Wikesjö U M, Razi S S, Sigurdsson T J, Tatakis D N, Lee M B, Ongpipattanakul B, Nguyen T, Hardwick R
Loma Linda University, CA, USA.
J Clin Periodontol. 1998 Jun;25(6):475-81. doi: 10.1111/j.1600-051x.1998.tb02476.x.
This study evaluated alveolar bone and cementum regeneration following surgical implantation of recombinant human transforming growth factor-beta1 (rhTGF-beta1) in conjunction with guided tissue regeneration (GTR). Supraalveolar, critical size, periodontal defects were surgically created around the 3rd and 4th mandibular premolar teeth in right and left jaw quadrants in 5 beagle dogs. Alternate jaw quadrants in consecutive animals received rhTGF-beta1, in a CaCO3/hydroxyethyl starch carrier with GTR, or carrier with GTR alone (control). 20 microg of rhTGF-beta1 in buffer solution was incorporated into approximately 0.8 ml of carrier for each defect scheduled to receive rhTGF-beta1. Animals were sacrificed at week 4 postsurgery and tissue blocks were harvested and processed for histometric analysis. Clinical healing was generally uneventful. Minor membrane exposures were observed. Defects with membrane exposure displayed an inflammatory infiltrate underneath the membrane. Bone regeneration of trabecular nature, apparent in all animals, was generally limited to the very apical aspect of the defects. Cementum regeneration was limited without obvious differences between experimental conditions. Comparing rhTGF-beta1, to control defects, statistically significant differences were found for area (1.8+/-0.4 and 1.3+/-0.6 mm2, respectively; p<0.05) and density (0.3+/-0.1 and 0.2+/-0.03, respectively; p<0.05) of alveolar bone regeneration. Observed differences are small and represent a clinically insignificant potential for enhanced regeneration in this preclinical model. Within the limitations of study, it may be concluded that rhTGF-beta1 has a restricted potential to enhance alveolar bone regeneration in conjunction with GTR.
本研究评估了重组人转化生长因子β1（rhTGF-β1）与引导组织再生（GTR）联合手术植入后牙槽骨和牙骨质的再生情况。在5只比格犬的左右下颌象限的第三和第四前磨牙周围手术制造了龈上、临界大小的牙周缺损。连续动物的交替颌象限接受rhTGF-β1，其置于碳酸钙/羟乙基淀粉载体中并联合GTR，或仅接受载体联合GTR（对照）。对于每个预定接受rhTGF-β1的缺损，将20μg rhTGF-β1加入约0.8ml缓冲溶液中，并混入载体。在术后第4周处死动物，采集组织块并进行组织计量分析。临床愈合通常顺利。观察到少量膜暴露。有膜暴露的缺损在膜下显示有炎症浸润。所有动物均可见的小梁状骨再生通常仅限于缺损的最根尖部分。牙骨质再生有限，实验条件之间无明显差异。与对照缺损相比，rhTGF-β1组在牙槽骨再生面积（分别为1.8±0.4和1.3±0.6mm2；p<0.05）和密度（分别为0.3±0.1和0.2±0.03；p<0.05）方面存在统计学显著差异。观察到的差异较小，在该临床前模型中代表了增强再生的临床无意义潜力。在研究的局限性内，可以得出结论，rhTGF-β1与GTR联合增强牙槽骨再生具有有限的潜力。
