仿生修复技术在口腔颌面部硬组织缺损修复中的应用进展

doi:10.7518/hxkq.2021.02.002

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (2): 129-135.doi: 10.7518/hxkq.2021.02.002

仿生修复技术在口腔颌面部硬组织缺损修复中的应用进展

牛丽娜(), 焦凯, 方明, 陈吉华

军事口腔医学国家重点实验室，国家口腔疾病临床医学研究中心，陕西省口腔医学重点实验室，空军军医大学口腔医院，西安 710032

收稿日期:2020-11-04 修回日期:2020-12-14 出版日期:2021-04-01 发布日期:2021-04-09
通讯作者: 牛丽娜 E-mail:niulina831013@126.com
作者简介:牛丽娜，教授，博士，E-mail：niulina831013@126.com
基金资助:
国家自然科学基金(81722015);陕西省重点科技创新团队(2020TD-033);陕西高校青年创新团队（2019）

Application of biomimetic restoration in oral-maxillofacial hard tissue repair

Niu Lina(), Jiao Kai, Fang Ming, Chen Jihua

State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Key Laboratory of Stomatology, School of Stomatology, Air Force Medical University, Xi, an 710032, China

Received:2020-11-04 Revised:2020-12-14 Online:2021-04-01 Published:2021-04-09
Contact: Niu Lina E-mail:niulina831013@126.com
Supported by:
The National Natural Science Foundation of China(81722015);Shanxi Key Scientific and Technological Innovation Team(2020TD-033);Youth Innovation Team of Shanxi University(2019)

摘要/Abstract

摘要：

口腔颌面部硬组织是颌面部外形结构的支撑和口颌系统功能的基础，一旦发生缺损，不仅影响患者的咀嚼、发音等生理功能，还会对患者的心理及社交造成重大影响。而口腔颌面部硬组织的自我修复能力有限，缺损修复离不开人工材料，但人工材料的理化性能及结构特性与人体硬组织差距巨大，导致修复效果不佳。基于此，学者们通过模拟硬组织发育中的生物矿化过程，即仿生矿化技术，来提高材料的结构及功能的仿生性，实现增强修复效果的目的。目前对生物矿化理论的认识及仿生修复体系的构建处在快速发展阶段，新的研究不断涌现。本文将从几个方面对近年来仿生修复技术在口腔颌面部硬组织修复应用中取得的进展进行综述。

关键词: 仿生修复, 骨组织, 釉质, 牙本质

Abstract:

Oral-maxillofacial hard tissue is the support of maxillofacial structure and appearance, and lays the foundation for functions of oral and maxillofacial system. Once the defect occurs, it will not only affect the physiological functions such as chewing and pronunciation, but also have a significant impact on the psychological and social life of patients. However, the self-repairing capability of the oral-maxillofacial hard tissue is pretty limited, in which case, substitute materials are required for tissue repair. A huge gap exists between the physical, chemical, structural characteristics of conventional substitute materials and those of human hard tissues, resulting in poor repair effect. Based on this, scholars simulated the process of biomineralization in the development of hard tissues, to improve the structure and function of materials through biomimetic mineralization technology and enhance the repair performance of materials. The current understanding of biomineralization theory and the construction of biomimetic repair technology is still in the stage of rapid development. In recent years, a mass of innovative studies are keeping emerging. In this review, the representative advances in the repair of oral-maxillofacial hard tissues of the past five years are reviewed.

Key words: biomimetic repair, bone, enamel, dentin

中图分类号:

Q 81

牛丽娜, 焦凯, 方明, 陈吉华. 仿生修复技术在口腔颌面部硬组织缺损修复中的应用进展[J]. 华西口腔医学杂志, 2021, 39(2): 129-135.

Niu Lina, Jiao Kai, Fang Ming, Chen Jihua. Application of biomimetic restoration in oral-maxillofacial hard tissue repair[J]. West China Journal of Stomatology, 2021, 39(2): 129-135.

