正畸微种植体(orthodontic mini-implant, OMI)以其独特的优势广泛应用于临床,如何将OMI精准、微创、安全地植入骨内是目前的研究热点。数字化导板技术可为OMI植入提供较为精准的辅助定位,本文主要阐述数字化导板引导下植入正畸微种植体,以期为实现精准正畸理念提供参考。Orthodontic mini-implant (OMI) has been widely used in clinical practice with its unique advantages. How to implant OMI into bone accurately, minimally invasive and safely is a research hotspot at present. Digital guides technology can provide more accurate auxiliary positioning for OMI implantation. This paper mainly describes the implantation of orthodontic mini-implant under the guidance of digital guide, in order to provide reference for the realization of accurate orthodontic concept.
背景:巨噬细胞M1/M2极化方向的调节在组织工程应用中尤为关键,及时调控可最大程度地减少促炎、促进抗炎或组织愈合反应。目的:将慢病毒介导的miRNA-378a过表达巨噬细胞株复合胶原蛋白海绵回植入动物模型,据此检测免疫调节在体内环境中的相关表达水平等组织修复相关的指标,进一步阐明在体内环境中miRNA-378a是否促进巨噬细胞M2极化及其对免疫调节和组织修复的作用。方法:将慢病毒介导的miRNA-378a过表达巨噬细胞株、阴性对照病毒巨噬细胞株扩增、筛选,复苏培养巨噬细胞株后与胶原蛋白海绵共培养以此构成复合体,具体分组如下:①阳性组:过表达miRNA-378a巨噬细胞-胶原蛋白海绵复合体;②阴性组:阴性对照病毒介导的miRNA-378a巨噬细胞-胶原蛋白海绵复合体;③对照组:巨噬细胞-胶原蛋白海绵;④空白对照组:胶原蛋白海绵。通过免疫荧光及扫描电镜观察各组细胞密度、表型、黏附情况,后回植入小鼠背部皮下模型,分别于造模后4,7 d处死小鼠,通过大体观察、苏木精-伊红染色、Masson染色、免疫组化分析慢病毒介导的miRNA-378a过表达巨噬细胞胶原蛋白海绵复合体中巨噬细胞极化的方向及其对机体免疫调控、组织修复的作用。结果与结论:①免疫荧光镜下观察各组巨噬细胞株确实与胶原蛋白海绵形成复合体;②扫描电镜下慢病毒介导的miRNA-378a巨噬细胞(阳性组)较其他分组细胞密度增加,细胞出现球形、椭圆形及多边形分化,具有更多的伪足;③大体观察下总体7 d愈合好于4 d,慢病毒介导的miRNA-378a过表达巨噬细胞(阳性组)无论4,7 d愈合均好于其他分组;④苏木精-伊红染色、Masson染色下,慢病毒介导的miRNA-378a过表达巨噬细胞(阳性组)具有较多量的纤维细胞、毛细血管、成纤维细胞以及胶原纤维增生;⑤免疫组化显示,慢病毒介导的miRNA-378a过表达巨噬细胞(阳性组)无论4,7 d M2极化细胞阳性率均大于其他分组;对照组及阴性组巨噬细胞无论4,7 d M2极化细胞阳性率均大于空白对照组,而对照组及阴性组之间无统计学差异;阳性组、阴性组、对照组无论4,7 d染色细胞数量均大于空白对照组,且阳性组>阴性组≈对照组>空白对照组;⑥提示在体内环境中miRNA-378a过表达巨噬细胞具有较多量的纤维细胞、毛细血管、成纤维细胞以及胶原纤维增生,对组织修复起到了正向作用,并且能促进巨噬细胞向M2型极化并抑制M1型极化,从而有助于减少机体炎症反应。
口腔种植作为牙列缺损的重要修复方法之一,目前在临床上得到广泛应用,种植材料的优化对于种植成功具有重要意义。聚醚醚酮(polyetheretherketone, PEEK)是聚芳醚酮家族中的一种半结晶形态热塑性聚合物,相比于传统的口腔种植材料,PEEK具有与骨组织相近的弹性模量、化学稳定性和射线可透性等一系列优异的性能,能够避免金属腐蚀以及应力遮挡效应导致的骨吸收。然而,PEEK表面的生物惰性可能会导致骨结合不良以及感染等问题,不利于其在口腔种植领域的应用。因此,PEEK的表面改性日益成为研究的热点之一。研究人员探索了多种生物活性材料的改性方法,以有效增强PEEK及其复合材料的成骨和抗菌性。因此,本文主要综述了近年来生物活性材料改性后的PEEK的研究进展,对PEEK的成骨及抗菌策略进行了分析,并对改性后的PEEK在口腔种植领域的应用进行了展望。As one of the important repair methods for dentition defects, oral implant is widely used in clinic. The optimization of implant materials is of great significance to the success of implants. Polyetheretherketone (PEEK) is a semi-crystalline thermoplastic polymer in the polyaryletherketone family. Compared with traditional oral implant materials, PEEK has a series of excellent properties such as elastic modulus, chemical stability and ray permeability similar to bone tissue, which can avoid metal corrosion and bone resorption caused by stress shielding effect. However, the biological inertia of PEEK surface may lead to problems such as poor osseointegration and infection, which is not conducive to its application in the field of oral implantology. Therefore, the surface modification of PEEK has increasingly become one of the research hotspots. Researchers have explored a variety of modification methods of bioactive materials to effectively enhance the osteogenic and antibacterial properties of PEEK and its composites. Therefore, this paper mainly reviews the research progress of PEEK modified by bioactive materials in recent years, analyzes the osteogenesis and antibacterial strategies of PEEK, and looks forward to the application of modified PEEK in the field of oral implantology.
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