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新型异种纤维蛋白生物聚合物在拔牙后牙槽骨愈合中的疗效和安全性:一项实验性临床前研究。

Efficacy and safety of a new heterologous fibrin biopolymer on socket bone healing after tooth extraction: An experimental pre-clinical study.

机构信息

Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil.

Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil.

出版信息

J Clin Periodontol. 2024 Aug;51(8):1017-1033. doi: 10.1111/jcpe.13992. Epub 2024 Apr 29.

Abstract

AIM

To assess the efficacy of heterologous fibrin biopolymer (HFB) in promoting alveolar bone healing after tooth extraction in rats.

MATERIALS AND METHODS

The upper right incisors of 48 Wistar rats were extracted. Toothless sockets were filled with HFB (HFBG, n = 24) or blood clot (BCG, n = 24). The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric and immunohistochemical (for Runt-related transcription factor 2/Runx2 and tartrate-resistant acid phosphatase/TRAP) analyses on days 0, 7, 14 and 42 after extraction.

RESULTS

Socket volume remained similar between days 0 and 14 (69 ± 5.4 mm), except in the BCG on day 14, when it was 10% lower (p = .043). Although the number of Runx2+ osteoblasts was high and similar in both groups (34 × 10 cells/mm), the HFBG showed lower inflammatory process and osteoclast activity than BCG at 7 days. On day 14, the number of Runx2+ osteoblasts remained high and similar to the previous period in both groups. However, osteoclast activity increased. This increase was 55% lower in the HFBG than BCG. In the BCG, the presence of an inflammatory process and larger and numerous osteoclasts on day 14 led to resorption of the alveolar bone ridge and newly formed bone. On day 42, numbers of Runx2+ osteoblast and TRAP+ osteoclasts decreased dramatically in both groups. Although the BCG exhibited a more mature cortical bone formation, it exhibited a higher socket reduction (28.3 ± 6.67%) and smaller bone volume (37 ± 5.8 mm) compared with HFBG (socket reduction of 14.8 ± 7.14% and total bone volume of 46 ± 5.4 mm).

CONCLUSIONS

HFB effectively suppresses osteoclast activity and reduces alveolar bone resorption compared with blood clot, thus preventing three-dimensional bone loss, particularly during the early healing period. HFB emerges as a promising biopharmaceutical material for enhancing healing processes after tooth extraction.

摘要

目的

评估异种纤维蛋白生物聚合物(HFB)在促进大鼠拔牙后牙槽骨愈合中的疗效。

材料和方法

将 48 只 Wistar 大鼠的右上切牙拔出。无牙窝分别用 HFB(HFBG,n=24)或血凝块(BCG,n=24)填充。拔牙后第 0、7、14 和 42 天,对拔牙部位进行微计算机断层扫描(micro-CT)、组织学、组织形态计量学和免疫组织化学(用于 Runt 相关转录因子 2/Runx2 和抗酒石酸酸性磷酸酶/TRAP)分析。

结果

第 0 天和第 14 天之间的牙槽窝容积保持相似(69±5.4mm),但第 14 天 BCG 时降低了 10%(p=0.043)。尽管两组的 Runx2+成骨细胞数量较高且相似(34×10 个细胞/mm),但 HFBG 在第 7 天的炎症过程和破骨细胞活性低于 BCG。第 14 天,两组的 Runx2+成骨细胞数量仍然较高且与前一时期相似。然而,破骨细胞活性增加。HFBG 中的破骨细胞活性比 BCG 低 55%。在 BCG 中,第 14 天的炎症过程和更大、更多的破骨细胞导致牙槽骨嵴吸收和新骨形成。第 42 天,两组的 Runx2+成骨细胞和 TRAP+破骨细胞数量急剧下降。尽管 BCG 表现出更成熟的皮质骨形成,但与 HFBG 相比,它表现出更高的牙槽窝减少(28.3±6.67%)和更小的骨量(37±5.8mm)(牙槽窝减少 14.8±7.14%和总骨量 46±5.4mm)。

结论

与血凝块相比,HFB 能有效抑制破骨细胞活性,减少牙槽骨吸收,从而防止三维骨丢失,特别是在早期愈合期。HFB 作为一种有前途的生物制药材料,可增强拔牙后的愈合过程。

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