Imbronito Ana Vitoria, Todescan Jose H, Carvalho Cassio V, Arana-Chavez Victor E
Department of Histology and Embryology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil.
Biomaterials. 2002 Oct;23(20):4079-86. doi: 10.1016/s0142-9612(02)00145-x.
Two main types of membrane barriers are used for bone regeneration, non-resorbable and resorbable. Polytetrafluorethilene non-resorbable membranes have been extensively studied but they require a second surgical step for removal. Although polylactic acid (PLA) resorbable membranes avoid this problem, they have not been sufficiently evaluated on bone defects. The purpose of this pilot study was to compare the healing events of bone regeneration after placement of non-resorbable or resorbable membranes and to evaluate the amount of newly formed bone 2 and 4 months after membrane placement. Mandibular second, third and fourth premolars of four adult mongrel dogs were extracted bilaterally. Two rectangular bone defects (8 mm corono-apical and 12 mm mesial-distal) were created bilaterally 3 months after tooth extractions. Each dog received two resorbable membranes and one non-resorbable membrane; one defect was left untreated. Two dogs were killed at 2 months and the remaining two at 4 months following surgery. Undecalcified sections were obtained and stained with toluidine blue and pyronin G. Histomorphometric analysis was performed using the NIH Image software. Newly formed bone was observed under both resorbable and non-resorbable membranes. The amount of regenerated bone was similar between both treatments at 2 and 4 months after surgery. At 2 months, the newly formed bone was still immature whereas at 4 months some areas of woven bone were observed. The bone formation observed in the untreated defects was significantly lower than that observed in both resorbable and non-resorbable membrane-protected defects. In summary, the present study suggests that PLA membranes can yield good results when used on bone defects while avoid a second surgical procedure.
用于骨再生的膜屏障主要有两种类型,即不可吸收型和可吸收型。聚四氟乙烯不可吸收膜已得到广泛研究,但需要二次手术取出。尽管聚乳酸(PLA)可吸收膜避免了这一问题,但它们在骨缺损方面尚未得到充分评估。本初步研究的目的是比较放置不可吸收或可吸收膜后骨再生的愈合情况,并评估膜放置后2个月和4个月新形成骨的量。对4只成年杂种犬双侧拔除下颌第二、第三和第四前磨牙。拔牙3个月后双侧制造两个矩形骨缺损(冠根向8mm,近远中向12mm)。每只犬接受两张可吸收膜和一张不可吸收膜;一个缺损不做处理。术后2个月处死2只犬,其余2只在4个月处死。获取未脱钙切片,用甲苯胺蓝和派洛宁G染色。使用NIH Image软件进行组织形态计量分析。在可吸收和不可吸收膜下均观察到新形成的骨。术后2个月和4个月,两种治疗方法的再生骨量相似。2个月时,新形成的骨仍不成熟,而4个月时观察到一些编织骨区域。未处理缺损中观察到的骨形成明显低于可吸收和不可吸收膜保护缺损中观察到的骨形成。总之,本研究表明,PLA膜用于骨缺损时可取得良好效果,同时避免二次手术。