Stoetzer Marcus, Alevizakos Vasilios, Rahlf Björn, Gellrich Nils-Claudius, Kampmann Andreas, von See Constantin
Hanover Medical School, Hanover, Germany.
Danube Private University, Center for Digital Technologies in Dentistry and CAD/CAM, Krems an der Donau, Austria.
J Oral Implantol. 2019 Oct;45(5):356-361. doi: 10.1563/aaid-joi-D-19-00050. Epub 2019 Sep 19.
Many animal studies show that an intact periosteum plays an important role in osseous regeneration. The potential effect of an in vivo periosteal barrier membrane on the expression of specific proteins has not been examined sufficiently. The aim of the present study is to investigate the influence of the flap preparation method and collagen membrane on the emission of inflammatory factors. This study examines 20 patients with dental implants who had previously undergone an augmentation. A soft tissue sample was taken during augmentation and 3 months later from the same location. Samples were always taken from the margins of a previously prepared mucoperiosteal flap. The flap was raised with a conventional periosteal elevator in the control group and with a piezoelectric device in the test group. In both groups, we covered half of the augmented bone with a native collagen membrane (NCM; Geistlich Bio-Gide). This allowed us to examine the same incision area with and without a membrane. An immunohistochemical analysis was performed for collagen IV, fibronectin, and inflammatory factors such as cluster of differentiation 31 (CD31), cyclooxygenase-2 (COX-2), and interleukin 6 (IL-6). There was a clear difference in the expression of specific proteins after the piezoelectric device and the periosteal elevator were used. The expression of fibronectin, IL-6, and COX-2 was higher after preparation with the periosteal elevator than after piezoelectric periosteum dissection. The expression of collagen IV was higher after the piezoelectric procedure. No difference was observed for CD31. The membrane had no effect on the expression of collagen IV, fibronectin, IL-6, and COX-2. The type of periosteal preparation influences the expression of specific proteins. With regard to the factors examined here, NCM did not appear to influence the wound healing cascade.
许多动物研究表明，完整的骨膜在骨再生中起重要作用。体内骨膜屏障膜对特定蛋白质表达的潜在影响尚未得到充分研究。本研究的目的是探讨皮瓣制备方法和胶原膜对炎性因子释放的影响。本研究对20例曾接受过增量手术的牙种植患者进行了检查。在增量手术期间以及3个月后从同一位置采集软组织样本。样本均取自先前制备的黏骨膜瓣的边缘。对照组用传统骨膜剥离器掀起皮瓣，试验组用压电装置掀起皮瓣。在两组中，我们用天然胶原膜（NCM；盖氏生物引导膜）覆盖一半的增量骨。这使我们能够在有膜和无膜的情况下检查相同的切口区域。对IV型胶原、纤连蛋白以及炎性因子如分化簇31（CD31）、环氧化酶-2（COX-2）和白细胞介素6（IL-6）进行免疫组化分析。使用压电装置和骨膜剥离器后特定蛋白质的表达存在明显差异。用骨膜剥离器制备后纤连蛋白、IL-6和COX-2的表达高于压电骨膜剥离术后。压电手术后IV型胶原的表达较高。CD31未观察到差异。该膜对IV型胶原、纤连蛋白、IL-6和COX-2的表达没有影响。骨膜制备类型影响特定蛋白质的表达。就此处检测的因素而言，NCM似乎未影响伤口愈合级联反应。
