Wikesjö U M, Bogle G C, Nilvéus R E
Graduate Periodontics, Loma Linda University, CA.
J Periodontol. 1992 Feb;63(2):107-13. doi: 10.1902/jop.1992.63.2.107.
This study evaluated the effect of a composite graft as an adjunct to gingival flap surgery in induced chronic supraalveolar periodontal defects in the mandibular premolar region in beagle dogs. The vertical dimension of the defects, measured from the cemento-enamel junction to the alveolar bone, approximated 5 mm. Root surface treatment in quadrants receiving the graft protocol included conditioning with both critic acid and tetracycline. The composite graft (including: hydroxyapatite, freeze-dried decalcified bone, tetracycline, and fibronectin) was then fitted to the defects. Flaps were placed and sutured to cover most of the crowns of the teeth but the tips of the cusps. The root surfaces in contralateral jaw quadrants were conditioned with critic acid and the flaps similarly placed and sutured. Dogs were sacrificed 6 weeks after surgery and tissue blocks including teeth and surrounding structures processed for histometric analysis. Connective tissue repair to the root surface in teeth treated with the graft protocol approximated 60% of the defect height. Connective tissue repair in teeth treated with citric acid only was significantly greater and averaged 98% of the defect height (P less than or equal to 0.01). Cementum formation was limited following both treatments (approximately 6% of the defect height). Bone regeneration was significantly smaller in grafted sites than in sites treated with citric acid only (approximately 2% and 10% of the defect height, respectively; P less than or equal to 0.05). Root resorption was observed in almost all teeth. Ankylosis was present in two citric acid-treated specimens, both from the same dog.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究评估了复合移植物作为牙龈瓣手术辅助手段,对比格犬下颌前磨牙区诱导性慢性牙槽嵴上牙周缺损的影响。缺损的垂直尺寸,即从牙骨质-釉质界至牙槽骨的距离,约为5毫米。接受移植方案的象限中的牙根表面处理包括用柠檬酸和四环素进行预处理。然后将复合移植物(包括:羟基磷灰石、冻干脱钙骨、四环素和纤连蛋白)贴合到缺损处。放置并缝合牙龈瓣以覆盖大部分牙冠,但不包括牙尖。对侧颌骨象限中的牙根表面用柠檬酸进行预处理,同样放置并缝合牙龈瓣。术后6周处死犬只,将包括牙齿和周围结构的组织块进行组织计量分析。接受移植方案治疗的牙齿中,牙根表面的结缔组织修复约占缺损高度的60%。仅用柠檬酸治疗的牙齿中的结缔组织修复明显更大,平均占缺损高度的98%(P≤0.01)。两种治疗后牙骨质形成均有限(约占缺损高度的6%)。移植部位的骨再生明显小于仅用柠檬酸治疗的部位(分别约占缺损高度的2%和10%;P≤0.05)。几乎所有牙齿均观察到牙根吸收。在两个柠檬酸治疗的标本中出现了牙骨质粘连,均来自同一只犬。(摘要截断于250字)