Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA.
Department of Plastic Surgery, China Medical University Hospital, Shenyang, China.
J Periodontol. 2020 Dec;91(12):1632-1644. doi: 10.1002/JPER.19-0524. Epub 2020 May 28.
Autologous bone can be harvested from the flutes of a conventional drill or from a bone scraper; here we compared whether autologous bone chips generated by a new slow-speed instrument were more osteogenic than the bone chips generated by conventional drills or bone scrapers. Additionally, we tested whether the osteogenic potential of bone chips could be further improved by exposure to a Wnt signaling (WNT) therapeutic.
Osteotomies were prepared in fresh rat maxillary first molar extraction sockets using a conventional drill or a new osseo-shaping instrument; titanium alloy implants were placed immediately thereafter. Using molecular/cellular and histologic analyses, the fates of the resulting bone chips were analyzed. To test whether increasing WNT signaling improved osteogenesis in an immediate post-extraction implant environment, a WNT therapeutic was introduced at the time of implant placement.
Bone collected from a conventional drill exhibited extensive apoptosis; in contrast, bone generated by the new instrument remained in situ, which preserved their viability. Also preserved was the viability of the osteoprogenitor cells attached to the bone chips. Exogenous treatment with a WNT therapeutic increased the rate of osteogenesis around immediate post-extraction implants.
Compared with conventional drills or bone scrapers, a new cutting instrument enabled concomitant site preparation with autologous bone chip collection. Histology/histomorphometric analyses revealed that the bone chips generated by this new tool were more osteogenic and could be further enhanced by exposure to a WNT therapeutic. Even though gaps still existed in placebo controls and liposomal WNT3A (L-WNT3A) cases, the area of peri-implant bone was significantly greater in L-WNT3A treated sites.
自体骨可以从传统钻头的凹槽或骨刮器中采集；在这里，我们比较了新的低速仪器产生的自体骨屑是否比传统钻头或骨刮器产生的骨屑更具成骨能力。此外，我们还测试了骨屑的成骨潜能是否可以通过暴露于 Wnt 信号（WNT）治疗进一步提高。
使用传统钻头或新型骨成形仪在新鲜大鼠上颌第一磨牙拔牙窝中制备骨切开术；随后立即放置钛合金植入物。使用分子/细胞和组织学分析来分析由此产生的骨屑的命运。为了测试增加 Wnt 信号是否能改善即时拔牙后植入物环境中的成骨作用，在植入物放置时引入了 Wnt 治疗。
从传统钻头采集的骨显示出广泛的细胞凋亡；相比之下，新型仪器产生的骨保持原位，从而保持了其活力。附着在骨屑上的成骨前体细胞的活力也得以保留。外源性 WNT 治疗增加了即时拔牙后植入物周围成骨的速度。
与传统钻头或骨刮器相比，新型切割器械可同时进行自体骨屑采集和位点准备。组织学/组织形态计量学分析显示，这种新工具产生的骨屑具有更高的成骨能力，并可通过暴露于 WNT 治疗进一步增强。尽管在安慰剂对照和脂质体 WNT3A（L-WNT3A）病例中仍存在差距，但 L-WNT3A 治疗部位的种植体周围骨面积明显更大。
