Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Polymer Chemistry Division, Chemical Resources Laboratory, Tokyo Institute of Technology, Kanagawa, Japan.
J Periodontal Res. 2017 Oct;52(5):863-871. doi: 10.1111/jre.12456. Epub 2017 Mar 27.
Tissue engineering by using recombinant human (rh) growth factor technology may offer a promising therapeutic approach for treatment of gingival recession. Fibroblast growth factor-2 (FGF-2) has shown the ability to promote periodontal regeneration. Gelatin/beta-tricalcium phosphate (gelatin/β-TCP) sponges have been developed to control the release of growth factors. The present study evaluated the periodontal regenerative efficacy of rhFGF-2 by comparing gelatin/β-TCP sponges incorporated with rhFGF-2 to the scaffolds alone in artificially created recession-type defects in dogs.
Critically sized buccal gingival recession defects were surgically created on maxillary canine teeth of five dogs. In each animal, defects were randomized to receive either a gelatin/β-TCP sponge soaked with rhFGF-2 (gelatin/β-TCP/rhFGF-2) or phosphate-buffered saline (gelatin/β-TCP). Eight weeks after surgery, biopsy specimens were obtained and subjected to microcomputed tomography and histological analyses.
Complete root coverage was achieved in both groups. Microcomputed tomography revealed significantly greater new bone volume in the gelatin/β-TCP/rhFGF-2 group. Histologically, both groups achieved periodontal regeneration; however, gelatin/β-TCP/rhFGF-2 sites exhibited more tissue regeneration, characterized by significantly larger amounts of new cementum and new bone. Gelatin/β-TCP sites featured increased long junctional epithelium and connective tissue attachment. In the gelatin/β-TCP/rhFGF-2 sites, new bone exhibited many haversian canals and circumferential lamellae as well as remarkably thick periosteum with blood vascularization and hypercellularity.
Within the limitations of this study, rhFGF-2 in gelatin/β-TCP sponges exhibits an increased potential to support periodontal wound healing/regeneration in canine recession-type defects.
利用重组人(rh)生长因子技术进行组织工程可能为治疗牙龈退缩提供一种有前途的治疗方法。成纤维细胞生长因子-2(FGF-2)已显示出促进牙周再生的能力。明胶/β-磷酸三钙(gelatin/β-TCP)海绵已被开发出来以控制生长因子的释放。本研究通过比较载有人 rhFGF-2 的明胶/β-TCP 海绵与单独的支架在犬人工创建的退缩型缺陷中的牙周再生效果,评估 rhFGF-2 的牙周再生效果。
在 5 只犬的上颌犬牙上,通过手术创建临界大小的颊侧龈退缩缺损。在每种动物中,将缺陷随机分为接受载有人 rhFGF-2 的明胶/β-TCP 海绵(gelatin/β-TCP/rhFGF-2)或磷酸盐缓冲盐水(gelatin/β-TCP)治疗的两组。手术后 8 周,获取活检标本,并进行微计算机断层扫描和组织学分析。
两组均实现了完全的根覆盖。微计算机断层扫描显示载有人 rhFGF-2 的明胶/β-TCP/rhFGF-2 组的新骨体积明显更大。组织学上,两组均实现了牙周再生;然而,载有人 rhFGF-2 的明胶/β-TCP/rhFGF-2 组表现出更多的组织再生,其特征是新牙骨质和新骨的含量明显更大。明胶/β-TCP 组表现出增加的长结合上皮和连接组织附着。在载有人 rhFGF-2 的明胶/β-TCP/rhFGF-2 组中,新骨表现出许多哈弗斯管和环形板,以及具有丰富血管化和细胞增生的显著增厚的骨膜。
在本研究的限制范围内,载有人 rhFGF-2 的明胶/β-TCP 海绵在犬退缩型缺陷中具有增加的支持牙周伤口愈合/再生的潜力。