Prado Abraão Moratelli, Ferreira Cimara Fortes, Porto Luismar Marques, Rivero Elena Riet Correa, de Souza Magini Ricardo, Benfatti Cesar Augusto Magalhães, Rodriguez-Ivich Jair
Implant Dentistry, Private Practice, Florianópolis, SC, Brazil.
Department of Periodontics, University of Tennessee Health Science Center (UTHSC) College of Dentistry, Memphis, TN, USA.
J Periodontal Implant Sci. 2024 Feb;54(1):25-36. doi: 10.5051/jpis.2200940047. Epub 2023 May 30.
Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model.
Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema.
The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group.
Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.
牙龈黏膜缺损(MGD),如牙根退缩、前庭深度降低和角化组织缺失,在牙科诊所中很常见。MGD可能导致功能、美观和卫生方面的问题。在这些情况下,自体软组织移植被认为是金标准治疗方法。本研究在大鼠模型中比较了游离牙龈移植(FGG)与接种了来自富含血小板血浆培养的成纤维细胞的细菌纤维素基质(BCM)和人脱细胞真皮基质(ADM)的愈合过程。
在大鼠身上制造手术缺损,并以随机方式给予以下治疗:第一组,阴性对照(仅制造缺损);第二组,阳性对照(FGG);第三组,BCM;第四组,BCM + 成纤维细胞;第五组,ADM;第六组,ADM + 成纤维细胞。移植后15天进行临床、组织学和免疫学分析。临床检查记录上皮的规则性以及溃疡、红斑和/或水肿的存在情况。
组织学分析揭示了再上皮化程度、宽度、规则性和角蛋白的存在情况。对结果应用Fisher精确统计检验(<0.05)。除第一组外,没有其他组出现溃疡。所有组的上皮均规则,无红斑和水肿。组织学上,所有组均表现为有角化的规则上皮,结缔组织中存在肌成纤维细胞。接受工程化移植的组在临床和组织学结果上与FGG组相似。
在本研究的局限性内,得出结论认为BCM和ADM可作为细胞支架,其中ADM产生的效果最佳。本研究支持在人体中使用该技术方案。