Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany.
Int J Oral Maxillofac Surg. 2020 Jan;49(1):135-142. doi: 10.1016/j.ijom.2019.04.005. Epub 2019 May 1.
The in vivo regeneration of bone flaps might be an alternative to autogenous bone grafting. The first human case of mandibular reconstruction using the greater omentum as a bioreactor was reported in 2016. However, whether engineered bone will support the osseointegration of dental implants has not yet been investigated. In this study, bone tissue engineering was performed in the greater omentum of nine miniature pigs using bone morphogenetic protein 2, bone marrow aspirate, and three different scaffolds: hydroxyapatite, biphasic calcium phosphate (BCP), and titanium. After 8 weeks, two implants were placed in each scaffold; after another 8 weeks, the bone blocks were harvested for radiographic, histological, and histomorphometric analysis. All implants exhibited sufficient primary stability, and the success rate was 100%. The bone-to-implant contact ratios (BICs) were 38.2%, 68.5%, and 42.9%; the inter-thread bone densities were 29.4%, 64.9%, and 33.5%; and the peri-implant bone-scaffold densities were 56.4%, 87.6%, and 68.6% in the hydroxyapatite, BCP, and titanium groups, respectively. The BIC showed a strong correlation (r = 0.76) with the peri-implant bone-scaffold density. This study shows that de novo engineered bone leads to successful osseointegration and therefore may allow implant-based prosthodontic rehabilitation.
骨瓣的体内再生可能是自体骨移植的一种替代方法。2016 年首次报道了使用大网膜作为生物反应器进行下颌骨重建的首例人类病例。然而，工程化骨是否能支持牙种植体的骨整合尚未得到研究。在这项研究中，使用骨形成蛋白 2、骨髓抽吸液和三种不同的支架（羟基磷灰石、双相磷酸钙和钛）在 9 头小型猪的大网膜中进行了骨组织工程。8 周后，每个支架中植入 2 个种植体；8 周后，取出骨块进行放射学、组织学和组织形态计量学分析。所有种植体均表现出足够的初始稳定性，成功率为 100%。骨-种植体接触比（BIC）分别为 38.2%、68.5%和 42.9%；螺纹间骨密度分别为 29.4%、64.9%和 33.5%；种植体周围骨-支架密度分别为 56.4%、87.6%和 68.6%，羟基磷灰石、双相磷酸钙和钛组。BIC 与种植体周围骨-支架密度呈强相关性（r=0.76）。本研究表明，新形成的工程化骨可导致成功的骨整合，因此可能允许基于植入物的修复体修复。
