Gruber Rudolf Matthias, Ludwig Arwed, Merten Hans-Albert, Pippig Susanne, Kramer Franz-Josef, Schliephake Henning
Department of Oral and Maxillofacial Surgery, Georgia Augusta University, Goettingen, Germany.
Clin Oral Implants Res. 2009 Feb;20(2):175-82. doi: 10.1111/j.1600-0501.2008.01628.x. Epub 2008 Dec 1.
The aim of this study was to test the hypothesis that recombinant human growth and differentiation factor-5 (rhGDF-5) in combination with a beta-tricalcium phosphate (beta-TCP) scaffold material results in superior bone formation in sinus floor augmentations in miniature pigs compared with a particulated autogenous bone graft combined with the scaffold material.
Six adult female Goettingen minipigs underwent a maxillary sinus floor augmentation procedure. In a split-mouth design, the sinus floors were augmented with beta-TCP mixed with autogenous cortical bone chips, in a ratio of approximately 1 : 1, on one side. The contralateral test site was augmented using beta-TCP coated with two concentrations of rhGDF-5 (400 microg rhGDF-5/g beta-TCP or 800 microg rhGDF-5/g beta-TCP; three animals in each case). Simultaneously, one dental implant was inserted into each sinus floor augmentation. After 12 weeks, a histological and histomorphometric assessment of non-decalcified histological specimens was made.
There were significantly higher mean values of volume density of newly formed bone using beta-TCP coated with two concentrations of rhGDF-5 (400 microg: 32.9%; 800 microg: 23.9%) than with the corresponding control (autogenous bone/beta-TCP) (14.6%, 12.9%) (P=0.012, P=0.049). The bone-to-implant contact rates (BIC) were significantly enhanced in test sites (400 microg: 84.2%; 800 microg: 69.8%) compared with the corresponding control sites (24.8%, 40.8%) (P=.027, P=.045).
rhGDF-5 delivered on beta-TCP significantly enhanced bone formation compared with beta-TCP combined with autogenous bone in sinus lift procedures in miniature pigs.
本研究旨在验证以下假设:与颗粒状自体骨移植联合支架材料相比,重组人生长分化因子-5(rhGDF-5)与β-磷酸三钙(β-TCP)支架材料联合应用于小型猪的上颌窦底提升术中,能实现更优的骨形成。
6只成年雌性哥廷根小型猪接受了上颌窦底提升手术。采用双侧对照设计,一侧上颌窦底用β-TCP与自体皮质骨屑按约1:1比例混合进行提升。对侧试验部位使用涂有两种浓度rhGDF-5(400μg rhGDF-5/g β-TCP或800μg rhGDF-5/g β-TCP;每种浓度各3只动物)的β-TCP进行提升。同时,在每个上颌窦底提升部位植入一枚牙种植体。12周后,对未脱钙组织学标本进行组织学和组织形态计量学评估。
涂有两种浓度rhGDF-5的β-TCP(400μg:32.9%;800μg:23.9%)新形成骨的体积密度平均值显著高于相应对照组(自体骨/β-TCP)(14.6%,12.9%)(P=0.012,P=0.049)。与相应对照部位(24.8%,40.8%)相比,试验部位的骨与种植体接触率(BIC)显著提高(400μg:84.2%;800μg:69.8%)(P=0.027,P=0.045)。
在小型猪的上颌窦提升手术中,与β-TCP联合自体骨相比,β-TCP负载rhGDF-5能显著增强骨形成。