Schultze-Mosgau S, Wehrhan F, Wichmann M, Schlegel K A, Holst S, Thorwarth M
Department of Oral and Maxillofacial Surgery/Plastic Surgery, University of Jena, Germany.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 May;101(5):565-71. doi: 10.1016/j.tripleo.2005.07.037. Epub 2006 Feb 21.
Overexpression of inflammatory cytokines interleukin 1-beta (IL-1beta), transforming growth factor beta-1 (TGF-beta1), and vascular endothelial growth factor (VEGF) may cause healing impairment following implant insertion, jeopardizing success especially in patients previously irradiated. Limited data is available regarding expression pattern of inflammatory cytokines in peri-implant soft tissue caused by the surgical intervention itself.
This study examined 21 patients receiving dental implants. Biopsies of peri-implant tissue were harvested at re-entry 4 months after initial surgery. Eight patients underwent probing of untreated mucosa. Three groups were created (group 1: regular peri-implant mucosa; group 2: patients with irradiated peri-implant mucosa, radiation treatment due to oral squamous cell cancer; group 3: control). Immunohistochemical staining was performed for TGFss1, IL-1ss, and VEGF.
Following the placement of dental implants (group 1 vs group 3) a significant increase (P > .05) in TGF-beta1, IL-1beta, and VEGF expression in the peri-implant mucosa was demonstrated. No alteration of this distinct pattern was found for previously irradiated tissue (group 1 vs. group 2).
The study highlights the fundamental involvement of TGF-beta1, IL-1beta, and VEGF during the regeneration of peri-implant soft tissue structures. The use of extended interim solutions may be one clinical implication of these prolonged tissue remodeling processes.
炎性细胞因子白细胞介素1β(IL-1β)、转化生长因子β1(TGF-β1)和血管内皮生长因子(VEGF)的过度表达可能导致种植体植入后愈合受损,尤其在既往接受过放疗的患者中会危及种植成功。关于手术干预本身导致的种植体周围软组织中炎性细胞因子表达模式的数据有限。
本研究检查了21例接受牙种植体的患者。在初次手术后4个月再次切开时获取种植体周围组织活检样本。8例患者对未处理的黏膜进行探查。分为三组(第1组:正常种植体周围黏膜;第2组:种植体周围黏膜接受过放疗的患者,因口腔鳞状细胞癌接受放疗;第3组:对照组)。对TGF-β1、IL-1β和VEGF进行免疫组织化学染色。
牙种植体植入后(第1组与第3组相比),种植体周围黏膜中TGF-β1、IL-1β和VEGF表达显著增加(P>.05)。对于既往接受过放疗的组织(第1组与第2组相比),未发现这种独特模式有改变。
本研究强调了TGF-β1、IL-1β和VEGF在种植体周围软组织结构再生过程中的重要作用。采用延长的临时解决方案可能是这些延长的组织重塑过程的一个临床意义。