Miron Richard J, Zhang Qiao, Sculean Anton, Buser Daniel, Pippenger Benjamin E, Dard Michel, Shirakata Yoshinori, Chandad Fatiha, Zhang Yufeng
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, People's Republic of China.
Faculté de Medecine Dentaire, Pavillon de Médecine Dentaire, Université de Laval, 2420 rue de la Terrasse, Québec, G1V 0A6, Canada.
Clin Oral Investig. 2016 Nov;20(8):2259-2265. doi: 10.1007/s00784-016-1724-4. Epub 2016 Jan 27.
Guided bone regeneration (GBR) aims to predictably restore missing bone that has been lost due to trauma, periodontal disease or a variety of systemic conditions. Critical to this procedure is the ability of a bone grafting material to predictably serve as a 3-dimensional scaffold capable of inducing cell and bone tissue in-growth at the material surface. Although all bone grafts are osteoconductive to bone-forming osteoblasts, only a small number of commercially available bone grafts with FDA approval are osteoinductive including demineralized freeze-dried bone allographs (DFDBA) and scaffolds containing bone morphogenetic proteins (BMPs). Recently, a class of synthetic bone grafts fabricated from biphasic calcium phosphate (BCP) sintered at a low temperature have been shown to form ectopic bone formation in non-skeletal sites without the use of growth factors. Therefore, the present study aimed to compare the osteoinductive potential of this group of synthetic BCP alloplasts with autografts, allografts and xenografts.
In the present study, 4 types of bone grafting materials including autogenous bone harvested with a bone mill, DFDBA (LifeNet, USA), a xenograft derived from bovine bone mineral (NBM, BioOss, Geistlich, Switzerland) and a novel synthetic biphasic calcium phosphate (BCP, Straumman, Switzerland) were implanted into intramuscular pouches of 24 rats and analysed histologically for their ability to form ectopic bone formation around grafting particles. A semi-quantitative osteoinductive score was used to quantify the osteoinductive ability of each bone graft.
The results from the present study reveal that (1) autogenous bone resorbed rapidly in vivo, (2) the xenograft showed no potential to form ectopic bone formation and (3) both DFDBA and BCP were able to stimulate ectopic bone formation.
These studies demonstrate that these newly developed synthetic bone grafts have potential for inducing ectopic bone formation similar to DFDBA. Future clinical testing is necessary to reveal their bone-inducing properties in clinical scenarios including GBR procedures and in combination with implant dentistry.
Novel BCP scaffolds are able to induce ectopic bone formation without the use of osteoinductive growth factors such as BMP2 and thus demonstrate a large clinical possibility to further enhance bone formation for a variety of clinical procedures.
引导骨再生（GBR）旨在可预测地修复因创伤、牙周病或多种全身性疾病而缺失的骨组织。该手术的关键在于骨移植材料能够可预测地作为三维支架，在材料表面诱导细胞和骨组织向内生长。尽管所有骨移植材料对成骨的成骨细胞都具有骨传导性，但只有少数获得美国食品药品监督管理局（FDA）批准的市售骨移植材料具有骨诱导性，包括脱矿冻干骨同种异体移植（DFDBA）和含有骨形态发生蛋白（BMP）的支架。最近，一类由低温烧结的双相磷酸钙（BCP）制成的合成骨移植材料已被证明在不使用生长因子的情况下，能在非骨骼部位形成异位骨。因此，本研究旨在比较这类合成BCP异体骨与自体骨、同种异体骨和异种骨的骨诱导潜力。
在本研究中，将4种骨移植材料植入24只大鼠的肌袋中，包括用骨磨采集的自体骨、DFDBA（美国LifeNet公司）、一种源自牛骨矿物质的异种骨（NBM，瑞士Geistlich公司的BioOss）和一种新型合成双相磷酸钙（BCP，瑞士Straumman公司），并对其在移植颗粒周围形成异位骨的能力进行组织学分析。采用半定量骨诱导评分来量化每种骨移植材料的骨诱导能力。
本研究结果表明：（1）自体骨在体内迅速吸收；（2）异种骨无形成异位骨的潜力；（3）DFDBA和BCP均能刺激异位骨形成。
这些研究表明，这些新开发的合成骨移植材料具有与DFDBA相似的诱导异位骨形成的潜力。未来有必要进行临床测试，以揭示它们在包括GBR手术以及与种植牙科联合应用等临床场景中的骨诱导特性。
新型BCP支架能够在不使用诸如BMP2等骨诱导生长因子的情况下诱导异位骨形成，因此在多种临床手术中进一步促进骨形成方面显示出巨大的临床应用潜力。
