Acellular dermal matrix used for guiding bone regeneration in the dental implant area

doi:10.3969/j.issn.2095-4344.2013.25.021

Abstract

Abstract:

BACKGROUND: Acellular dermal matrix is a kind of prosthodontics membrane material which has been widely used due to the good biocompatibility.
OBJECTIVE: To evaluate the effect of acellular dermal matrix in guiding bone regeneration in the dental implant area.
METHODS: Immunohistochemical staining was performed, and the microscope was used to observe the microstructure and cell compatibility of acellular dermal matrix, in order to evaluate the feasibility of acellular dermal matrix in guiding bone regeneration. The dental implantation patients who received bone regeneration with acellular dermal matrix were followed-up to evaluate the osteogenesis effect and the effect on soft tissue defects. Then, the effects of Bio-Gide membrane and Bot medical collagen membrane on guiding bone regeneration were compared.
RESULTS AND CONCLUSION: The microstructure of acellular dermal matrix showed there was basement membrane surface and tissue surface. The stylode-like structure and hair follicle could be observed on the basement membrane surface and the tissue surface was scaly structure, and acellular dermal matrix had no influence on the proliferation activity osteoblast-like cells and the alkaline phosphatase activity, but had good cell compatibility. The clinical researches showed that acellular dermal matrix used in dental implantation was effective for bone regeneration, and there was no significant difference in the effect on guiding bone regeneration when compared with Bio-Gide membrane and Bot medical collagen membrane. The acellular dermal matrix had good bone regeneration effect in repairing soft tissue deficiencies after bone augmentation.

Key words: biomaterials, biomaterial academic discussion, acellular dermal matrix, dental implant, guided bone regeneration, Haiao repair membrane, Bio-Gide membrane, polytetrafluoroethylene, infection, ulcers, oral, gums

CLC Number:

R318

Zhou Jing, Deng Cai, Zhang Jin-feng. Acellular dermal matrix used for guiding bone regeneration in the dental implant area[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(25): 4715-4720.

Figures/Tables 2

2.1 异种脱细胞真皮基质的结构与细胞相容性刘曼等[18]对异种脱细胞真皮基质的微观结构进行观察，光学显微镜观察可见，苏木精-伊红染色后，脱细胞真皮基质膜的横截面呈现粉红色，由胶原纤维组成大小不一的孔隙，基底膜面可见致密的胶原纤维，未见孔隙；组织面由长度为几十微米至几百微米的孔隙组成，孔隙相互交错构成三维立体结构。扫描电镜观察可见脱细胞真皮基质膜平面中组织面为鳞片状的结构，胶原纤维相互交错组成片状结构，其间可见形状不规则、大小不均匀的孔隙；基底膜面可见致密结构，其上有许多指突状结构包绕着直径约150 μm的毛囊孔。刘曼等[18]实验中还对异种脱细胞真皮基质的细胞相容性进行了研究，并与膨体聚四氟乙烯膜和空白对照进行比较。研究中将MG63成骨样细胞接种于异种脱细胞真皮基质膜和膨体聚四氟乙烯膜上，空白组则将细胞放置于直径约34 mm的钛圈上，应用细胞活力分析仪检测3组细胞增殖活力，酶联免疫法检测细胞内碱性磷酸酶的表达，扫描电镜观察细胞接种后第1天和第5天的黏附及增殖情况。细胞活力测定结果显示，3组细胞在接种后的1，3，5，7 d时的细胞活力度无统计学差异，3组结果间的差异也无统计学意义，每组细胞在不同时间点的细胞活力度无统计学差异。细胞内碱性磷酸酶活性测定结果显示3组间的结果无统计学差异，每组在不同时间点上的测定结果具有统计学差异，而在第3天与第 5天，每组碱性磷酸酶的测定结果无统计学差异，为平台期。扫描电镜观察结果显示，异种脱细胞真皮基质膜上接种MG63成骨样细胞后的第1天，可见长梭形的细胞，细胞伸展充分，伪足伸向各个方向，和胶原纤维相互交联，胞核清楚，胞浆丰富，接种后第5天，可见细胞覆层生长，细胞之间以及细胞与胶原纤维之间均有交联，细胞生长良好。膨体聚四氟乙烯膜上接种成骨样细胞后的第1天，可见零星分散的细胞，呈长梭形，伪足伸张长短不一，胞核清楚，胞浆丰富，接种后第5天，可见不同区域呈片状分布的细胞，多个细胞相互交联，细胞伪足伸展不充分，细胞生长良好。 2.2 异种脱细胞真皮基质在牙种植中引导骨再生韦丽萍等[15]对异种脱细胞真皮基质在牙种植中引导骨再生进行了研究，研究对象为应用引导骨再生技术进行骨增量的种植患者78例，年龄17-75岁。78例患者均为前牙或前磨牙区单牙或连续多牙缺失，其中前牙区52颗，前磨牙区26颗。78例患者分为2组，研究组中38例患者应用国产海奥异种脱细胞真皮基质行引导骨再生技术引导骨形成，对照组中40例患者应用Bio-Gide生物膜行引导骨再生技术引导骨形成。结果显示，所有患者切口均为甲级愈合，愈合率达100%，对照组中1例患者在植骨后3天发生面部肿胀，经对症处理后肿胀消失，其余患者未出现肿胀、感染、发热等不良症状。78例患者经过6-12个月随访观察，骨生成效果明显，骨愈合良好，种植体功能正常。2组患者骨生长效果比较见表2。"

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