In dental clinical practice, systemic steroids are often applied at the end of implant surgeries to reduce postsurgical inflammation (tissue swelling, etc.) and to reduce patient discomfort. However, the use of systemic steroids is associated with generalized catabolic effects and with a temporarily reduced immunological competence. We hypothesize that by applying locally anticytokine antibodies (antitumor necrosis factor alpha and anti-interleukin-1 beta) together with a bioactive osteogenic implant at the time of the surgical intervention for the placement of a construct, we will be able to achieve the same beneficial effects as those using systemic steroids but are able to avoid the generalized antianabolic effects and the reduced immunocompetence effects, associated with the systemic use of steroids. In an adult rat model, a collagen sponge, soaked with the osteogenic agent bone morphogenetic protein-2, was used as an example for a bioactive implant material and was surgically placed subcutaneously. In the acute inflammatory phase after implantation (2 days after surgery) we investigated the local inflammatory tissue response, and 18 days postsurgically the efficiency of local osteogenesis (to assess possible antianabolic effects). We found that the negative control groups, treated postsurgically with systemic steroids, showed a significant suppression of both the inflammatory response and the osteogenetic activity, that is, they were associated with significant general antianabolic effects, even when steroids were used only at a low dose level. The local anticytokine treatment, however, was able to significantly enhance new bone formation activity, that is, the anabolic activity, over positive control values with BMP-2 only. However, the anticytokine treatment was unable to reduce the local inflammatory and swelling responses.

中文翻译：

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抗细胞因子活性增强生物活性植入物的成骨

在牙科临床实践中，系统性类固醇通常在植入手术结束时使用，以减少术后炎症（组织肿胀等）并减少患者不适。然而，全身性类固醇的使用与广泛的分解代谢作用和暂时降低的免疫能力有关。我们假设，通过在手术干预时应用局部抗细胞因子抗体（抗肿瘤坏死因子 α 和抗白细胞介素 1 β）以及生物活性成骨植入物来放置构建体，我们将能够实现相同的有益效果与使用全身性类固醇的效果相同，但能够避免与全身性使用类固醇相关的普遍的抗合成代谢作用和降低的免疫活性效应。在成年大鼠模型中，胶原蛋白海绵，用成骨剂骨形态发生蛋白-2浸泡，作为生物活性植入材料的例子，并通过手术放置在皮下。在植入后的急性炎症阶段（手术后 2 天），我们研究了局部炎症组织反应，并在术后 18 天研究了局部成骨的效率（以评估可能的抗合成代谢作用）。我们发现，术后用全身性类固醇治疗的阴性对照组显示出对炎症反应和成骨活性的显着抑制，也就是说，它们与显着的一般抗合成代谢作用相关，即使仅在低剂量使用类固醇时也是如此等级。然而，局部抗细胞因子治疗能够显着增强新骨形成活性，即合成代谢活性，仅使用 BMP-2 超过阳性对照值。然而，抗细胞因子治疗无法减少局部炎症和肿胀反应。