Department of Oral & Maxillofacial Surgery, Division of Implant Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Craniofacial Sciences, Division of Oral & Maxillofacial Surgery, School of Dental Medicine, University of Connecticut, Farmington, CT, USA.
Clin Oral Implants Res. 2017 Nov;28(11):1411-1420. doi: 10.1111/clr.13005. Epub 2017 Mar 9.
To evaluate the efficacy of various scaffold systems and a Ti scaffold-retaining device with and without non-glycosylated rhBMP-2 (BMP-2) for increasing the vertical alveolar bone growth in the intra-oral mini-pig model.
Forty-eight Straumann Bone Level implants with hydrophilic (SLActive) surfaces were partially embedded in mandibles of 12 adult mini-pigs with the shoulder of the implant located 3 mm above the bone crest. Twenty-four implants were placed in conjunction with BMP-2 (50 μg) incorporated within resorbable scaffolds. Twenty-four additional control implants were placed with scaffolds only. Scaffolds were placed around the implant and stabilized with a newly developed Ti "umbrella" scaffold retainer. Scaffolds included (i) HA-coated collagen (Healos); (ii) biphasic HA/β-TCP crystals (Straumann Bone Ceramic, SBC); and (iii) SBC crystals infused with polyethylene glycol (PEG) hydrogel. Eight test and control pairs for each scaffold group were implanted. At 9 weeks, soft tissue healing was assessed and the extent of new vertical bone was evaluated with microCT and histomorphometry.
microCT analysis revealed a mean of 167 ± 47 mm new supracrestal mineralized tissue volume formation around the test sites where BMP-2 was released from the scaffold whereas the control group (no BMP-2) showed a significantly lower mineralized tissue volume of 106 ± 55 mm . The SBC+BMP-2 group had the highest mineralized tissue volume of 189 ± 36 mm . Histomorphometry showed bone-to-implant contact of 54.5% for the test groups and 33.3% for the control groups and new vertical bone growth of 2.2 ± 1.0 and 1.0 ± 0.9 mm, respectively. The SBC+BMP-2 group again demonstrated the best outcome (2.7 ± 0.4 mm). The qualitative scoring of soft tissue dehiscence showed that the presence of BMP-2 yielded far superior outcomes, 0.63 vs. 1.75 for all control implant sites (with scores ranging from 0, reflecting no soft dehiscence, to 4, showing a completely exposed umbrella).
The release of BMP-2 from a SBC scaffold adjacent to a hydrophilic, rough Ti implant and scaffold retention umbrella consistently regenerated the greatest volume and height of new vertical bone along the length of the implant.
评估不同支架系统和钛支架保留装置在有和没有非糖基化 rhBMP-2（BMP-2）的情况下对内口腔小型猪模型中增加牙槽骨垂直生长的疗效。
将 48 个表面亲水的 Straumann 骨水平植入物（SLActive）部分嵌入 12 只成年小型猪的下颌骨中，植入物的肩部位于骨嵴上方 3mm 处。24 个植入物与包含可吸收支架的 BMP-2（50μg）一起放置。另外 24 个对照植入物仅与支架一起放置。支架放置在植入物周围，并使用新开发的钛“伞”支架固定器稳定。支架包括（i）HA 涂层胶原（Healos）；（ii）双相 HA/β-TCP 晶体（Straumann Bone Ceramic，SBC）；和（iii）SBC 晶体注入聚乙二醇（PEG）水凝胶。每个支架组各有 8 个测试和对照对。在 9 周时，评估软组织愈合情况，并使用 microCT 和组织形态计量学评估新的垂直骨的程度。
microCT 分析显示，支架释放 BMP-2的测试部位周围有 167±47mm³新的超骨嵴矿化组织体积形成，而对照组（无 BMP-2）显示出明显较低的矿化组织体积 106±55mm³。SBC+BMP-2 组的矿化组织体积最高，为 189±36mm³。组织形态计量学显示，测试组的骨-种植体接触率为 54.5%，对照组为 33.3%，新的垂直骨生长分别为 2.2±1.0 和 1.0±0.9mm。SBC+BMP-2 组再次表现出最佳结果（2.7±0.4mm）。软组织裂开的定性评分显示，BMP-2 的存在产生了更好的结果，所有对照植入物部位的评分分别为 0.63 对 1.75（评分范围从 0 表示无软组织裂开，到 4 表示完全暴露的伞）。
SBC 支架在亲水粗糙 Ti 植入物和支架保留伞旁释放 BMP-2 可始终再生最大体积和高度的新垂直骨，沿植入物长度生长。
