目的:探讨牙周膜干细胞复合生物支架材料增高重建牙槽嵴效果,为缺牙后牙槽嵴重度萎缩的种植义齿修复奠定基础.方法:分离培养牙周膜干细胞(PDLSCs),将其分别与骨组织工程支架材料羟基磷灰石-磷酸三钙(HA/TCP)及附着龈组织工程材料脱细胞真皮基质(ADM)复合诱导后,植入犬双尖牙缺失致牙槽嵴缺损部位,PDLSCs-HA/TCP植入骨缺损区,PDLSCs-ADM植入粘骨膜缺损区.植入32周,大体测量植入前后增高牙槽嵴高度;X-线片显示牙槽嵴高度与密度变化;组织学观察边界区新生牙槽骨结构,未植入做对照.结果:细胞-材料复合体植入后牙槽嵴高度显著增高,由移植前4.15±0.20,增加到移植后9.30±0.15(P<0.05).X-线显示邻牙标记部位冠方有类骨密度硬组织形成,牙槽嵴明显增高.组织学显示:与对照组比较,细胞材料移植组可见缺损区有新生骨样组织形成,可见骨陷窝和骨细胞样结构.结论:PDLSCs分别与骨及粘骨膜组织工程支架材料HA/TCP、ADM复合后体内移植,可显著增高牙槽嵴高度,是牙槽嵴增高重建、实现无牙合种植修复的有效途径.
Objective: To explore the effects of periodontal ligament stem cells (PDLSCs) in combination with bioactive scaffolds on alveolar ridge augmentation by tissue engineering technique in dogs and to provide useful way for augmentation of the edentuous atrophic mandibular and dental implant placement. Methods: Dog PDLSCs were cultured and isolated by immunomagnetic cell selection technique, and then they were seeded onto bioactive material- porous hydroxyapatite (HA)/13-tricalcium phosphate ([3-TCP) ceramic scaffolds and acellular dermal matrix (ADM), respectively. After induced for 5 days, the stem cell-scafford constructs were implanted into the defects of alveolar ridge with PDLSCs- HA/TCP for alveolar bone and PDLSCs- ADM for mucosal bone membrane. 32 weeks after implant operation, the height of newly formed alveolar ridge was measured, and the changes of x-rays and the histological structures before and after implantation were analyzed as well. No constructs operation was used as control group. Results: The alveolar ridge after the constructs implantation was significantly higher than the control group with changes from 4.15±0.20 pre-operation to 9.30±0.15 post-operation(p 〈0.05). The results of X-radiograph showed the newly formed X-ray translucent tissue accumulated on the upper of labeled reference line which suggested vertical ridge augmentation. The findings fi'om histology of newly alveolar ridge demonstrated that there were bone and cement-like tissue formation both in the mesio- and distal- area of the defects, and the bone lacunae and osteo cytes could also been seen. Conclusion: PDLSCs combined respectively with HA/TCP and ADM could augment alveolar ridge both hard tissue and soft tissue. This may provide a useful way for PDLSCs-based tissue engineering for augmentation of the edentuous atrophic mandibular.