Fritz M E, Jeffcoat M K, Reddy M, Koth D, Braswell L D, Malmquist J, Lemons J
Emory University, Yerkes Regional Primate Research Center, Atlanta, GA, USA.
J Periodontol. 2000 Sep;71(9):1484-91. doi: 10.1902/jop.2000.71.9.1484.
An earlier publication from our laboratory described the use of guided bone regeneration to fill large bone voids in the mandible created through en bloc resection in primates. The present report is an embellishment of this paper and describes bone regeneration experiments in 18 adult male Macaca mulatta monkeys to determine how long membranes must be in position to promote guided bone regeneration.
Thirty-six lesions were created in the mandibles of 18 monkeys in a standardized mandibular defect of 8 x 19 mm. Reinforced ePTFE membranes were placed in the animals and held in place with mini screws and sutures for anywhere from 1 to 12 months. No material was added to the defect. In addition to clinical studies, digital subtraction radiology and fluorescent labeling with tetracycline and histomorphometry are described.
The results indicate that no bone gain was observed in membranes exposed for 1 month or less, but bone gain (approximately well over 90% of defects) was observed at 12 months when membranes were left in situ for 2 to 12 months (P <0.0001). No significant difference in the amount of bone gained at 12 months was observed for membranes left in place for intervals ranging from 2 to 12 months. A significant correlation between the amount of bone gain observed at 3 and 12 months was observed (P <0.0001).
Data therefore suggest that membranes left in situ for 1 month or less result in minimal bone gain compared with membranes left in place from 2 to 12 months. In addition, labeling and stained sections clearly showed that the bone produced after 2 months of membrane placement is mature.
我们实验室早期发表的一篇论文描述了使用引导骨再生技术来填充灵长类动物下颌骨因整块切除而产生的大骨缺损。本报告是对该论文的补充，描述了在18只成年雄性恒河猴身上进行的骨再生实验，以确定膜必须在位多长时间才能促进引导骨再生。
在18只猴子的下颌骨上制造了36个病变，形成标准化的8×19毫米下颌骨缺损。将增强型聚四氟乙烯膜放置在动物体内，并用微型螺钉和缝线固定1至12个月不等。缺损处未添加任何材料。除了临床研究外，还描述了数字减影放射学以及用四环素进行荧光标记和组织形态计量学。
结果表明，暴露1个月或更短时间的膜未观察到骨增量，但当膜在位2至12个月时，在12个月时观察到骨增量（约超过90%的缺损）（P<0.0001）。对于在位2至12个月的膜，在12个月时观察到的骨增量没有显著差异。在3个月和12个月时观察到的骨增量之间存在显著相关性（P<0.0001）。
因此，数据表明，与在位2至12个月的膜相比，在位1个月或更短时间的膜导致的骨增量最小。此外，标记和染色切片清楚地表明，膜放置2个月后产生的骨是成熟的。
