Kohal R J, Trejo P M, Wirsching C, Hürzeler M B, Caffesse R G
Dept of Prosthodontics, Albert-Ludwigs-University, Freiburg, Germany.
Clin Oral Implants Res. 1999 Jun;10(3):226-37. doi: 10.1034/j.1600-0501.1999.100306.x.
The aim of this clinical investigation was to evaluate the effect of guided bone regeneration around non-submerged implants using different barrier membranes. Five adult mongrel dogs were used in this investigation. After having all premolars extracted and implant osteotomies performed in the regions of the former premolars, buccal bone defects were created. Subsequently, 3 implants were placed and the defects treated with 1 of the following 3 modalities: a) guided bone regeneration using an expanded polytetrafluoroethylene membrane, b) guided bone regeneration using a bioabsorbable membrane made from a synthetic copolymer of glycolide and lactide and c) no membrane application. Following implant and membrane placement, the mucoperiosteal flaps were repositioned and tightly sutured around the neck of the implants allowing for a non-submerged healing. After a healing period of 6 months, the animals were sacrificed and the specimens processed for histologic evaluation. The clinical pre-treatment defects between the different treatment groups were not statistically different (bioinert membrane group: 4.9 mm; control group: 4.8 mm; bioabsorbable membrane group: 4.5 mm). The remaining histological defects after 6 months of healing amounted to approximately 2.5 mm in the bioinert membrane group, 5.7 mm in the control group and 6.0 mm in the bioabsorbable membrane group. A significant difference was observed between the bioinert membrane group and the other 2 groups. The mineralized bone-to-implant contact in the bioinert membrane group was 51.5%, in the control group 46.3% and in the bioabsorbable membrane group 37.5%. The values between the bioinert membrane group and the bioabsorbable membrane group were statistically different. The results of this study indicate that bone regeneration with bioinert e-PTFE membranes around non-submerged implants is possible. The utilized absorbable polyglycolic/polylactid membrane did not show any bone regenerative effect and the results did not differ from the control group without membrane application.
本临床研究的目的是评估使用不同屏障膜在非潜入式种植体周围引导骨再生的效果。本研究使用了5只成年杂种犬。在拔除所有前磨牙并在前磨牙区域进行种植体截骨术后，制造颊侧骨缺损。随后，植入3枚种植体，并用以下3种方式之一处理缺损：a）使用膨体聚四氟乙烯膜引导骨再生，b）使用由乙交酯和丙交酯的合成共聚物制成的生物可吸收膜引导骨再生，c）不使用膜。在植入种植体和放置膜后，将粘骨膜瓣重新定位并在种植体颈部周围紧密缝合，以实现非潜入式愈合。经过6个月的愈合期后，处死动物并对标本进行组织学评估。不同治疗组之间的临床治疗前缺损无统计学差异（生物惰性膜组：4.9 mm；对照组：4.8 mm；生物可吸收膜组：4.5 mm）。愈合6个月后的剩余组织学缺损在生物惰性膜组约为2.5 mm，对照组为5.7 mm，生物可吸收膜组为6.0 mm。在生物惰性膜组与其他两组之间观察到显著差异。生物惰性膜组的矿化骨与种植体接触率为51.5%，对照组为46.3%，生物可吸收膜组为37.5%。生物惰性膜组与生物可吸收膜组之间的值有统计学差异。本研究结果表明，在非潜入式种植体周围使用生物惰性e-PTFE膜进行骨再生是可行的。所使用的可吸收聚乙醇酸/聚乳酸膜未显示出任何骨再生效果，其结果与未使用膜的对照组无差异。
