浓缩生长因子在口腔中骨缺损方向的应用进展

再生医学在医学领域是一门全新的热门学科。浓缩血小板凭借其所含丰富的生长因子,目前已被证明具有强大的再生潜力,广泛应用于拔牙后位点保存、牙槽骨缺损、牙周组织再生、根尖手术和种植等口腔治疗领域。第三代浓缩血小板-浓缩生长因子（Concentrated growth factors,CGF）是一种新型的口腔生物材料,具有来源便利、生物相容性强、安全性高等优势,目前在口腔临床应用中崭露头角,其在组织缺损、骨再生方面的作用倍受关注。笔者通过查阅有关浓缩生长因子的国内外文献,进而熟悉CGF的制取方式、作用机制、适用范围与条件,并且通过与第二代浓缩血小板-富血小板纤维蛋白（Platelet-rich fibrin,PRF）进行生长因子含量、临床应用效果的对比,更好地突出CGF在临床应用中的前景。本文进一步就CGF在口腔临床中骨缺损方向的应用进展展开论述,分别从颌骨缺损、引导骨组织再生（Guided bone regeneration,GBR)+、拔牙术后三个方面阐述诸多学者的研究结果,最终得出结论 CGF在口腔临床成骨方面具有非常积极的影响,肯定了CGF在口腔牙槽外科治疗领域的应用意义。     

生物降解聚合物在口腔领域的应用

生物降解聚合物具有良好生物相容性，其生物降解中用于骨固定，组织诱导再生药物控释等领域。本文就该材料在颌骨骨折。颞颌关节盘置换，牙周牙槽骨再生及口腔药物控释方面的研究从材料的种类、性能和应用前景等作一综述。     

牙本质作为骨移植材料的研究进展

随着口腔材料学的不断发展,不同类型的骨移植材料被应用于修复牙槽骨。牙本质来源于天然的牙体组织,作为一种新兴的骨移植材料在骨再生领域中应用广泛,其不仅具有优异的生物相容性,骨诱导、骨引导能力,且来源广泛、抗原性低、制作简单。将废弃的牙齿进行再次利用,为患者节省骨粉费用,并且含有骨形态发生蛋白和多种生长因子,吸收速率与新骨形成速率适宜,动物实验和临床研究均证实了其良好的骨再生效果。本文就牙本质在骨再生领域中的研究进展作一综述。     

富血小板纤维蛋白在牙体牙髓治疗中的应用进展

再生医学作为一门旨在修复、替换或再生人体各种组织和器官的全新学科,其在口腔领域的研究和应用日趋深入,为分子生物学领域增添了新动力。在口腔再生医学中,血小板浓缩制品的再生潜力已得到确认。富血小板纤维蛋白(platelet-rich fibrin,PRF)为第二代血小板浓缩制品,其纤维蛋白基质中富含血小板、白细胞、多种生长因子和细胞因子,可在血管生成、组织再生和骨组织愈合中发挥重要的作用。本文在回顾相关文献的基础上,就PRF在牙体牙髓临床治疗中的应用现状及研究进展进行综述。     

间充质干细胞相关生长因子在牙槽骨修复的应用进展

牙槽骨缺损是导致口腔功能障碍的主要原因,如何修复骨缺损,并恢复其功能是近年来的关注重点。目前临床中使用的骨重建技术有一定的局限性,组织工程学和骨再生医学应运而生。间充质干细胞因其增殖分化后能够代替损伤的组织,有望成为治疗骨缺损的有效替代方案。最近的研究表明间充质干细胞旁分泌生长因子能够诱导骨修复。该文总结了近年来骨缺损修复的基础研究和临床实验结果,重点对间充质干细胞旁分泌效应在牙槽骨修复中的作用及相关生长因子的特点进行介绍。     

应用组织工程技术修复牙周组织缺损的研究进展

牙周病可造成牙槽骨吸收、牙齿脱落。组织工程技术在牙周组织再生治疗中的应用,为牙周病的治疗及牙周缺损的修复提供了新的技术手段。本文就近年来牙周组织再生治疗中关于生物材料、生长因子、细胞治疗和基因治疗等组织工程技术的研究及应用进展作一综述。     

组织工程技术应用于牙周膜再生研究进展

组织工程技术是一项利用生物替代材料修复受损组织的技术,广泛应用于组织再生,也为口腔牙周膜再生提供了新的方法。文章就近年来牙周膜再生治疗中关于支架材料、生长因子、种子细胞等组织工程技术的研究及应用进展做一综述。     

生长因子与牙周组织再生

促进功能性牙周组织再生,重建牙槽骨、牙骨质和牙周膜的生理结构是牙周病治疗的最终目的。生长因子在牙周组织再生过程中起着重要作用,本文就牙周组织再生中生长因子的作用及其临床应用、控释技术等作一综述。     

