生物活性玻璃与脱矿冻干同种异体骨移植治疗犬下颌种植体周围骨内缺损的比较。

Comparison of bioactive glass to demineralized freeze-dried bone allograft in the treatment of intrabony defects around implants in the canine mandible.

作者信息

Hall E E, Meffert R M, Hermann J S, Mellonig J T, Cochran D L

机构信息

Department of Periodontics, University of Texas Health Science Center, San Antonio 78440, USA.

出版信息

J Periodontol. 1999 May;70(5):526-35. doi: 10.1902/jop.1999.70.5.526.

Abstract

BACKGROUND

The purpose of this study was to evaluate and compare the healing of different bone grafting materials adjacent to titanium plasma-sprayed (TPS) endosseous dental implants.

METHODS

Implant osteotomy sites were prepared and standardized 3-walled intrabony defects (3 mm x 5 mm x 5 mm) were created at the mesial of each implant site. Thirty-two TPS implants were placed in edentulous mandibular ridges of the 4 dogs. Periodontal dressings were placed in the defect sites so as to create a defect simulating bone loss around an implant. After 3 months, the periodontal dressing was removed, the defect sites debrided and evaluated for size, and intramarrow penetration performed. The graft materials tested were 1) canine demineralized freeze-dried bone allograft (cDFDBA); 2) bioactive glass granules of a broad size range 90 to 710 microns (BRG); and 3) bioactive glass granules of narrow size range 300 to 355 microns (NRG). One site on each side of the mandible was not filled and served as a control. Dogs were sacrificed 4 months after graft placement.

RESULTS

Histologically, differences in percent bone-to-implant contact in the defect area were observed between the treatment groups. cDFDBA>control=BRG=NRG with statistical significance found between cDFDBA and control (P = 0.0379), but no statistically significant difference between control or either bioactive glass material. When comparing percent bone height fill of the defect in the grafted area, cDFDBA (65.7%) was significantly better than the control (48.9%; P < or = 0.05) with no statistically significant difference between control, broad range bioactive glass (57.3%) and narrow range bioactive glass (56.6%). When total bone area was measured, the percentage of new bone in the grafted area was cDFDBA (42.1%), broad range glass (33.1%) and narrow range glass (22.6%) with significance found between cDFDBA and NRG (P = 0.0102). The content of residual graft particles in soft tissue was significant (P = 0.0304) between cDFDBA (1.4%) and NRG (11.4%) with no significant difference between graft material for residual particle content in bone tissue.

CONCLUSIONS

The results of this study indicate that percent bone-to-implant contact and percent bone height fill in an intrabony defect around titanium plasma-sprayed implants are statistically significantly higher with the use of DFDBA when compared to bioactive glass material.

摘要

背景

本研究的目的是评估和比较不同骨移植材料在钛等离子喷涂(TPS)牙种植体周围的愈合情况。

方法

制备种植体截骨部位,并在每个种植体部位的近中侧创建标准化的三壁骨内缺损(3毫米×5毫米×5毫米)。将32枚TPS种植体植入4只犬的无牙下颌牙槽嵴。在缺损部位放置牙周敷料,以模拟种植体周围的骨丢失缺损。3个月后,去除牙周敷料,清理缺损部位并评估其大小,然后进行骨髓内穿刺。测试的移植材料为:1)犬脱矿冻干骨同种异体移植物(cDFDBA);2)粒径范围为90至710微米的生物活性玻璃颗粒(BRG);3)粒径范围为300至355微米的生物活性玻璃颗粒(NRG)。下颌每侧的一个部位不填充作为对照。移植后4个月处死犬。

结果

组织学上,各治疗组缺损区域骨与种植体接触百分比存在差异。cDFDBA>对照=BRG=NRG,cDFDBA与对照之间有统计学意义(P = 0.0379),但对照与任何一种生物活性玻璃材料之间无统计学显著差异。比较移植区域缺损的骨高度填充百分比时,cDFDBA(65.7%)显著优于对照(48.9%;P≤0.05),对照、宽范围生物活性玻璃(57.3%)和窄范围生物活性玻璃(56.6%)之间无统计学显著差异。测量总骨面积时,移植区域新骨的百分比为cDFDBA(42.1%)、宽范围玻璃(33.1%)和窄范围玻璃(22.6%),cDFDBA与NRG之间有显著性差异(P = 0.0102)。软组织中残余移植颗粒的含量在cDFDBA(1.4%)和NRG(11.4%)之间有显著性差异(P = 0.0304),骨组织中残余颗粒含量在移植材料之间无显著差异。

结论

本研究结果表明,与生物活性玻璃材料相比,使用DFDBA时,钛等离子喷涂种植体周围骨内缺损的骨与种植体接触百分比和骨高度填充百分比在统计学上显著更高。

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