Hunziker E B, Liu Y, Muff M, Haegi T, Shintani N, Lippuner K
Departments of Osteoporosis and Orthopaedic Surgery, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010 Bern, Switzerland.
Eur Cell Mater. 2021 Feb 13;41:170-183. doi: 10.22203/eCM.v041a12.
The aim of the present study was to investigate in vivo whether bone morphogenetic protein-7 (BMP-7) was able to promote and accelerate dental implant healing at a low dose in an osteopenic environment by using a delayed drug-release system. Skeletally mature Chinese goats, having physiologically osteopenic (osteoporotic-like) facial bones, served as an animal model. Dental implants were provided with a delayed-release drug-delivery system and BMP-7 was applied at three different dosages. The implants, inserted into healed extraction sockets, were removed 1, 2 and 3 weeks after surgery. Quantification of osseointegration and formation of new bone in the peri- implant space were measured histomorphometrically. Data revealed no evidence of any adverse drug effect at or near the implantation sites. After the first postoperative week, bone neoformation was minimal; after the second week, peri-implant bone formation appeared, particularly in the groups with low dosages of BMP-7. After 3 weeks, new-bone volume was the largest in the group with the lowest (near-physiological) dosage of BMP-7, also showing the highest efficacy of BMP-7. Other dosage or release modes were found to be significantly less effective. BMP-7 was highly efficacious in promoting and accelerating bone formation in the peri-implant space in a hostile osteopenic environment if released by a slow-mode mechanism over time at near physiological activities. Therefore, biological functionalisation of dental implants by a high-power osteogenic factor may improve their healing success in hostile bony environments (osteopenia, osteoporosis, bone atrophy etc.).
本研究的目的是通过使用延迟药物释放系统,在体内研究骨形态发生蛋白-7(BMP-7)在低剂量下能否在骨质减少的环境中促进和加速牙种植体的愈合。骨骼成熟的中国山羊,其面部骨骼具有生理性骨质减少(类似骨质疏松),作为动物模型。牙种植体配备延迟释放药物递送系统,并以三种不同剂量应用BMP-7。将种植体插入愈合的拔牙窝中,在术后1、2和3周取出。通过组织形态计量学测量种植体周围间隙的骨整合量化和新骨形成。数据显示在植入部位或其附近没有任何药物不良反应的证据。术后第一周后,骨新形成极少;第二周后,种植体周围骨形成出现,特别是在低剂量BMP-7组。3周后,BMP-7最低(接近生理)剂量组的新骨体积最大,也显示出BMP-7的最高疗效。发现其他剂量或释放模式的效果明显较差。如果通过慢模式机制在接近生理活性的水平上随时间释放,BMP-7在骨质减少的不利环境中促进和加速种植体周围间隙的骨形成方面非常有效。因此,通过高功率成骨因子对牙种植体进行生物功能化可能会提高其在不利骨环境(骨质减少、骨质疏松、骨萎缩等)中的愈合成功率。