基于骨稳态调控理念认识牙周生物材料及对骨形成的影响

Understanding of periodontal biomaterials based on the concept of bone homeostasis control and the effects on bone formation

背景:牙周炎会导致牙槽骨破坏,是导致成年人失牙的主要口腔疾病之一。为了能够提高再生效果,近年来有学者通过修饰材料的可控性能,主动引导牙周局部骨稳态向有利于牙槽骨再生的方向发展,为牙周再生材料的研发提供了新方向。目的:文章就目前牙周炎局部骨稳态失衡的研究现状和基于调控骨稳态理念的牙周生物材料修饰策略作一综述,并探讨当前策略应用于牙周再生领域的前景和挑战。方法:在Web of Science、PubMed、中国知网和万方数据库中进行文献检索。中文关键词:"骨、牙周组织、稳态、生物材料、再生",英文关键词:"Bone,Periodontal Tissue,Homeostasis,Biomaterials,Regeneration",文献发表时间限定为2000年1月至2020年12月,根据主题选择与综述内容相关的文献,排除与文章内容无关的文章,最终纳入61篇文章进行综述。结果和结论:(1)口腔微生物及其产物、炎性因子会导致牙周微环境中成骨调控和破骨代谢失衡,是牙周炎骨破坏的主要原因之一。(2)生物材料物理化学性能的改变会影响到局部骨稳态平衡,因此可通过改变材料的理化性能来调节局部骨稳态,主要方式包括修饰材料的物理特性、传递生物活性分、调节炎症反应和抑制破骨细胞生成。(3)基于骨稳态调控理念被应用于牙周生物材料的开发中,可提高牙周生物材料的成骨效果,促进牙周组织工程材料的发展和临床牙周组织再生。

BACKGROUND:Periodontitis is one of main diseases that cause destruction of alveolar bone and tooth loss in adults.To improve the regeneration effect,regulating bone homeostasis in periodontal tissue through modifying controllable properties of materials can effectively improve the effect of alveolar bone regeneration,which provides a popular development direction of periodontal biomaterials.OBJECTIVE:To summarize the current research status of local bone homeostasis imbalance in periodontitis and periodontal biomaterial modification strategies based on the concept of regulating bone homeostasis,and to discuss the prospects and challenges of current strategies in periodontal regeneration.METHODS:The articles were searched on Web of Science,PubMed,CNKI,and Wanfang databases.The Chinese and English key words were"bone,periodontal tissue,homeostasis,biomaterials,regeneration".The publication time was limited from January 2000 to December 2020.The articles that were associated with the review content were selected according to the topic.Sixty-one articles were included for the final analysis after excluding the articles that were not related to the content of the article.RESULTS AND CONCLUSION:(1)Oral microflora,its products and inflammation destroy the dynamic balance of osteogenesis and osteoclast metabolism in the periodontal tissue.(2)Physical and chemical properties of biomaterials may affect the dynamic balance of bone homeostasis of periodontal tissue.Therefore,the local bone homeostasis can be adjusted by changing the physical and chemical properties of the material.The main methods include:modifying the physical properties of the material,transmitting biological activity,adjusting inflammatory response,and inhibiting osteoclast production.(3)The concept of regulating bone homeostasis is applied to the development of periodontal biomaterials,which improves the osteogenic effect of periodontal biomaterials,and promotes the development of periodontal tissue engineering materials and clinical periodontal regeneration.