Hämmerle C H, Chiantella G C, Karring T, Lang N P
Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland.
Clin Oral Implants Res. 1998 Jun;9(3):151-62. doi: 10.1034/j.1600-0501.1998.090302.x.
The aim of the present experiment was to test the effect of a deproteinized bovine bone mineral (Bio-Oss) on guided bone regeneration (GBR) in dehiscence defects around implants. The first 2 molars and all premolars were extracted on both sides of the mandibles of 3 monkeys (Macaca fascicularis). Three months later, 2 titanium plasma-coated cylindrical implants were placed in all quadrants of each monkey. During the surgical procedure, standardized dehiscence defects were produced buccally and lingually, measuring 2.5 mm in width and 3 mm in height. Four different experimental situations were created: 2 sites in each monkey were covered with an ePTFE membrane (M), 2 were filled with the graft material (DBBM), 2 were filled with the graft material and also covered with a membrane (M + DBBM), and 2 control sites were neither grafted nor covered (C). The flaps were sutured to allow for primary healing. Linear measurements of bone height and width were calculated on histological specimens obtained 6 months following surgery. In addition, values for bone density and for surface fraction of graft to new bone contact were measured. Vertical bone growth along the implant surface of 100% (SD 0%) for M + DBBM, 91% (SD 9%) for M, 52% (SD 24%) for DBBM, and 42% (SD 35%) for C was measured. The width of the regenerated bone 1.5 mm above the bottom of the original defect, i.e. at the 50% mark of the vertical extension of the defect, in relation to the width at the bottom of the defect amounted to 97% (SD 2%) for M + DBBM, 85% (SD 9%) for M, 42% (SD 41%) for DBBM, and 23% (SD 31%) for C. Assessment of bone density within the confinement of the regenerated bone resulted in an increase of 30% (SD 11%) for M + DBBM, 45% (SD 20%) for M, 33% (SD 20%) for DBBM, and 22% (SD 23%) for C. The values for graft to new bone contact within this compartment amounted to 80% (SD 15%) for M + DBBM and 89% (SD 14%) for DBBM. In conclusion, Bio-Oss exhibited osteoconductive properties and hence can be recommended for GBR procedures in dehiscence defects with respect to vertical and horizontal growth of bone.
本实验的目的是测试脱蛋白牛骨矿物质（Bio-Oss）对种植体周围裂开性骨缺损引导骨再生（GBR）的影响。在3只猕猴（食蟹猴）的下颌两侧拔除前2颗磨牙和所有前磨牙。3个月后，在每只猕猴的所有象限植入2枚钛等离子喷涂圆柱形种植体。在手术过程中，在颊侧和舌侧制造标准化的裂开性骨缺损，宽度为2.5 mm，高度为3 mm。创建了4种不同的实验情况：每只猕猴的2个部位覆盖ePTFE膜（M），2个部位填充移植材料（DBBM），2个部位填充移植材料并覆盖膜（M + DBBM），2个对照部位既不移植也不覆盖（C）。缝合皮瓣以实现一期愈合。在术后6个月获得的组织学标本上计算骨高度和宽度的线性测量值。此外，还测量了骨密度以及移植材料与新骨接触的表面分数值。测量了沿种植体表面的垂直骨生长情况：M + DBBM为100%（标准差0%），M为91%（标准差9%），DBBM为52%（标准差24%），C为42%（标准差35%）。在原始骨缺损底部上方1.5 mm处，即缺损垂直延伸的50%标记处，再生骨的宽度与缺损底部宽度相比，M + DBBM为97%（标准差2%），M为85%（标准差9%），DBBM为42%（标准差41%），C为23%（标准差31%）。对再生骨范围内的骨密度评估结果为：M + DBBM增加30%（标准差11%），M增加45%（标准差20%），DBBM增加33%（标准差20%），C增加22%（标准差23%）。该区域内移植材料与新骨接触的值，M + DBBM为80%（标准差15%），DBBM为89%（标准差14%）。总之，Bio-Oss表现出骨传导特性，因此就骨的垂直和水平生长而言，可推荐用于裂开性骨缺损的GBR手术。
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