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下颌骨组织工程的系统综述性文献分析

Systematic scoping review of mandibular bone tissue engineering.

作者信息

Basyuni S, Ferro A, Santhanam V, Birch M, McCaskie A

机构信息

Department of Oral and Maxillo-Facial Surgery, Cambridge University Hospitals, Cambridge, United Kingdom; Department of Surgery, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.

Department of Oral and Maxillo-Facial Surgery, Cambridge University Hospitals, Cambridge, United Kingdom.

出版信息

Br J Oral Maxillofac Surg. 2020 Jul;58(6):632-642. doi: 10.1016/j.bjoms.2020.03.016. Epub 2020 Apr 1.

Abstract

Tissue engineering is a promising alternative that may facilitate bony regeneration in small defects in compromised host tissue as well as large mandibular defects. This scoping systematic review was therefore designed to assess in vivo research on its use in the reconstruction of mandibular defects in animal models. A total of 4524 articles were initially retrieved using the search algorithm. After screening of the titles and abstracts, 269 full texts were retrieved, and a total of 72 studies included. Just two of the included studies employed osteonecrosis as the model of mandibular injury. All the rest involved the creation of a critical defect. Calcium phosphates, especially tricalcium phosphate and hydroxyapatite, were the scaffolds most widely used. All the studies that used a scaffold reported increased formation of bone when compared with negative controls. When combined with scaffolds, mesenchymal stem cells (MSC) increased the formation of new bone and improved healing. Various growth factors have been studied for their potential use in the regeneration of the maxillofacial complex. Bone morphogenic proteins (BMP) were the most popular, and all subtypes promoted significant formation of bone compared with controls. Whilst the studies published to date suggest a promising future, our review has shown that several shortfalls must be addressed before the findings can be translated into clinical practice. A greater understanding of the underlying cellular and molecular mechanisms is required to identify the optimal combination of components that are needed for predictable and feasible reconstruction or regeneration of mandibular bone. In particular, a greater understanding of the biological aspects of the regenerative triad is needed before we can to work towards widespread translation into clinical practice.

摘要

组织工程是一种很有前景的替代方法,它可能有助于在受损宿主组织中的小骨缺损以及大型下颌骨缺损处实现骨再生。因此,本综述性系统评价旨在评估在动物模型中使用组织工程重建下颌骨缺损的体内研究。最初使用搜索算法检索到4524篇文章。在筛选标题和摘要后,检索到269篇全文,共纳入72项研究。纳入的研究中只有两项采用骨坏死作为下颌骨损伤模型。其余所有研究都涉及制造临界缺损。磷酸钙,尤其是磷酸三钙和羟基磷灰石,是使用最广泛的支架材料。所有使用支架的研究均报告与阴性对照相比,骨形成增加。与支架结合时,间充质干细胞(MSC)可增加新骨形成并促进愈合。人们对各种生长因子在颌面部复合体再生中的潜在用途进行了研究。骨形态发生蛋白(BMP)最受关注,与对照组相比,所有亚型均能显著促进骨形成。尽管迄今为止发表的研究表明前景广阔,但我们的综述表明,在将这些发现转化为临床实践之前,必须解决几个不足之处。需要更深入地了解潜在的细胞和分子机制,以确定可预测和可行的下颌骨重建或再生所需的最佳成分组合。特别是,在我们努力将其广泛转化为临床实践之前,需要更深入地了解再生三联体的生物学方面。

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