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重组人骨形态发生蛋白-2固定的脱矿牙本质基质在骨移植中的愈合潜力评估

Evaluation of the Healing Potential of Demineralized Dentin Matrix Fixed with Recombinant Human Bone Morphogenetic Protein-2 in Bone Grafts.

作者信息

Kim Sang-Yun, Kim Young-Kyun, Park Yeoung-Hyun, Park Joo-Cheol, Ku Jeong-Kui, Um In-Woong, Kim Ji-Yun

机构信息

Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 82 Gumi-ro 173, 173beon-gil, Bundang-gu, Seongnam 13620, Korea.

Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea.

出版信息

Materials (Basel). 2017 Sep 7;10(9):1049. doi: 10.3390/ma10091049.

Abstract

We aimed to evaluate the efficacy of demineralized dentin matrix (DDM) fixed with recombinant human bone morphogenetic protein-2 (rhBMP-2) through an experimental and a clinical study. Unilateral upper second and third premolars of eight beagles were extracted. A mucoperiosteal flap was elevated around the extraction socket, and a bone defect was made using a surgical drill. Each DDM was fixed with rhBMP-2, and autogenous bone was grafted at the bone defect area with a collagenous membrane. The beagles were euthanized at two, four, eight, and 12 weeks after receiving the bone graft. Block specimens involving grafted bone and surrounding natural bone were extracted. A total of 23 patients who received bone grafts using human DDM fixed with rhBMP-2 (AutoBT BMP) with implant placements (36 implants; maxilla: 14, mandible: 22) were selected. The implant stability, marginal bone loss, and clinical outcome were evaluated. Three trephine cores were harvested fourmonths after bone grafting, and histologic examination was performed. In the histological evaluation performed four weeks after the bone graft, autogenous bone showed 52% new bone formation and DDM fixed with rhBMP-2 showed 33% new bone formation. Twelve weeks after the bone graft, autogenous bone showed 75% new bone formation and DDM fixed with rhBMP-2 showed 48% new bone formation. In the clinical study, favorable osseointegration was obtained in 35 out of 36 implant sites (one case of osseointegration failure). In all cases, severe complications were not observed. Histomorphometrically, new bone formation was observed in 14.98% of the cases. The residual DDM particles were 6.22%. AutoBT BMP provides good osteoinductive and osteoconductive potential and clinical efficacy.

摘要

我们旨在通过一项实验研究和一项临床研究,评估用重组人骨形态发生蛋白-2(rhBMP-2)固定的脱矿牙本质基质(DDM)的疗效。拔除8只比格犬的单侧上颌第二和第三前磨牙。在拔牙窝周围掀起黏骨膜瓣,并用手术钻制造骨缺损。将每个DDM用rhBMP-2固定,并在骨缺损区域用胶原膜移植自体骨。在接受骨移植后2周、4周、8周和12周对这些比格犬实施安乐死。提取包含移植骨和周围天然骨的块状标本。共选择了23例接受用rhBMP-2固定的人DDM(自体骨移植BMP)进行骨移植并植入种植体(36枚种植体;上颌:14枚,下颌:22枚)的患者。评估种植体稳定性、边缘骨丢失和临床结果。在骨移植4个月后采集3个环钻骨芯,并进行组织学检查。在骨移植后4周进行的组织学评估中,自体骨显示有52%的新骨形成,用rhBMP-2固定的DDM显示有33%的新骨形成。骨移植12周后,自体骨显示有75%的新骨形成,用rhBMP-2固定的DDM显示有48%的新骨形成。在临床研究中,36个种植位点中有35个获得了良好的骨整合(1例骨整合失败)。在所有病例中,均未观察到严重并发症。组织形态计量学分析显示,14.98%的病例有新骨形成。残留的DDM颗粒为6.22%。自体骨移植BMP具有良好的骨诱导和骨传导潜力及临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc7/5615704/6413103ad225/materials-10-01049-g001.jpg

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