Cömert Kiliç Songül, Özdal Murat, Kiliç Nihat, Ceylan Onur, Koç Gönül
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University, Erzurum, Turkey.
Department of Biology, Faculty of Science, Ataturk University, Erzurum, Turkey.
J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4S):102321. doi: 10.1016/j.jormas.2025.102321. Epub 2025 Mar 28.
This study aimed to evaluate and compare the effects of bone grafting materials, including xenograft alone, DBC alone, xenograft + DBC, xenograft + boric acid, and xenograft + boric acid-absorbed DBC, on the newly formed bone, the immune reactivity score of osteoprotegerin (OPG) and Receptor Activator Nuclear Kappa-B Ligand (RANKL) and the OPG/RANKL ratio by histological, histomorphometric and immunohistochemical analysis in rabbit maxillary sinus augmentation (MSA) model. Fourteen maxillary sinuses of New Zealand albino rabbits were augmented. Five groups were formed: xenograft alone (group1), dispersed bacterial cellulose (DBC) alone (group2), xenograft + DBC (group3), xenograft + boric acid (group4), xenograft +boric acid-absorbed DBC (group5). Eight weeks later, the species were examined. SEM, XRD, and FTIR analyses were carried out for DBC and boric acid-absorbed DBC. Inter-group comparisons were carried out by using the Kruskal-Wallis test for the immune reactivity score of OPG and RANKL and the independent sample t-test for OPG/RANKL ratio. The highest newly formed bone was observed in groups 3 and 5, and the lowest was in group 1. The percentages of newly formed bone area from highest to lowest occurred at 43.3 %, 38.3 %, 33.3 %, 30 %, and 19.5 % in groups 5, 3, 4, 2, and 1, respectively. Increased expression of OPG and RANKL was observed around newly formed bone areas in all groups. The immune reactivity score of OPG and RANKL expression was highest in group 5 and lowest in group 1, with no significant difference between the groups. The OPG/RANKL ratio was 1 in all groups, except the ratio was > 1 in only group 5, with no significant difference between the groups. The surface of DBC showed a well-organized, irregular, and interconnected porous structure. DBC found a biocompatible material. Boric acid-absorbed DBC produced a more remarkable and enlarged pore structure than DBC alone. The findings of the present pilot study indicated that DBC alone can be used as a scaffold and it seems an innovative bone graft material to filling bone defect areas that it caused enhanced bone regeneration during MSA. Moreover, adding DBC or boric acid-absorbed DBC to xenograft increased newly formed bone significantly.
本研究旨在通过组织学、组织形态计量学和免疫组织化学分析，评估和比较单独使用异种移植物、单独使用脱细胞细菌纤维素（DBC）、异种移植物+DBC、异种移植物+硼酸以及异种移植物+硼酸吸附的DBC等骨移植材料对兔上颌窦提升（MSA）模型中新形成骨、骨保护素（OPG）和核因子κB受体活化因子配体（RANKL）的免疫反应性评分以及OPG/RANKL比值的影响。对14只新西兰白兔的上颌窦进行了提升。形成了五组：单独使用异种移植物（第1组）、单独使用脱细胞细菌纤维素（DBC，第2组）、异种移植物+DBC（第3组）、异种移植物+硼酸（第4组）、异种移植物+硼酸吸附的DBC（第5组）。8周后，对标本进行检查。对DBC和硼酸吸附的DBC进行了扫描电子显微镜（SEM）、X射线衍射（XRD）和傅里叶变换红外光谱（FTIR）分析。采用Kruskal-Wallis检验对OPG和RANKL的免疫反应性评分进行组间比较，采用独立样本t检验对OPG/RANKL比值进行组间比较。在第3组和第5组中观察到新形成骨最多，在第1组中最少。新形成骨面积的百分比从高到低依次为第5组43.3%、第3组38.3%、第4组33.3%、第2组30%和第1组19.5%。在所有组的新形成骨区域周围均观察到OPG和RANKL表达增加。OPG和RANKL表达的免疫反应性评分在第5组中最高，在第1组中最低，组间无显著差异。除第5组比值>1外，所有组的OPG/RANKL比值均为1，组间无显著差异。DBC表面呈现出组织良好、不规则且相互连通的多孔结构。发现DBC是一种生物相容性材料。硼酸吸附的DBC比单独的DBC产生了更显著且扩大的孔隙结构。本初步研究结果表明，单独的DBC可作为支架使用，似乎是一种创新的骨移植材料，用于填充骨缺损区域，它在MSA过程中可促进骨再生。此外，将DBC或硼酸吸附的DBC添加到异种移植物中可显著增加新形成骨。
