School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
J Periodontal Res. 2020 Aug;55(4):529-538. doi: 10.1111/jre.12740. Epub 2020 Feb 24.
To achieve periodontal regeneration, numerous investigations have concentrated on biomolecule supplement and optimization of bone substitute or barrier membrane. This study evaluated the benefit of combining these strategies for periodontal regeneration.
Biphasic cryogel scaffold (BCS) composed of gelatin (ligament phase) and gelatin with beta-tricalcium phosphate/hydroxyapatite (BH) (bone phase) was designed as tested bone substitute, and both enamel matrix derivatives (EMD) and bone morphogenetic protein-2 (BMP-2) were applied to formulate a biomolecule-aided BCS (BBS). Functionally graded membrane (FGM) was designed as tested barrier membrane by adhering PDGF-encapsulated poly(L-lactide-co-D/L-lactide) nanofibers on the conventional membrane (CM). BBS and FGM were characterized and tested for biocompatibility in vitro. Thirty 4 × 4 × 5 mm periodontal intrabony defects were created on 6 Beagle dogs. Each defect was evenly assigned to one of the following treatments including BH-CM, BCS-CM, BBS-CM, BH-FGM, BCS-FGM, and BBS-FGM, for 12 weeks. The therapeutic efficiency was assessed by micro-CT and histology.
BCS and FGM sustained the release of biomolecules. The viability of MSCs was maintained in both phases of BCS and was promoted while seeding on the PDGF-encapsulated nanofibers. In CM-covered sites, BBS showed significantly greater osteogenesis (P < .01) and early defect fill (P < .05) relative to BH. FGM significantly promoted osteogenesis (P < .05) in BH-treated sites but showed limited benefit in BBS-treated sites. On denuded roots, cementum deposition was evident in BBS-treated sites.
PDGF-loaded FGM promoted periodontal osteogenesis, and BBS with EMD-BMP-2 had potential for reconstructing alveolar ridge, periodontal ligament, and cementum. FGM and BBS combination provided limited additional benefit.
为了实现牙周组织再生,许多研究集中在生物分子的补充和优化骨替代物或屏障膜上。本研究评估了将这些策略结合起来用于牙周组织再生的益处。
设计了由明胶(韧带相)和含β-磷酸三钙/羟基磷灰石的明胶(骨相)组成的双相冷冻凝胶支架(BCS)作为测试用骨替代物,并将釉基质衍生物(EMD)和骨形态发生蛋白-2(BMP-2)应用于配方生物分子辅助 BCS(BBS)。功能性梯度膜(FGM)通过在常规膜(CM)上粘附 PDGF 包封的聚(L-乳酸-co-D/L-乳酸)纳米纤维而设计为测试用屏障膜。对 BBS 和 FGM 进行了特性和体外生物相容性测试。在 6 只比格犬上创建了 30 个 4×4×5mm 的牙周骨内缺损。每个缺损平均分配到以下治疗组之一,包括 BH-CM、BCS-CM、BBS-CM、BH-FGM、BCS-FGM 和 BBS-FGM,治疗 12 周。通过微 CT 和组织学评估治疗效果。
BCS 和 FGM 持续释放生物分子。MSCs 在 BCS 的两个相中均保持活力,并在 PDGF 包封的纳米纤维上接种时得到促进。在 CM 覆盖的部位,BBS 相对于 BH 显示出明显更高的成骨作用(P<.01)和早期缺损填充(P<.05)。FGM 显著促进了 BH 治疗部位的成骨作用(P<.05),但在 BBS 治疗部位的益处有限。在裸露的根上,BBS 治疗部位有明显的牙骨质沉积。
负载 PDGF 的 FGM 促进了牙周骨的生成,并且含有 EMD-BMP-2 的 BBS 具有重建牙槽嵴、牙周韧带和牙骨质的潜力。FGM 和 BBS 联合使用提供了有限的额外益处。