Weng D, Hürzeler M B, Quiñones C R, Ohlms A, Caffesse R G
Department of Prosthodontics, Dental School, Julius-Maximilians-University, Würzburg, Germany.
Clin Oral Implants Res. 2000 Dec;11(6):546-54. doi: 10.1034/j.1600-0501.2000.011006546.x.
The periosteum has been referred to as a protective barrier in the regeneration of bone defects. The objective of this study was to determine the contribution of periosteum as a natural barrier to bone formation in guided bone regeneration. Mucoperiosteal flaps were elevated bilaterally on the buccal aspect of the mandibular angle in 5 cynomolgus monkeys. Bleeding was induced by perforating the cortical bone. A hemispherical titanium mesh was fixed over the areas thus creating a void 5 mm in height between the mesh and the bone surface. One one side the mesh was covered with an ePTFE membrane (test side). The contralateral side did not receive further treatment (control side). After 4 month healing, histomorphometric analyses were used to determine the percentage of new bone in the void underneath the mesh, and the ratio between mineralized tissue and marrow spaces in new and old bone. The mean percentage of new bone tissue was 77.2 +/- 7.5% for the test sides and 68.6 +/- 8.4% for the control sides (P = 0.018, t-test). This new bone contained 80.0 +/- 3.6% mineralized tissue in the test group and 82.5 +/- 5.0% in the control group (P > 0.05, t-test). In both groups the newly formed bone exhibited significantly less mineralized tissue than the old bone (P < 0.05, t-test). It is concluded from this study that new bone formation was enhanced by the additional use of an ePTFE membrane under a periosteum-lined mucoperiosteal flap when space maintenance was excluded as a critical factor.
骨膜在骨缺损再生中被视为一种保护屏障。本研究的目的是确定骨膜作为引导性骨再生中骨形成的天然屏障的作用。在5只食蟹猴的下颌角颊侧双侧掀起黏骨膜瓣。通过穿透皮质骨诱导出血。将一个半球形钛网固定在这些区域上方，从而在网与骨表面之间形成一个5毫米高的空隙。在一侧，网被ePTFE膜覆盖（试验侧）。对侧未接受进一步处理（对照侧）。愈合4个月后，采用组织形态计量学分析来确定网下方空隙中新骨的百分比，以及新骨和旧骨中矿化组织与骨髓腔的比例。试验侧新骨组织的平均百分比为77.2±7.5%，对照侧为68.6±8.4%（P = 0.018，t检验）。试验组中这种新骨含有80.0±3.6%的矿化组织，对照组为82.5±5.0%（P>0.05，t检验）。在两组中，新形成的骨的矿化组织均明显少于旧骨（P<0.05，t检验）。从本研究得出结论，当排除空间维持作为关键因素时，在骨膜内衬的黏骨膜瓣下额外使用ePTFE膜可促进新骨形成。
