Dhawan Shivani, Dhawan Rajan, Gill Amarjit Singh, Sikri Poonam
Department of Periodontology, National Dental College and Hospital, Derabassi, India.
Indian J Dent Res. 2010 Oct-Dec;21(4):557-63. doi: 10.4103/0970-9290.74220.
Experimentation confirmed the conclusion that bone allografts, like other tissue and organ allografts, are immunogenic. These immune responses cause resorption of allograft, thus lowering the bone formation capacity of the graft. An attempt has been made in this study to prevent immune reactions and achieve enhanced regeneration of allograft-demineralized freeze-dried bone matrix by incorporating it with an immunosuppressive drug Cyclosporine-A (CsA) in the treatment of human periodontal infrabony defects.
Fifteen patients showing clinical evidence of almost bilateral infrabony defects requiring bone grafting procedures were selected. In each patient, the infrabony defect of one side of the arch was designated as Group A (control site) and the infrabony defect of the contralateral side of the same arch was designated as Group B (test site).
On comparative evaluation of the two groups (by Student t-test), the mean values of reduction in probing depth (P=0.81 NS ) and gain in clinical attachment level (P=1.00 NS ) of Group B were found to be greater than that of Group-A, but the differences were statistically non-significant. The mean linear bone fill (P=0.010 FNx08 ) of Group B was also detected to be higher than that of Group A, and the difference was found to be statistically significant.
Increase in linear bone fill in Group B signifies the role of CsA in augmenting the regenerative potential of allograft by eliminating immune reactions.
实验证实了同种异体骨移植与其他组织和器官同种异体移植一样具有免疫原性这一结论。这些免疫反应会导致同种异体骨吸收,从而降低移植骨的骨形成能力。本研究尝试通过将免疫抑制药物环孢素A(CsA)与同种异体脱矿冻干骨基质结合,用于治疗人类牙周骨下缺损,以预防免疫反应并增强同种异体骨的再生能力。
选取15例有双侧骨下缺损临床证据且需要进行骨移植手术的患者。在每位患者中,牙弓一侧的骨下缺损被指定为A组(对照部位),同一牙弓对侧的骨下缺损被指定为B组(试验部位)。
通过两组对比评估(采用学生t检验),发现B组的探诊深度减少平均值(P = 0.81,无统计学意义)和临床附着水平增加平均值(P = 1.00,无统计学意义)均高于A组,但差异无统计学意义。还检测到B组的平均线性骨填充(P = 0.010)高于A组,且差异具有统计学意义。
B组线性骨填充的增加表明CsA通过消除免疫反应增强同种异体骨再生潜力的作用。