多功能骨修复膜通过诱导内源性再生促进牙槽位点保存的作用及机制研究

拔牙创愈合常伴有牙槽骨吸收，增加了后期修复和种植治疗的难度与风险。拔牙位点保存术是目前临床上减少拔牙后牙槽骨吸收常用的技术方法，但仍存在诸多弊端，如胶原膜缺乏抗菌性能、降解快、易塌陷，充填材料骨诱导性能不足且降解速度过慢、造成占位而延缓了骨新生与改建。为此，本研究提出通过制备兼具骨诱导性和抗菌性能等多功能的骨修复膜来优先“搭建”拔牙创顶层骨壁的修复思路，预设拟恢复牙槽骨量、改善牙槽窝成骨微环境，充分利用患者自身的修复能力来实现牙槽窝骨再生。具体设计是在前期研究基础上引入分步固化丝蛋白/HA-NB双网络水凝胶体系构建新型骨修复膜，提升膜的支撑强度、优化降解并赋予其组织粘接性能，还拟使用优选的“V”型微沟槽与锶-锌离子联合实现成骨诱导和抗菌的双重功效，协同诱导内源性再生。结合分子生物学、单细胞测序、模式动物等研究手段深入探讨内源性再生诱导机制，以期推动牙槽位点保存技术的优化和治疗理念的升级。

The rapid absorption of residual alveolar bone after tooth extraction is inevitable. How to maintain sufficient bone to support the subsequent prosthodontics and implant treatment is an urgent clinical problem to be solved. At present, there are still some drawbacks of the commonly used technique of socket preservation, such as the lack of antibacterial capacity, insufficient strength and rapid degradation of the barrier membranes, the limited osteoinductive capacity and slow degradation of the filling material. Therefore, the present study intents to maintain the height and width of alveolar ridge by "building" the top bone wall of the socket firstly through fabricating a novel barrier membrane with multiple functions, such as osteoinductivity and antibacterial capacity. By improving the bone regenerative microenvironment of the sockets, the self-repair ability of the patients could be improved, which results in the acceleration of the rehabilitation of the sockets. Based on our preliminary results, a two-step silk fibroin /HA-NB double network hydrogel system with interpenetrating network is introduced to enhance the mechanical strength and degradation capacity of the membrane and enable it can adhere to tissues. The dual effect of osteoinduction and antibacterial property would be achieved by the V-shaped groove-microstructures surface and Sr-Zn ions release. In this study, advanced techniques, such as the molecular biological, single-cell sequencing, fate-mapping techniques, will be used to explore the mechanism of the endogenous bone regeneration. We are looking forward to providing a new treatment strategy for socket preservation technology and promoting the upgrading of the treatment concept.