Faculty of Dentistry, Thammasat University, Pathumthani, Thailand.
Centre for Oral Immunobiology and Regenerative Medicine & Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Turner Street, London, E1 2AD, UK.
Clin Oral Investig. 2019 Aug;23(8):3307-3318. doi: 10.1007/s00784-018-2752-z. Epub 2018 Nov 29.
To describe changes in growth factor mediators in the gingival crevicular fluid (GCF) of patients with aggressive periodontitis (AgP) undergoing regenerative (GTR) and access flap (AF) surgery.
This was a 12-month, single-blind, split-mouth RCT involving 18 AgP patients with a bilateral intrabony defect which was treated with GTR or AF. GCF was collected prior to surgery and at subsequent follow-up visits from 3 days to 12 months post-operatively, and the levels of angiopoietin-1 (Ang-1), vascular-endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), bone morphogenetic protein-2 (BMP-2), osteoprotegerin (OPG), tissue inhibitor of metalloproteinase 1 (TIMP-1), keratinocyte growth factor (KGF) and platelet-derived growth factor-AB (PDGF-AB) were measured. At baseline, 6 and 12 months post-surgery, periodontal clinical parameters were evaluated. ANOVA was applied to test for differences in the amount of mediators (p < 0.05).
Higher amounts of BMP-2 and OPG and a higher area under the curve (AUC) of KGF at the GTR versus AF sites were observed. The maximum change in the amount of KGF correlated significantly with periodontal clinical parameters at the GTR sites at 6 and 12 months. The AUC over 30 days of the amount of Ang-1, VEGF and KGF significantly correlated with periodontal clinical parameters at the AF sites at 6 months.
AF and GTR differentially affected the profile of the growth mediators in GCF, and significant correlations between certain GCF mediators and periodontal clinical outcomes were identified.
GCF components represent attractive prognostic markers for periodontal tissues undergoing repair or regeneration. However, the available evidence is not robust enough to suggest the use of a specific marker, and future adequately powered studies are warranted to identify the most relevant mediators that could be applied in clinical practice.
描述侵袭性牙周炎（AgP）患者接受再生（GTR）和翻瓣（AF）手术时龈沟液（GCF）中生长因子介质的变化。
这是一项为期 12 个月、单盲、双侧随机对照研究，共纳入 18 名双侧骨内缺损的 AgP 患者，分别接受 GTR 或 AF 治疗。在手术前和术后 3 天至 12 个月的随访中收集 GCF，并测量血管生成素-1（Ang-1）、血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）、骨形态发生蛋白-2（BMP-2）、护骨素（OPG）、基质金属蛋白酶抑制剂-1（TIMP-1）、角质细胞生长因子（KGF）和血小板衍生生长因子-AB（PDGF-AB）的水平。在基线、术后 6 个月和 12 个月时，评估牙周临床参数。应用方差分析（ANOVA）检验介质量的差异（p<0.05）。
在 GTR 部位观察到 BMP-2 和 OPG 含量较高，KGF 的曲线下面积（AUC）较高。GTR 部位 KGF 含量的最大变化与 6 个月和 12 个月时的牙周临床参数显著相关。6 个月时，30 天内 Ang-1、VEGF 和 KGF 量的 AUC 与 AF 部位的牙周临床参数显著相关。
AF 和 GTR 对 GCF 中生长因子谱的影响不同，并且确定了某些 GCF 介质与牙周临床结果之间的显著相关性。
GCF 成分代表修复或再生过程中牙周组织的有吸引力的预后标志物。然而，现有证据还不够充分，无法建议使用特定的标志物，需要进行未来足够强大的研究来确定最相关的介质，这些介质可以应用于临床实践。
