Schou Søren, Holmstrup Palle, Jørgensen Torben, Skovgaard Lene Theil, Stoltze Kaj, Hjørting-Hansen Erik, Wenzel Ann
Departments of Oral and Maxillofacial Surgery, School of Dentistry, University of Copenhagen and University Hospital (Rigshospitalet), Institute of Experimental Clinical Research, University of Aarhus, Aarhus, Denmark.
Clin Oral Implants Res. 2003 Oct;14(5):535-47. doi: 10.1034/j.1600-0501.2003.00911.x.
The purpose of the present study was to evaluate the effect of anorganic porous bovine-derived bone mineral (Bio-Oss) and expanded polytetrafluoroethylene (ePTFE) membrane in the treatment of peri-implantitis. A total of 64 implants with a titanium plasma-sprayed (TPS) surface was inserted in eight cynomolgus monkeys (Macaca fascicularis). After a 3-month healing period with plaque control, experimental peri-implantitis characterized by a bone loss of 4-6 mm was induced during a period of 9-18 months. Surgical treatment involving Bio-Oss+membrane, Bio-Oss, membrane, or a conventional flap procedure (control) only was carried out. The animals were sacrificed six months after treatment. Evaluation by clinical parameters, radiography including quantitative digital subtraction radiography, histology, and stereology demonstrated healthy peri-implant tissue irrespective of the applied surgical procedure. However, the amount of re-osseointegration and the total amount of bone (Bio-Oss and regenerated bone) were significantly higher in defects treated with membrane-covered Bio-Oss as compared with the other three treatment procedures. A mean bone-to-implant contact of 36% was obtained within defects treated with membrane-covered Bio-Oss. The corresponding values for the three other treatment procedures were 13-23%. The Bio-Oss particles were in general highly integrated within the regenerated bone, but the particles in the occlusal part of the defects were entirely surrounded by connective tissue irrespective of membrane coverage. The present study demonstrates that surgical treatment involving Bio-Oss covered by an ePTFE membrane is a useful treatment modality of experimental peri-implantitis around implants with a TPS surface in cynomolgus monkeys. However, the treatment outcome is not as encouraging as seen with membrane-covered autogenous bone graft particles documented in a study with same experimental design.
本研究的目的是评估无机多孔牛源骨矿物质（Bio-Oss）和膨体聚四氟乙烯（ePTFE）膜在治疗种植体周围炎中的作用。将总共64颗具有钛等离子喷涂（TPS）表面的种植体植入8只食蟹猴（猕猴）体内。在进行3个月的菌斑控制愈合期后，在9至18个月的时间内诱导出以骨吸收4 - 6毫米为特征的实验性种植体周围炎。进行了涉及Bio-Oss + 膜、Bio-Oss、膜或仅进行传统翻瓣手术（对照）的手术治疗。治疗后6个月对动物实施安乐死。通过临床参数、包括定量数字减影放射摄影在内的放射学、组织学和体视学评估表明，无论采用何种手术治疗方法，种植体周围组织均健康。然而，与其他三种治疗方法相比，用膜覆盖的Bio-Oss治疗的缺损处再骨结合量和骨总量（Bio-Oss和再生骨）明显更高。在用膜覆盖的Bio-Oss治疗的缺损处，平均骨与种植体接触率为36%。其他三种治疗方法的相应值为13% - 23%。Bio-Oss颗粒总体上与再生骨高度整合，但缺损咬合部分的颗粒无论是否有膜覆盖，均完全被结缔组织包围。本研究表明，在食蟹猴中，涉及用ePTFE膜覆盖Bio-Oss的手术治疗是治疗TPS表面种植体周围实验性种植体周围炎的一种有效治疗方式。然而，治疗结果不如在相同实验设计的研究中记录的用膜覆盖的自体骨移植颗粒那样令人鼓舞。
