PDF(Pubmed)
Abstract：
In reconstructive surgery, complications post-fibula free flap (FFF) reconstruction, notably peri-implant hyperplasia, are significant yet understudied. This study analyzed peri-implant hyperplastic tissue surrounding FFF, alongside peri-implantitis and foreign body granulation (FBG) tissues from patients treated at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. Using light microscopy, pseudoepitheliomatous hyperplasia, anucleate and pyknotic prickle cells, and excessive collagen deposition were observed in FFF hyperplastic tissue. Ultrastructural analyses revealed abnormal structures, including hemidesmosome dilation, bacterial invasion, and endoplasmic reticulum (ER) swelling. In immunohistochemical analysis, unfolded protein-response markers ATF6, PERK, XBP1, inflammatory marker NFκB, necroptosis marker MLKL, apoptosis marker GADD153, autophagy marker LC3, epithelial-mesenchymal transition, and angiogenesis markers were expressed variably in hyperplastic tissue surrounding FFF implants, peri-implantitis, and FBG tissues. NFκB expression was higher in peri-implantitis and FBG tissues compared to hyperplastic tissue surrounding FFF implants. PERK expression exceeded XBP1 significantly in FFF hyperplastic tissue, while expression levels of PERK, XBP1, and ATF6 were not significantly different in peri-implantitis and FBG tissues. These findings provide valuable insights into the interconnected roles of ER stress, necroptosis, apoptosis, and angiogenesis in the pathogenesis of oral pathologies, offering a foundation for innovative strategies in dental implant rehabilitation management and prevention.
摘要：
在重建手术中，腓骨游离皮瓣(FFF)重建术后并发症,尤其是种植体周围增生，意义重大但研究不足。这项研究分析了FFF周围的种植体周围增生组织，与口腔颌面外科治疗患者的种植体周围炎和异物肉芽（FBG）组织一起，首尔国立大学牙科医院。使用光学显微镜，假上皮瘤增生，无核和毛突刺状细胞，在FFF增生组织中观察到过度的胶原沉积。超微结构分析显示结构异常，包括半染色体扩张，细菌入侵，内质网（ER）肿胀。在免疫组织化学分析中，未折叠的蛋白质反应标记ATF6，PERK，XBP1,炎症标志物NFκB,凋亡标志物MLKL,细胞凋亡标志物GADD153,自噬标志物LC3,上皮间质转化,血管生成标志物在FFF植入物周围的增生组织中表达不同，种植体周围炎,和FBG组织。与FFF植入物周围的增生组织相比，NFκB在种植体周围炎和FBG组织中的表达更高。PERK在FFF增生组织中的表达显著超过XBP1,而PERK的表达水平，XBP1和ATF6在种植体周围炎和FBG组织中没有显着差异。这些发现为ER压力的相互联系的作用提供了有价值的见解，坏死,凋亡，和口腔疾病发病机理中的血管生成，为牙种植体康复管理和预防的创新策略奠定基础。
