重组人生长/分化因子-5（rhGDF-5）对屏障膜保护的钛牙种植体周围骨再生的影响：一项在比格犬下颌骨的初步研究。

The effects of recombinant human growth/differentiation factor-5 (rhGDF-5) on bone regeneration around titanium dental implants in barrier membrane-protected defects: a pilot study in the mandible of beagle dogs.

作者信息

Weng Dietmar, Poehling Sylke, Pippig Susanne, Bell Matthias, Richter Ernst-Jürgen, Zuhr Otto, Hürzeler Markus B

机构信息

Department of Prosthodontics, School of Dental Medicine, Bavarian Julius-Maximilians-University, Würzburg, Germany.

出版信息

Int J Oral Maxillofac Implants. 2009 Jan-Feb;24(1):31-7.

PMID:19344022

Abstract

PURPOSE

This dog study sought to evaluate guided bone regeneration (GBR) in peri-implant defects following implantation of beta-tricalcium phosphate (beta-TCP) with and without osteoinductive recombinant human growth/differentiation factor-5 (rhGDF-5).

MATERIALS AND METHODS

In five beagle dogs, all mandibular premolars and the first molar were extracted. After 2 months, six buccolingual critical-size defects were created, and an implant was inserted into the center of each defect. One defect was filled with beta-TCP coated with rhGDF-5 (600 microg/g beta-TCP) and covered with a titanium-reinforced e-PTFE membrane (GDF group). A second defect received the same treatment, but pure uncoated beta-TCP was used (TCP group). A third defect was filled with beta-TCP mixed with autograft and not protected with a membrane (control group). The remaining three defects were filled with other biomaterials. After 2 months, total new bone area, regenerated bone height, and residual amount of beta-TCP were determined histomorphometrically.

RESULTS

All implants osseointegrated. One membrane in each group became exposed. Mean new bone area for GDF, TCP, and control sites was 43.9 +/- 18.7 mm2, 32.3 +/- 16.1 mm2, and 13.1 +/- 4.0 mm2, respectively, with a significant difference between GDF and control groups. Mean regenerated bone height was 103.8 +/- 29.7%, 75.4 +/- 36.6%, and 67.2 +/- 19.1% for the GDF, TCP, and control groups, respectively. Mean residual matrix volumes were 25.9 +/- 13.6%, 30.0 +/- 13.0%, and 13.4 +/- 6.5%, respectively. Membrane protection of peri-implant defects filled with beta-TCP resulted in a stronger effect on bone regeneration, although this was not statistically significant. The most pronounced regenerative results were achieved in rhGDF-5/beta-TCP filled membrane-protected defects.

CONCLUSION

Delivery of rhGDF-5 on beta-TCP might have the potential to enhance the results of GBR in peri-implant defects.

摘要

目的

本犬类研究旨在评估在植入含或不含骨诱导性重组人生长/分化因子-5（rhGDF-5）的β-磷酸三钙（β-TCP）后，种植体周围缺损处引导骨再生（GBR）的情况。

材料与方法

选取5只比格犬，拔除所有下颌前磨牙和第一磨牙。2个月后，制造6个颊舌向临界尺寸缺损，并在每个缺损中心植入一枚种植体。一个缺损用涂有rhGDF-5（600微克/克β-TCP）的β-TCP填充，并用钛增强e-PTFE膜覆盖（GDF组）。第二个缺损接受相同处理，但使用的是纯未涂层β-TCP（TCP组）。第三个缺损用β-TCP与自体骨混合填充，未用膜保护（对照组）。其余三个缺损用其他生物材料填充。2个月后，通过组织形态计量学测定总新骨面积、再生骨高度和β-TCP的残留量。

结果

所有种植体均实现骨整合。每组各有一张膜暴露。GDF组、TCP组和对照组的平均新骨面积分别为43.9±18.7平方毫米、32.3±16.1平方毫米和13.1±4.0平方毫米，GDF组和对照组之间存在显著差异。GDF组、TCP组和对照组的平均再生骨高度分别为103.8±29.7%、75.4±36.6%和67.2±19.1%。平均残留基质体积分别为25.9±13.6%、30.0±13.0%和13.4±6.5%。用β-TCP填充的种植体周围缺损的膜保护对骨再生有更强的作用，尽管这在统计学上不显著。在rhGDF-5/β-TCP填充的膜保护缺损处获得了最显著的再生结果。