生长因子用于牙种植临床研究的热点

随着分子生物学和组织工程学的发展,生长因子开始在口腔颌面部骨组织缺损修复中显示其广阔的应用前景。富血小板血浆富含多种生长因子,它的制备简单易行,使用也安全可靠,是值得研究的生长因子成分。《富血小板血浆促进口腔种植骨再生的临床应用研究》一文将富血小板血浆用于临床常见的骨缺损修复,在国内尚未见到此类报告。该方     

富血小板纤维蛋白在口腔种植的临床应用

富血小板纤维蛋白（Platelet-rich fibrin,PRF）,即我们临床所应用的PRF,是新一代血小板浓缩制品,最早为法国科学家Choukroun研发,目前,在欧洲诸国口腔种植领域应用广泛。PRF为淡黄色凝胶状生物膜,富含血小板衍生生长因子（PDGF）、血管内皮生长因子（EGF）、转化生长因子（TGF）等多种与软硬组织愈合相关的细胞因子,因此其具有良好的促进软硬组织再生的能力,可以广泛应用于口腔种植临床。     

Orem自理模式在90例口腔鳞癌患者游离组织瓣移植术后的应用价值评价

目的 探讨Orem自理模式在口腔鳞癌患者游离皮瓣移植术后护理中的应用效果。方法 选择上海交通大学医学院附属第九人民医院浦东分部口腔综合病房2019年8月—2020年9月接受游离组织瓣移植术治疗的90例口腔鳞癌患者为研究对象,随机分为常规组（42例）和管理组（48例）。常规组采取常规护理模式,管理组在常规护理的基础上采用Orem自理模式干预的综合护理模式。采用心理状态评估量表(MSSNS)评估2组患者的心理状态,比较2组患者术后的心理状态,分析干预后2组患者生活质量改善情况以及并发症发生情况。采用SPSS 25.0软件包进行统计学分析。结果 管理组的不良情绪发生率低于常规组,差异有统计学意义（P<0.05）。管理组干预后的各项功能领域指标均高于常规组,并发症发生率低于常规组,差异均有统计学意义（P<0.05）。结论 对行游离组织瓣移植术口腔鳞癌患者采用Orem自理模式的综合护理模式,能够改善患者的心理状态,有利于减少术后并发症发生、缩短住院时间、改善患者生活质量,促进患者尽快康复。     

生长因子联合引导性再生技术在口腔种植治疗中的应用

随着膜屏障和骨移植材料的发展,引导性再生技术已广泛应用于口腔种植修复及外科重建领域.将生长因子复合到生物活性材料上,利用其促进骨再生的特性而进一步提高骨诱导活性并增强骨性整合已成为目前研究的热点.     

Autogenous platelet-rich plasma in combination with bovine-derived hydroxyapatite xenograft for treatment of a cystic lesion of the jaw

In the last 5 years, many studies about autogenous platelet-rich plasma have been undertaken pointing out its regenerative and reparative properties on tissues. The features of this product are an attribute of platelet cells, which, after cellular interactions, release growth factors. These molecules promote tissue healing and also induce cellular regeneration. Bone is a dynamic tissue subject to balanced processes of bony formation and reabsorption; autologous platelet gel or concentrate (PRP) can be used alone or in association with bony graft for the treatment of bony defect, cystic lesions, alveolar bone defects, and periodontal pockets. Its application fields are oral and maxillofacial surgery, plastic surgery, and general surgery, and it can be applied particularly in patients with coagulation diseases. In our experience, a giant cystic lesion of the jaw was treated with PRP and granules of bovine-derived hydroxyapatite xenograft to enhance bony regeneration and promote tissue healing.     

Periodontitis and tissue regeneration

Chronic periodontitis is a destructive disease that affects the supporting structures of the teeth including periodontal ligament, cementum, and alveolar bone. If left untreated, patients may lose multiple teeth and extensive prosthetic treatment will be required. In order to re-engineer lost tooth-supporting tissues, various therapeutic modalities have been used clinically. Periodontal regeneration procedures including guided tissue regeneration have achieved substantial effects. However, there are several issues to be solved. They are highly technique-sensitive, applicable to limited cases which are susceptible to treatment, and supposed to have relatively low predictability. Therefore, it is necessary to develop new approaches to improve the predictability and effectiveness of regenerative therapies for periodontal tissues. Recently, the concept of tissue engineering has been introduced to restore lost tissues more effectively where the biological process of healing is mimicked. To achieve this, integration of three key elements is required: progenitor/stem cells, growth factors and the extracellular matrix scaffold. Although it has been shown that implantation of bone marrow-derived mesenchymal stem cells into periodontal osseous defects induced regeneration of cementum, periodontal ligament and alveolar bone in dogs, further extensive preclinical studies are required. On the other hand, application of growth factors, particularly basic fibroblast growth factor in the treatment of human periodontitis, is promising and is now in clinical trial. Furthermore, the rate of release of growth factor from the scaffold also can profoundly affect the results of tissue engineering strategies and the development of new materials is expected. In addition, as tissue regenerative potential is negatively regulated by aging, the effects of aging have to be clarified to gain complete regeneration.     

