种植体骨结合中生物学过程与分子调控机制的研究进展

Overview of biological process and molecular regulatory mechanisms in early stage of implant osseointegration

以骨结合为重要生物学基础的种植修复因其无损邻牙且功能和美学效果好等优点已逐渐成为越来越多失牙患者的选择。种植修复的成功在很大程度上依赖于牙槽骨内种植体的稳定结合,其中骨结合的早期阶段不仅具有活跃的分子事件而且对种植体的初期稳定性起着至关重要的作用,所以被广泛研究。这一阶段涉及的生物学过程直接受到种植体周围细胞、信号分子、基质等骨微环境的影响,复杂的分子调控方式是决定种植效果的关键因素。深入认知骨结合早期的生物学行为并有效利用这些分子调控模式对于加快和改善骨结合过程,扩大牙科种植修复的临床适应征具有重要意义。因此本文着重从骨结合早期的骨免疫调节、成骨基因表达、成骨细胞外基质相关分子模式、破骨细胞活性及骨重塑方面对骨结合建立和维持过程中涵盖的主要生物学过程与分子调节机制进行综述,以进一步增加对种植体骨结合早期复杂网络的认知,寻找相关分子靶点,为改善种植体骨结合和扩大种植修复适应征提供良好的理论基础。

Implant restoration with osseointegration as an important biological basis has gradually become the choice of more and more patients with tooth loss due to its advantages such as non-damaging adjacent teeth and good functional and aesthetic effects.Successful clinical treatments are largely dependent on the stable integration and maintenance of implants in the alveolar bone.The molecular regulatory patterns and biological process of osseointegration are very complicated.The correct identification and effective utilization of these molecular regulatory patterns is of great significance for accelerating and strengthening the osseointegration process and improving and expanding the clinical indications of dental implant systems.This review focuses on the regulatory mechanisms for the establishment and maintenance of osseointegration in terms of osteoimmune regulatorymechanisms,osteogenic gene expression,osteogenic extracellular stromal relatedmolecular patterns,osteoclasts activity,and bone remodeling.