Barboza Eliane Porto, de Souza Rogério Oliveira, Caúla André Luis, Neto Luiz Geolás, Caúla Fernanda de Oliveira, Duarte Maria Eugenia Leite
Fluminense Federal University and Brazilian Institute of Periodontology, Rio de Janeiro, Brazil.
J Periodontol. 2002 Oct;73(10):1153-9. doi: 10.1902/jop.2002.73.10.1153.
Osteoinduction to treat osseous defects has been attempted by several means. Some clinical studies have demonstrated that a synthetic cell binding peptide (P-15) with anorganic bovine derived bone matrix (ABM) has the ability to enhance bone regeneration. These studies suggest that more histological data are necessary to better understand this process. We have developed a Class III chronic alveolar defect animal model to investigate space-maintaining regenerative materials. The objective of this study was to clinically and histologically evaluate the use of P-15/ABM with or without a bioabsorbable membrane (M) to regenerate localized chronic alveolar ridge defects in dogs.
Six adult, male mongrel dogs were used in this study. Bilateral, Class III, alveolar defects were surgically produced following extraction of the mandibular second premolar teeth and local reduction of the alveolar ridge. After an 8-week healing interval, mucoperiosteal flaps were elevated. P-15/ABM with or without bioabsorbable membranes were implanted into contralateral defects in 10 sites. Two sites received no biomaterial (controls). Mucoperiosteal flaps were advanced over the P-15/ABM or P-15/ABM/M constructs and sutured. Pre- and postaugmentation clinical evaluation was done utilizing periodontal probes and calipers. The animals were sacrificed 12 weeks postaugmentation and block specimens processed for histologic evaluation.
Clinical results showed no significant statistical augmentation on the control group (0.0 +/- 0.6 mm). In all experimental sites utilizing P-15/ABM or P-15/ABM/M, relevant ridge augmentation was observed (3.6 +/- 2.0 mm and 2.9 +/- 1.9 mm, respectively). Histologically, all experimental sites showed active bone formation with plump osteoblast and osteoid matrix deposition in the treated area. Bone ingrowth filled the area of the defects treated with P-15/ABM/M. Few P-15/ABM particles were seen in the cellular fibrous tissue surrounding the new formed bone trabeculae.
P-15/ABM with or without membranes can produce a significant clinical ridge augmentation. Bone formation was histologically observed in all test areas. The association of a membrane with P-15/ABM seemed to enhance the process of bone formation.
人们已尝试通过多种方法诱导骨生成以治疗骨缺损。一些临床研究表明，一种合成细胞结合肽（P-15）与无机牛源骨基质（ABM）具有促进骨再生的能力。这些研究表明，需要更多组织学数据来更好地理解这一过程。我们开发了一种III类慢性牙槽骨缺损动物模型，以研究维持空间的再生材料。本研究的目的是从临床和组织学角度评估使用P-15/ABM加或不加生物可吸收膜（M）来修复犬局部慢性牙槽嵴缺损的效果。
本研究使用了6只成年雄性杂种犬。在拔除下颌第二前磨牙并局部降低牙槽嵴后，通过手术制造双侧III类牙槽骨缺损。经过8周的愈合期后，掀起黏骨膜瓣。将含或不含生物可吸收膜的P-15/ABM植入10个部位的对侧缺损处。两个部位不植入生物材料（作为对照）。将黏骨膜瓣覆盖在P-15/ABM或P-15/ABM/M结构上并缝合。使用牙周探针和卡尺进行种植前和种植后的临床评估。在种植后12周处死动物，并对块状标本进行组织学评估。
临床结果显示，对照组无明显的统计学意义上的牙槽嵴增高（0.0±0.6毫米）。在所有使用P-15/ABM或P-15/ABM/M的实验部位，均观察到相关的牙槽嵴增高（分别为3.6±2.0毫米和2.9±1.9毫米）。组织学上，所有实验部位在治疗区域均显示有活跃的骨形成，有成骨细胞饱满且有类骨质基质沉积。骨长入填充了用P-15/ABM/M治疗的缺损区域。在新形成的骨小梁周围的细胞纤维组织中可见少量P-15/ABM颗粒。
含或不含膜的P-15/ABM均可显著增加牙槽嵴高度。在所有测试区域均观察到骨形成。膜与P-15/ABM的联合使用似乎增强了骨形成过程。
