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使用重组人生长/分化因子-5(rhGDF-5)涂层种植体进行牙槽嵴增高术。影像学观察。

Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor -5 (rhGDF-5). Radiographic observations.

作者信息

Leknes Knut N, Yang Jie, Qahash Mohammed, Polimeni Giuseppe, Susin Cristiano, Wikesjö Ulf M E

机构信息

Department of Clinical Dentistry - Periodontology, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.

出版信息

Clin Oral Implants Res. 2013 Nov;24(11):1185-91. doi: 10.1111/j.1600-0501.2012.02564.x. Epub 2012 Aug 6.

Abstract

OBJECTIVES

Application of growth factors onto dental implant surfaces is being considered to support local bone formation. Bone morphogenetic protein-2 (BMP-2) and BMP-7 have been shown to support local bone formation, but are also associated with adverse events including seroma formation, extensive bone remodeling, and implant displacement captured in the radiographic evaluation. This report presents mineralized tissue formation and associated adverse events following implantation of recombinant human growth/differentiation factor-5 (rhGDF-5) coated onto a purpose-designed titanium porous-oxide implant surface.

MATERIAL AND METHODS

Twelve young adult Labrador dogs were used. Three 10-mm titanium implants/jaw quadrant were placed 5 mm into the alveolar ridge in the posterior mandible following surgical extraction of the premolar teeth and reduction of the alveolar ridge. Six animals received implants coated with rhGDF-5 at 30 or 60 μg/implant in contralateral jaw quadrants. Six animals received implants coated with rhGDF-5 at 120 μg/implant or uncoated implants (sham-surgery control) using the same split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic recordings were made immediately postsurgery (baseline), and at week 4 and 8 (end of study). Two masked examiners performed the analysis using computer enhanced radiographic images.

RESULTS

rhGDF-5 coated implants displayed mineralized tissue formation significantly exceeding that of the sham-surgery control in a dose-dependent order. The greatest increase was observed for implants coated with rhGDF-5 at 60 μg and 120 μg amounting to approximately 2.2 mm for both groups at 8 weeks. Importantly, none of the implants showed evidence of peri-implant bone remodeling, implant displacement, or seroma formation. The newly formed mineralized tissues assumed characteristics of the resident bone.

CONCLUSIONS

rhGDF-5 coated onto a titanium porous-oxide implant surface exhibits a dose-dependent potential to stimulate local mineralized tissue formation. Application of rhGDF-5 appears safe as it is associated with limited, if any, adverse events.

摘要

目的

人们正在考虑将生长因子应用于牙种植体表面以支持局部骨形成。骨形态发生蛋白-2(BMP-2)和BMP-7已被证明可支持局部骨形成,但也与不良事件相关,包括血清肿形成、广泛的骨重塑以及在影像学评估中发现的种植体移位。本报告介绍了涂覆在专门设计的钛多孔氧化物种植体表面的重组人生长/分化因子-5(rhGDF-5)植入后矿化组织的形成及相关不良事件。

材料与方法

使用12只成年拉布拉多犬。在拔除前磨牙并降低牙槽嵴高度后,将3枚10毫米的钛种植体/颌骨象限植入下颌后部牙槽嵴内5毫米处。6只动物在对侧颌骨象限接受涂有30或60μg/种植体rhGDF-5的种植体。另外6只动物使用相同的分口设计,接受涂有120μg/种植体rhGDF-5的种植体或未涂覆的种植体(假手术对照)。推进、贴合并缝合粘骨膜瓣以将种植体埋入。在术后立即(基线)以及第4周和第8周(研究结束时)进行影像学记录。两名盲法检查者使用计算机增强的影像学图像进行分析。

结果

涂有rhGDF-5的种植体显示矿化组织形成明显超过假手术对照,且呈剂量依赖性。在8周时,涂有60μg和120μg rhGDF-5的种植体增加最为显著,两组均约为2.2毫米。重要的是,没有种植体显示出种植体周围骨重塑、种植体移位或血清肿形成的迹象。新形成的矿化组织具有宿主骨的特征。

结论

涂覆在钛多孔氧化物种植体表面的rhGDF-5具有剂量依赖性刺激局部矿化组织形成的潜力。rhGDF-5的应用似乎是安全的,因为即使有不良事件,其关联性也有限。

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