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新型合成碳酸磷灰石骨替代物对骨内缺损牙周再生的临床前评估

Preclinical evaluation of a new synthetic carbonate apatite bone substitute on periodontal regeneration in intrabony defects.

作者信息

Imber Jean-Claude, Imber Larissa Carmela, Roccuzzo Andrea, Stähli Alexandra, Muñoz Fernando, Weusmann Jens, Bosshardt Dieter Daniel, Sculean Anton

机构信息

Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland.

出版信息

J Periodontal Res. 2024 Feb;59(1):42-52. doi: 10.1111/jre.13203. Epub 2023 Nov 23.

Abstract

OBJECTIVE

To evaluate the potential of a novel synthetic carbonate apatite bone substitute (CO Ap-BS) on periodontal regeneration.

BACKGROUND

The use of various synthetic bone substitutes as a monotherapy for periodontal regeneration mainly results in a reparative healing pattern. Since xenografts or allografts are not always accepted by patients for various reasons, a synthetic alternative would be desirable.

METHODS

Acute-type 3-wall intrabony defects were surgically created in 4 female beagle dogs. Defects were randomly allocated and filled with CO Ap-BS (test) and deproteinized bovine bone mineral (DBBM) or left empty (control). After 8 weeks, the retrieved specimens were scanned by micro-CT, and the percentages of new bone, bone substitute, and soft tissues were evaluated. Thereafter, the tissues were histologically and histometrically analyzed.

RESULTS

Healing was uneventful in all animals, and defects were present without any signs of adverse events. Formation of periodontal ligament and cementum occurred to varying extent in all groups without statistically significant differences between the groups. Residues of both bone substitutes were still present and showed integration into new bone. Histometry and micro-CT revealed that the total mineralized area or volume was higher with the use of CO Ap-BS compared to control (66.06 ± 9.34%, 36.11 ± 6.40%; p = .014, or 69.74 ± 2.95%, 42.68 ± 8.68%; p = .014). The percentage of bone substitute surface covered by new bone was higher for CO Ap-BS (47.22 ± 3.96%) than for DBBM (16.69 ± 5.66, p = .114).

CONCLUSIONS

CO Ap-BS and DBBM demonstrated similar effects on periodontal regeneration. However, away from the root surface, more new bone, total mineralized area/volume, and higher osteoconductivity were observed for the CO Ap-BS group compared to the DBBM group. These findings point to the potential of CO Ap-BS for periodontal and bone regeneration.

摘要

目的

评估一种新型合成碳酸磷灰石骨替代物(CO Ap-BS)用于牙周组织再生的潜力。

背景

使用各种合成骨替代物作为牙周组织再生的单一疗法主要导致修复性愈合模式。由于异种移植物或同种异体移植物因各种原因并不总是被患者接受,因此需要一种合成替代物。

方法

对4只雌性比格犬进行手术,制造急性3壁骨内缺损。将缺损随机分组,分别用CO Ap-BS(试验组)、脱蛋白牛骨矿物质(DBBM)填充或不填充任何材料(对照组)。8周后,对取出的标本进行显微CT扫描,评估新骨、骨替代物和软组织的百分比。此后,对组织进行组织学和组织计量学分析。

结果

所有动物愈合过程均顺利,缺损部位无任何不良事件迹象。所有组均不同程度地出现了牙周膜和牙骨质形成,各组之间无统计学显著差异。两种骨替代物的残留物仍然存在,并显示与新骨融合。组织计量学和显微CT显示,与对照组相比,使用CO Ap-BS时总矿化面积或体积更高(66.06±9.34%,36.11±6.40%;p = 0.014,或69.74±2.95%,42.68±8.68%;p = 0.014)。CO Ap-BS组新骨覆盖的骨替代物表面百分比高于DBBM组(47.22±3.96%比16.69±5.66,p = 0.114)。

结论

CO Ap-BS和DBBM对牙周组织再生显示出相似的效果。然而,与DBBM组相比,在远离根面处,CO Ap-BS组观察到更多的新骨、总矿化面积/体积和更高的骨传导性。这些发现表明CO Ap-BS在牙周和骨组织再生方面具有潜力。

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