本研究旨在通过组织学和免疫组织化学方法评估在牙龈组织中注射的重组人骨形态发生蛋白(rh-BMP2)对加速伤口边缘上皮迁移和植入手术后上皮细胞增殖的影响。
方法:该研究包括20名在下颌骨前磨牙区接受双侧种植手术的患者,其次是引导骨再生。每个病人在两个地方都接受了植入物,但rh-BMP2只在右侧。手术后9天,在距最后一个植入物3mm处进行牙龈活检。总的来说,从左侧(对照组#1)收集20个样品,从右侧(测试组#1)收集20个样品。在愈合基牙放置期间以4个月的间隔重复此操作。处理组织并用苏木精-伊红染色,然后进行免疫组织化学以观察Ki-67的表达和进一步的组织学检查。
结果:在9天后,在55%的测试组和20%的对照组中观察到上皮完全闭合并形成新细胞。4个月时,尽管所有组的100%样本都有完全的上皮闭合,测试组显示,由于血管数量的增加,上皮细胞更有组织和成熟。实验组平均每mm新生上皮细胞数为17.15±7.545,16.12±7.683,分别,在9天和4个月以及对照组的10.99±5.660和10.95±5.768。
结论:从组织学观察来看,rh-BMP-2可以加速牙龈伤口的闭合,牙龈上皮组织的愈合过程,以及在接受牙种植治疗的患者中上皮细胞的形成。
This study aims to histologically and immunohistochemically evaluate the effect recombinant human bone morphogenetic protein (rh-BMP2) injected in gingival tissue has on the acceleration of the epithelial migration from the wound edges and epithelial cell proliferation after implant surgery.
METHODS: The study includes 20 patients who underwent bilateral implant surgeries in the premolar-molar region of the mandible, followed by guided bone regeneration. Each patient received an implant in both locations, but rh-BMP2 was only on the right side. At 9 days from the surgery, a gingival biopsy was performed 3 mm distally to the last implant. In total, 20 samples were collected from the left side (control group #1) and 20 from right (test group #1). This was repeated at a 4-month interval during healing abutment placements. Tissues were processed and stained with hematoxylin-eosin and then immunohistochemically for the expression of Ki-67 and further histological examination.
RESULTS: Complete closure of the epithelium with new cell formation was observed in the 55% test group and 20% control group after 9 days. At 4 months, although 100% samples of all groups had complete epithelial closure, the test group showed that the epithelial cells were more organized and mature due to the increased number of blood vessels. The average number of new epithelial cells was 17.15 ± 7.545 and 16.12 ± 7.683 cells per mm in test group, respectively, at 9 days and 4 months and 10.99 ± 5.660 and 10.95 ± 5.768 in control groups.
CONCLUSIONS: Evident from histological observations, rh-BMP-2 can accelerate the closure of gingival wounds, the healing process of epithelial gingival tissue, and the formation of epithelial cells in patients undergoing dental implant treatment.