Wikesjö Ulf M E, Lim Won Hee, Razi Saghi S, Sigurdsson Thorarinn J, Lee Michael B, Tatakis Dimitris N, Hardwick W Ross
Laboratory for Applied Periodontal and Craniofacial Regeneration, Department of Periodontology, Temple University, School of Dentistry, Philadelphia, PA 19140, USA.
J Periodontol. 2003 Jul;74(7):957-64. doi: 10.1902/jop.2003.74.7.957.
Collapse or compression of a barrier device into a periodontal defect or onto the root surface compromises outcomes following guided tissue regeneration (GTR). Bone biomaterials have been suggested to support regeneration of alveolar bone and to improve space provision with GTR devices. The objective of this study was to evaluate space provision, alveolar bone, and cementum regeneration following use of a bioabsorbable, calcium carbonate biomaterial in conjunction with GTR.
Routine, critical size, 5 to 6 mm, supraalveolar, periodontal defects were created in 5 young adult beagle dogs. Alternate jaw quadrants in consecutive animals received GTR and the coral biomaterial (cGTR) or GTR alone. The animals were euthanized 4 weeks postsurgery and tissue blocks processed for histometric analysis.
The coral implant particles were surrounded by newly-formed bone or immersed in connective tissue and appeared to resorb and be replaced by bone. There was limited, if any, appreciable cementum regeneration. Space provision was enhanced in cGTR compared to GTR sites (6.1 +/- 1.6 versus 2.4 +/- 0.8 mm2; P<0.05). Bone regeneration (height) was significantly increased in cGTR compared to GTR sites averaging 1.9 +/- 0.6 and 1.2 +/- 0.6 mm, respectively (P<0.05). Bone regeneration (area) was 2-fold greater in cGTR sites compared to the GTR control (3.3 +/- 1.8 versus 1.4 +/- 0.5 mm2), however the difference was not statistically significant (P>0.05).
The coral implant significantly enhanced space provision for GTR while alveolar bone formation appeared to be enhanced by its use. Increased healing intervals are needed to fully understand the biologic value of the coral implant as an adjunct to GTR.
屏障装置塌陷或压缩进入牙周缺损或牙根表面会影响引导组织再生(GTR)后的治疗效果。有研究表明骨生物材料可支持牙槽骨再生,并改善GTR装置的空间提供。本研究的目的是评估使用生物可吸收碳酸钙生物材料联合GTR后的空间提供、牙槽骨和牙骨质再生情况。
在5只年轻成年比格犬身上制造常规的、临界尺寸为5至6毫米的龈上牙周缺损。连续动物的交替颌象限接受GTR和珊瑚生物材料(cGTR)或仅接受GTR。术后4周对动物实施安乐死,并对组织块进行组织计量分析。
珊瑚植入颗粒被新形成的骨组织包围或浸入结缔组织中,似乎会吸收并被骨组织替代。牙骨质再生有限,即便有也不明显。与GTR部位相比,cGTR部位的空间提供有所增加(6.1±1.6对2.4±0.8平方毫米;P<0.05)。与GTR部位相比,cGTR部位的骨再生(高度)显著增加,平均分别为1.9±0.6和1.2±0.6毫米(P<0.05)。cGTR部位的骨再生(面积)是GTR对照组的2倍(3.3±1.8对1.4±0.5平方毫米),但差异无统计学意义(P>0.05)。
珊瑚植入物显著增强了GTR的空间提供,同时其使用似乎增强了牙槽骨形成。需要延长愈合时间间隔以充分了解珊瑚植入物作为GTR辅助手段的生物学价值。