Paolantonio M, Scarano A, Di Placido G, Tumini V, D'Archivio D, Piattelli A
Department of Periodontology, University G. D'Annunzio, Chieti, Italy.
Int J Periodontics Restorative Dent. 2001 Oct;21(5):505-15.
The authors report the clinical and histologic data on the healing of a severe periodontal lesion obtained in a one-walled intrabony defect using anorganic bovine bone under a bovine peritoneum-derived collagen membrane. Eight months after surgery, a bone-like tissue replaced the lost tissues. A biopsy of this tissue was carried out. In the part of the specimen closer to the residual bony wall of the original defect, anorganic bone particles (ABP) appeared to be surrounded by a layer of newly formed bone; its osteocyte lacunae were colonized by osteocytes from the host, and actively secreting osteoblasts were observed in many microscopic fields. No resorption phenomena were observed in the ABP Newly formed cementum with actively secreting cementoblasts was present on the tooth surface, and well-oriented fibers inserting in both newly formed cementum and bone were observed. In an area far from residual bone, all ABP did not appear to be surrounded by newly formed bone. Osteocytic lacunae appeared not to be colonized by cells, and ABP was surrounded by dense connective tissue without osteoblasts near the grafted particles. A very limited amount of newly formed bone, without relations with ABP, was observed close to the root surface. From a clinical point of view, anorganic bone in association with a collagen membrane can be effective in the treatment of bony defects characterized by an unfavorable architecture. From a histologic point of view, the clinical appearance of bone regeneration is not always confirmed in the part of the defect far from the bony walls.
作者报告了在单壁骨内缺损处使用无机牛骨并置于牛腹膜来源的胶原膜下治疗严重牙周病变的愈合情况的临床和组织学数据。术后八个月,骨样组织替代了缺失组织。对该组织进行了活检。在标本中靠近原始缺损残余骨壁的部分,无机骨颗粒(ABP)似乎被一层新形成的骨所包围;其骨细胞陷窝被来自宿主的骨细胞占据,并且在许多显微镜视野中观察到活跃分泌的成骨细胞。在ABP中未观察到吸收现象。牙齿表面存在具有活跃分泌的成牙骨质细胞的新形成的牙骨质,并且观察到有排列良好的纤维插入新形成的牙骨质和骨中。在远离残余骨的区域,所有ABP似乎未被新形成的骨所包围。骨细胞陷窝似乎未被细胞占据,并且ABP被致密结缔组织包围,在移植颗粒附近没有成骨细胞。在靠近牙根表面观察到极少量与ABP无关的新形成的骨。从临床角度来看,无机骨与胶原膜联合使用可有效治疗具有不良结构特征的骨缺损。从组织学角度来看,在远离骨壁的缺损部分并不总是能证实骨再生的临床表现。