后12,24周时对照侧骨移植材料有移位,骨质吸收明显,种植体顶部暴露,实验侧种植体顶部骨移植材料无移位现象,有较厚的骨质覆盖。随时间的增加,种植体牵出力增加,在24周时实验侧与对照侧差异有显著性意义(P < 0.05)。组织学检查可见双侧上颌窦底植入骨粉后均可见新生骨形成,随时间延长逐渐增多、成熟,骨粉颗粒逐渐减少,术后12,24周时实验组与对照组新生骨的面积比较差异有显著性意义    (P < 0.05)。结果显示生物膜引导再生技术可减少上颌窦提升后骨的吸收,促进新骨骨形成。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

A biphasic scaffold design combined with cell sheet technology for simultaneous regeneration of alveolar bone/periodontal ligament complex

This study describes the design of a biphasic scaffold composed of a Fused Deposition Modeling scaffold (bone compartment) and an electrospun membrane (periodontal compartment) for periodontal regeneration. In order to achieve simultaneous alveolar bone and periodontal ligament regeneration a cell-based strategy was carried out by combining osteoblast culture in the bone compartment and placement of multiple periodontal ligament (PDL) cell sheets on the electrospun membrane. In?vitro data showed that the osteoblasts formed mineralized matrix in the bone compartment after 21 days in culture and that the PDL cell sheet harvesting did not induce significant cell death. The cell-seeded biphasic scaffolds were placed onto a dentin block and implanted for 8 weeks in an athymic rat subcutaneous model. The scaffolds were analyzed by μCT, immunohistochemistry and histology. In the bone compartment, a more intense ALP staining was obtained following seeding with osteoblasts, confirming the μCT results which showed higher mineralization density for these scaffolds. A thin mineralized cementum-like tissue was deposited on the dentin surface for the scaffolds incorporating the multiple PDL cell sheets, as observed by H&E and Azan staining. These scaffolds also demonstrated better attachment onto the dentin surface compared to no attachment when no cell sheets were used. In addition, immunohistochemistry revealed the presence of CEMP1 protein at the interface with the dentine. These results demonstrated that the combination of multiple PDL cell sheets and a biphasic scaffold allows the simultaneous delivery of the cells necessary for in?vivo regeneration of alveolar bone, periodontal ligament and cementum.