帐篷钉技术在牙槽骨修复与再生中的临床应用及操作规范

牙槽骨是牙医学的基础,牙槽骨缺损的修复与再生和口腔种植、口腔正畸、牙周及口腔修复等亚专业学科关系密切.因此,对牙槽骨进行有效的修复与重建具有重要的临床意义和社会效益.随着引导骨再生(guide bone regeneration,GBR)技术的发展,基于以"稳定为核心"的牙槽骨修复与再生理念,一种全新的骨增量技术快速发...     

牙槽骨发生的研究进展

牙槽骨再生是牙周组织疾病治疗的根本。牙槽骨发生属于膜内成骨,成骨细胞来源于多潜能神经嵴牙囊间质细胞,伴随着牙体的发生而发生。牙胚由成釉器、牙乳头和牙囊组成,而牙囊则形成牙骨质、牙周膜和牙槽骨。骨形态发生蛋白（BMP）可启动、促进和调节骨的发生、发育、生长、重塑和修复。核心结合因子l可使牙囊间质细胞向成骨细胞分化,对膜内成骨和软骨内成骨有控制作用。成纤维细胞生长因子通过调控骨干细胞复制,成骨细胞分化和程序性死亡,各种细胞及相关因子的表达来控制骨形成。WNT在BMP的刺激下促进成骨细胞分化,增强BMP诱导下的I型胶原、特殊骨基质蛋白和骨钙蛋白表达。声音刺猬蛋白、转化生长因子β和肌节同源盒蛋白2在牙槽骨和牙骨质中表达强烈,其基因突变可致牙槽骨丧失。本文就牙槽骨发生与牙囊间的关系以及参与牙槽骨发生的细胞因子等研究进展作一综述。     

Plasma Rich in Growth Factors Promotes Bone Tissue Regeneration by Stimulating Proliferation,Migration, and Autocrine Secretion in Primary Human Osteoblasts

Background: Alveolar bone loss can be a major clinical concern affecting both functionality and esthetics. Osteoblasts are the main cells charged with the repair and regeneration of missing bone tissue. Plasma rich in growth factors (PRGF) allows delivery of a cocktail of proteins and growth factors that promote wound healing and tissue regeneration to the site of injury. This study tests the effect of this endogenous regenerative technology to stimulate alveolar osteoblast bone‐forming potential. Methods: Primary human osteoblasts were retrieved from alveolar bone of patients undergoing oral surgery. Cell proliferation was evaluated, and culture inserts and permeable transwell supports were used to assess cell migration and chemotaxis. The expression of differentiation markers was quantified by enzyme‐linked immunosorbent assay. Results: PRGF succeeded in increasing proliferation, migration, and chemotaxis of osteoblasts. Also, PRGF significantly enhanced the autocrine expression of two relevant proangiogenic factors, vascular endothelial growth factor and hepatocyte growth factor, and three markers of osteoblastic activity, procollagen I, osteocalcin, and alkaline phosphatase. Conclusion: The results indicate that PRGF can stimulate some of the biologic processes of the main cells responsible for bone regeneration and help support the positive clinical outcomes that have been reported with this technology.     

Current concepts in periodontal bioengineering

Repair of tooth supporting alveolar bone defects caused by periodontal and peri-implant tissue destruction is a major goal of reconstructive therapy. Oral and craniofacial tissue engineering has been achieved with limited success by the utilization of a variety of approaches such as cell-occlusive barrier membranes, bone substitutes and autogenous block grafting techniques. Signaling molecules such as growth factors have been used to restore lost tooth support because of damage by periodontal disease or trauma. This paper will review emerging periodontal therapies in the areas of materials science, growth factor biology and cell/gene therapy. Several different polymer delivery systems that aid in the targeting of proteins, genes and cells to periodontal and peri-implant defects will be highlighted. Results from preclinical and clinical trials will be reviewed using the topical application of bone morphogenetic proteins (BMP-2 and BMP-7) and platelet-derived growth factor-BB (PDGF) for periodontal and peri-implant regeneration. The paper concludes with recent research on the use of ex vivo and in vivo gene delivery strategies via gene therapy vectors encoding growth promoting and inhibiting molecules (PDGF, BMP, noggin and others) to regenerate periodontal structures including bone, periodontal ligament and cementum.