颌面部及牙周组织工程骨的血管化和成骨策略  

Maxillofacial and periodontal tissue-engineered bone: vascularization and osteogenesis strategies

作　　者：张馨月 李焰[2] 李晨军[1,2] 

机构地区：[1]四川医科大学口腔医学院,四川省泸州市646000 [2]解放军成都军区总医院附属口腔医院,四川省成都市610000

出　　处：《中国组织工程研究》2015年第42期6819-6825,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:颌面部骨缺损以及牙周组织缺损是影响人类功能和美观的重要疾病之一,组织工程骨成为了修复颌面部骨和牙周组织缺损的主要手段。目前已形成了种子细胞及细胞共培养、支架材料、微环境三者复合以构建组织工程骨的基本模式,将组织工程骨进行预血管化并促进其快速成骨可以减少植入物的坏死、吸收,提升骨缺损修复的成功概率。目的:归纳总结近5年内组织工程骨在口腔颌面部及牙周组织上的研究新进展。方法:对CNKI数据库和Pub Med数据库2010年至2015年文献进行检索,中文检索关键词为:颌面;组织工程骨;骨再生;血管化;基因修饰;种子细胞;支架材料;微环境,英文检索词为:oral and maxillofacial,bone tissue engineering,bone regeneration,vascularization,Genetic modification,Seed cells,Support material,Micro environment。排除无关性研究、重复性研究,保留68篇中英文文献进行归纳总结。结果与结论:组织工程骨在修复口腔颌面部及牙周缺损上的应用得到了巨大发展,在三维结构的支架材料上加载基因修饰的种子细胞可以有效的促进血管化进程,提高成骨效应,增加颌骨缺损修复术的成功概率。此外,在牙槽嵴缺损处或新鲜拔牙窝处植入组织工程骨材料,可以有效的恢复和保存牙槽嵴高度和宽度,为后续的修复治疗保证了良好的骨条件。在植入组织工程骨后,可在缺损处加载不同的外部环境刺激,可以通过调节细胞外基质成分或信号通路来改变血管化进程,而血管化是建立有效血循环,保证植入支架成功的前提条件。BACKGROUND：Maxilofacial bone and periodontal tissue defect is one of the important diseases that affect human functionality and aesthetic appearance, and bone tissue engineering becomes the main means to repair maxilofacial and periodontal tissue defects. Currently, the basic mode is constructed by the combination of co-culture of seed cels and cels, scaffolds and micro-environment. Pre-vascularization and rapid osteogenesis of tissue-engineered bone can reduce implant necrosis and absorption, and improve repair success rate. OBJECTIVE：To summarize the new progress of bone tissue engineering used in the oral and maxilofacial and periodontal tissue in the past 5 years. METHODS：CNKI database and PubMed database from 2010 to 2015 were searched using the keywords of “oral＆amp;nbsp;and maxilofacial, bone tissue engineering, bone regeneration, vascularization, genetic modification, seed cels, support material, microenvironment” in Chinese and English, respectively. After elimination of independent and repetitive studies, 68 articles were included in result analysis. RESULTS AND CONCLUSION： The tissue-engineered bone has achieved tremendous progress in the repair of oral and maxilofacial and periodontal tissue defects. The three-dimensional scaffold with gene-modified seed cels can effectively promote the vascularization, improve the osteogenic effect and increased the probability of success in mandibular defect repair. In addition, tissue-engineered bone implantation into the alveolar ridge defects or fresh extraction fossa can effectively restore and preserve alveolar ridge height and width, to ensure a good bone condition for subsequent restorative treatment. After the implantation of tissue-engineered bone, different external environmental stimuli could be loaded at defect sites, and the extracelular matrix components or signal pathway could be adjusted to change the process of vascularization. Vascularization is a premise condition for the establishment of an effective blood circulation to ensure the

关 键 词：组织构建 骨组织工程 颌面部骨缺损 牙周组织缺损 血管化骨再生 

分 类 号：R318[医药卫生—生物医学工程]