图/表 3

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表 3

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仿生策略	文献	修复材料	研究环境	研究结果
模拟NCP的作用	Chen等^[11]	PAMAM-磷酸	体外+大鼠口内	可诱导脱矿釉质形成新生HAP
	Chen等^[6]	PAMAM-羧基	体外	可模拟组装出类似釉原蛋白的结构
	Fan等^[12]	PAMAM-氨基，PAMAM-羧基， PAMAM-羟基	体外	PAMAM可促进深层脱矿釉质再矿化
	Kind等^[10]	P₁₁-4	体外	可促进釉质病变深层的再矿化，其作用方式与釉质自然形成过程相似
	Alkilzy等^[8]	P₁₁-4，氟化钠	体外	P₁₁-4对釉质的再矿化效果优于氟化钠
	Welk等^[9]	P₁₁-4	临床试验	可修复釉质白垩色斑
稳定并输送矿物或矿物前体	Gargouri等^[16]	CPP-ACP	体外	添加CPP-ACP的口香糖可促进脱矿釉质再矿化
	Ma等^[15]	CPP-ACP	体外+临床试验	可促进釉质白垩色斑的恢复，有助于诱导脱矿釉质再矿化并恢复其力学性能
	Shao等^[17]	钙磷离子团簇	体外	修复后的釉质与天然釉质具有相同的层次结构和力学性能

仿生策略	文献	修复材料	研究环境	研究结果
稳定并输送矿物或矿物前体	Niu等^[18]	ACP	体外	混有ACP的粘接剂具有再矿化作用且粘接性能无明显改变
	Luo等^[21]	介孔硅加载ACP	体外	可诱导脱矿牙本质再矿化，解决ACP难以输送的问题
	Yu等^[22]	介孔硅加载纳米HAP	体外	可有效地阻断牙本质小管，抗酸稳定性好，且不影响牙本质与自腐蚀粘接剂系统之间的即时粘结强度
模拟NCP的作用	Xie等^[23]	PAMAM	体外	可促进脱矿牙本质再矿化，并提高其显微硬度
	Bacino等^[24]	聚天冬氨酸	体外	可诱导矿化前体，修复脱矿牙本质的结构和力学性能
	Gulseren等^[19]	牙本质磷蛋白模拟肽	体外	可诱导牙本质再矿化

仿生策略	参考文献	修复材料	研究环境	研究结果
结构仿生	Sun等^[28-29]	硅化胶原支架	体外+大鼠骨缺损模型	硅化支架可通过单核细胞免疫调节促进原位骨再生和血管生成
	Niu等^[30]	杂化胶原支架	体外	该修复材料具有良好的机械性能
	Yao等^[31]	磷酸钙聚合物诱导的液体前体	体外+小鼠骨质疏松模型	可对形状不规则的骨缺损区域进行修复
	Song等^[32]	聚丙烯酸交联胶原	体外+小鼠颅骨缺损模型	可诱导在体内自矿化，解决聚电解质在体内引入困难的问题
功能仿生	Zhang等^[33]	双壳微小RNA纳米微球+纳米纤维聚合物支架	体外+骨质疏松小鼠临界骨缺损模型	解决了在组织工程中实现基于无细胞支架的微小RNA治疗的再生医学的关键挑战
	Liu等^[34]	可注射生物活性因子纳米微球	体外+小鼠牙周炎模型	可通过原位免疫调节促进骨修复
	Zhang等^[35]	磁控生长因子负载支架	体外	提高生长因子的传递效率
	Liu等^[37]	加载基质细胞来源因子的无细胞组织工程骨支架	体外+小鼠颅骨缺损模型	可增强间充质干细胞的归巢与迁移，加速血管化，促进骨形成
	Yu等^[39]	磷酸三钙加载骨形成蛋白	体外+犬下颌骨缺损模型	促进血管化及骨形成

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仿生修复技术在口腔颌面部硬组织缺损修复中的应用进展

Application of biomimetic restoration in oral-maxillofacial hard tissue repair

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