Lim S C, Lee M J, Yeo H H
Department of Pathology, College of Medicine, Chosun University, Kwangju, Korea.
Pathol Int. 2000 Aug;50(8):594-602. doi: 10.1046/j.1440-1827.2000.01089.x.
The purpose of the present study was to determine the best implant material, the best conditions to substitute absorbable membrane for non-absorbable membrane, and the factors influencing guided regeneration of critical size defects using experimental rats. An 8-mm circular transosseous calvarial bony defect was made and implant materials, such as demineralized freeze-dried bone (DFDB), absorbable membrane (BioMesh; Samyang Co., Seoul Korea), non-absorbable membrane (Millipore filter; Micro Filtration System, MA, USA) or a combination of these materials, was placed on the defect. As for the results of sequential time-based guided bone regeneration, histological, histochemical, immunohistochemical and histomorphometric aspects were observed, and a statistical comparative analysis was performed, with control group of a soft tissue flap. Bone formation was significantly enhanced when DFDB was retained within the defect with a protective absorbable membrane. Inframembranous DFDB-filling was required to prevent membrane collapse and to preserve spaces for bone regeneration. The absorbable membrane which was recommended to overcome the disadvantages of the non-absorbable membrane should remain intact for more than 5 weeks in order for it to be effective. The macrophages recruited by grafts were involved partly in decreasing bone regeneration via the sequential events of releasing fibronectin, and in chemotactic effect of the fibronectin to fibroblasts and collagen lay-down. Thus, the activity of new bone formation was dependent upon the physical barrier effect of the membrane, such as the preserving ability to secure spaces and the suppression ability of early infiltration of collagen and epithelium, inducible ability of inflammation by the implant material, and potential in guiding bone regeneration of the grafts.
本研究的目的是使用实验大鼠确定最佳的植入材料、用可吸收膜替代不可吸收膜的最佳条件以及影响临界尺寸骨缺损引导性骨再生的因素。制作一个8毫米的圆形经骨颅骨骨缺损，并将植入材料，如脱矿冻干骨（DFDB）、可吸收膜（BioMesh；韩国首尔三养公司）、不可吸收膜（密理博滤膜；美国马萨诸塞州微滤系统公司）或这些材料的组合放置在缺损处。至于基于时间顺序的引导性骨再生结果，观察了组织学、组织化学、免疫组织化学和组织形态计量学方面，并与软组织瓣对照组进行了统计学比较分析。当DFDB与保护性可吸收膜一起保留在缺损内时，骨形成显著增强。需要膜内填充DFDB以防止膜塌陷并保留骨再生空间。为克服不可吸收膜的缺点而推荐使用的可吸收膜应完整保留超过5周才能有效。移植物募集的巨噬细胞部分参与通过释放纤连蛋白的一系列事件减少骨再生，以及纤连蛋白对成纤维细胞的趋化作用和胶原沉积。因此，新骨形成的活性取决于膜的物理屏障作用，如确保空间的保留能力、对胶原和上皮早期浸润的抑制能力、植入材料诱导炎症的能力以及移植物引导骨再生的潜力。
