Sawada Kosaku, Fujioka-Kobayashi Masako, Kobayashi Eizaburo, Schaller Benoit, Miron Richard J
Resident, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland; and Nippon Dental University, School of Life Dentistry at Niigata, Advanced Research Center, Niigata, Japan.
Resident, Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern, Bern, Switzerland.
J Oral Maxillofac Surg. 2016 Feb;74(2):247-54. doi: 10.1016/j.joms.2015.09.029. Epub 2015 Oct 3.
Antiseptic solutions are commonly used in dentistry for a number of sterilization procedures, including harvesting of bone chips, irrigation of extraction sockets, and sterilization of osteonecrotic bone. Despite its widespread use, little information is available regarding the effects of various antiseptic solutions on bone cell viability, morphology, and the release of growth factors.
The antiseptic solutions included 1) 0.5% povidone iodine (PI), 2) 0.2% chlorhexidine diguluconate (CHX), 3) 1% hydrogen peroxide (H2O2), and 4) 0.25% sodium hypochlorite (HYP). Bone samples collected from porcine mandibular cortical bone were rinsed in the antiseptic solutions for 10 minutes and assessed for cell viability using an MTS assay and protein release of transforming growth factor (TGF-β1), bone morphogenetic protein 2 (BMP2), vascular endothelial growth factor (VEGF), interleukin (IL)-1β, and receptor activator of nuclear factor κB ligand (RANKL) using an enzyme-linked immunosorbent assay at 15 minutes and 4 hours after rinsing.
After antiseptic rinsing, changes to the surface protein content showed marked alterations, with an abundant protein layer remaining on CHX-rinsed bone samples. The amount of surface protein content gradually decreased in the following order: CHX, H2O2, PI, and HYP. A similar trend was also observed for the relative cell viability from within bone samples after rinsing, with up to 6 times more viable cells found in the CHX-rinsed bone samples than in the HYP- and PI-rinsed samples. An analysis of the growth factors found that both HYP and PI had significantly lower VEGF and TGF-β1 protein release from bone samples at 15 minutes and 4 hours after rinsing compared with CHX and H2O2. A similar trend was observed for RANKL and IL-1β protein release, although no change was observed for BMP2.
The results from the present study have demonstrated that antiseptic solutions present with very different effects on bone samples after 10 minutes of rinsing. Rinsing with CHX maintained significantly higher cell viability and protein release of growth factors potent to the bone remodeling cycle.
抗菌溶液常用于牙科的多种消毒程序，包括采集骨屑、冲洗拔牙窝以及坏死骨的消毒。尽管其应用广泛，但关于各种抗菌溶液对骨细胞活力、形态以及生长因子释放的影响，目前可用信息较少。
抗菌溶液包括：1）0.5%聚维酮碘（PI）；2）0.2%葡萄糖酸洗必泰（CHX）；3）1%过氧化氢（H2O2）；4）0.25%次氯酸钠（HYP）。从猪下颌骨皮质骨采集的骨样本在抗菌溶液中冲洗10分钟，然后使用MTS法评估细胞活力，并在冲洗后15分钟和4小时使用酶联免疫吸附测定法检测骨形态发生蛋白2（BMP2）、转化生长因子（TGF-β1）、血管内皮生长因子（VEGF）、白细胞介素（IL）-1β和核因子κB受体活化因子配体（RANKL）的蛋白质释放情况。
抗菌冲洗后，表面蛋白含量发生显著变化，CHX冲洗后的骨样本上残留有丰富的蛋白层。表面蛋白含量按以下顺序逐渐降低：CHX、H2O2、PI、HYP。冲洗后骨样本内相对细胞活力也呈现类似趋势，CHX冲洗后的骨样本中活细胞数量比HYP和PI冲洗后的样本多6倍。对生长因子的分析发现，与CHX和H2O2相比，HYP和PI冲洗后15分钟和4小时时，骨样本中VEGF和TGF-β1的蛋白质释放显著降低。RANKL和IL-1β的蛋白质释放也呈现类似趋势，不过BMP2未观察到变化。
本研究结果表明，冲洗10分钟后，抗菌溶液对骨样本的影响差异很大。用CHX冲洗可显著提高细胞活力以及对骨重塑周期有重要作用的生长因子的蛋白质释放。
