| Abstract: | 牙周組織遭受細菌感染後，最初形成牙齦炎，若未治癒，將繼而形成牙周炎。牙周炎的特色為附連喪失及齒槽骨形成缺損。當骨形成缺損後，將造成牙齒的動搖度，因此促成骨新生是牙醫師希望能達成的目標。引導骨組織再生為促進牙周附連再生之手術，其中需使用再生膜以隔絕上皮細胞侵入，但由於再生膜無良好機械性質，因此常輔以骨粉作為支撐。如今市面上骨粉品牌眾多，各有優點，但卻各有缺點，如機械性質仍不甚優良或無法促進骨新生等。本研究之目的在於希望能做出一結合再生膜及骨粉性質的複合材料。幾丁聚醣為廣泛使用之生物材料，具有生物相容性、可降解性、易於修飾等等，因此作為本研究複合材之基底。另外石墨烯為近代新興材料，為當前世界上最薄最硬之材料，已應用於生醫領域。本實驗將幾丁聚醣與石墨烯結合作為一複合材，並且加入骨成形蛋白，經材料降解測試、BMP2釋放程度測試、生物相容性測試、骨新生程度測試後，發現本複合材料具有良好的降解性，間葉幹細胞可攀附生長，並可促進細胞之骨分化生長。於最後進入動物實驗。於動物實驗中，合併了二極體雷射，做低能量雷射治療，以期能促進骨的新生。動物實驗結果同樣顯示，幾丁聚醣與石墨烯孔洞複合材是一有良好生物相容性並可促進骨新生之材料。
其他文獻指出，石墨烯複合材可促進間葉幹細胞分化為造骨細胞，與本研究結果相呼應，經一連串結果顯示石墨烯複合材有相當優異之性質，期望未來能成為醫療上廣泛使用的骨缺損複合材。When there is dental plaque accumulation around periodontium for a period of time, gingiva would be red and swelling, and this condition is called gingivitis. When gingiva inflammation gets worse, periodontitis is formed. The features of periodontitis are connective tissue attachment loss, bone loss, and teeth mobility. Thus the goal of bone regeneration is an important issue for dentists. The procedure of guided bone tissue regeneration is using barrier membrane to seal the bony defect area, preventing connective tissue cell to invade, and thus allow bone cell to grow. One of the disadvantages of barrier membrane is weak mechanical support. The goal of this study is to fabricate a scaffold which is strong enough to maintain space, and has the ability of promoting new bone generation. Chitosan is widely used in biomedical field, its features includes good biocompatibility, degradability, so we use chitosan as base of our composite scaffold. Graphene is the hardest and thinnest material, so we use chitosan and graphene to fabricate a scaffold, and add bone morphogenic protein 2 to induce osteogenesis. In the experiment, we analyze biodegradability, biocompalibility, BMP2 release, osteogenesis degree of the scaffold,
and we found this material has good degradability 、biocompatibility, and human mesenchymal stem cells could adhere and grow well. In the last, we did animal study to confirm the features of chitosan-graphene porous scaffold, and combined low level laser therapy to enhance osteogenesis. The results revealed that chitosan-graphene scaffold has good biocompatibility and is osteoinductive, we hope that it could widely used in guided bone regeneration in the future. |
