骨形成蛋白和氯己定双缓释的壳聚糖温敏凝胶用于牙周组织再生的实验研究

An animal experiment for the regeneration of periodontal defect by application of the dual-release chitosan thermosensitive hydrogel system

目的观察双重缓释骨形成蛋白和氯己定的壳聚糖温敏载药凝胶修复牙周组织缺损的效果。方法制备犬前磨牙Ⅱ度根分叉牙周组织缺损模型，分5组于牙周组织缺损处分别注人：①自制的双重缓释骨形态发生蛋白和氯己定的载药凝胶（T1组）；②仅加载缓释骨形态发生蛋白的壳聚糖温敏凝胶（T2组）；③仅加载缓释氯己定的壳聚糖温敏凝胶（T3组）；④未加载任何药物的壳聚糖温敏凝胶（C1组）；⑤不注射任何载体及药物（Co组）。术后不使用抗生素，常规护理，8周后取材进行大体及组织学观察牙龈炎性反应及牙周组织再生情况。结果应用壳聚糖温敏凝胶，可以方便地通过注射方式局部安放载体。T1组新生牙槽骨高度平均达到缺损高度的99．2％，T2组新生牙槽骨高度平均达到缺损高度的87．8％，T3组为63．6％，C1组为37．0％，C0组为34．3％；牙龈炎性反应细胞浸润情况显示T1及T3组炎细胞数量明显少于其他组。结论自制双缓释壳聚糖温敏凝胶有效发挥了骨形态发生蛋白和氯己定各自的作用，并且在牙周组织再生治疗中具有简便性和有效性。

Objective To observe the effect of the self-made ehitosan thermosensitive hydrogel system with dual-release bone morphogenetie protein and ehlorhexidine on periodontal defects repair. Methods The furcation defect model was established on dog premolar. The models were divided into five groups, including three experimental groups, one control group and one blank control group. The hydrogel with the ehlorhexidine/β-eyelodextrin inclusion complexes （IC）/rhBMP-2, hydrogel with rhBMP-2, hydrogel with IC, the pure hydrogel were applied to the defects of the four groups, respectively, and the blank control group did not receive any agent. The dogs were sacrificed 8 weeks later and the periodontal regeneration and gingival condition were observed by histological examination. Results Obvious periodontal tissue regeneration was found in group one and two. The heights of new bone reached 99. 2% of the defects in group one, 87.8%, 63.6%, 37.0% and 34. 3% in group two, three, four and blank control groups, respectively. The inflammation of the affected gingiva showed less significant in group one and group three than in the other groups. Conclusions rhBMP-2 and ehlorhexidine played their independent role in repairing periodontal defects and the dual-release ehitosan thermosensitive hydrogel system is effective and convenient to use.