Zubery Yuval, Goldlust Arie, Alves Antoine, Nir Eran
J Periodontol. 2007 Jan;78(1):112-21. doi: 10.1902/jop.2007.060055.
Collagen membranes for guided bone regeneration (GBR) and guided tissue regeneration (GTR) are used extensively as bioabsorbable barriers. Cross-linking of collagen increases its biodurability and enables the control of its degradation kinetics and barrier function. A novel cross-linking technology was used to produce a porcine type I collagen membrane (GLYM). The purpose of this study was to evaluate the safety, efficacy, and degradation kinetics of GLYM compared to a non-cross-linked bilayer type I and III porcine collagen membrane (BCM) in surgically created defects in dogs.
After tooth extraction, two mandibular bilateral critical size defects were created in 12 beagle dogs that were randomly assigned to one of five groups: GLYM + bovine bone mineral (BBM), BCM + BBM, BBM alone, sham-operated, or GLYM alone. Dogs were euthanized after 8, 16, and 24 weeks, and sites were prepared for qualitative, semiquantitative, and quantitative light microscopy analyses.
Membrane-protected sites displayed bone filling between the BBM particles with almost complete restoration of the original ridge morphology that increased with time up to 16 weeks and remained unchanged at 24 weeks. Both membranes showed marked degradation within 16 to 24 weeks, with BCM inconsistency that was undetectable in one of four sites at 8, 16, and 24 weeks. Membrane ossification was observed in all GLYM sites and in only one BCM site, which progressed with time to 24 weeks. Bone increased by approximately 1 mm on the lingual side, where the GLYM membrane was in direct contact with bone.
Both membranes were safe and effective in supporting bone regeneration in critical size alveolar ridge defects in dogs and completely degraded within 24 weeks with marked BCM inconsistency. In areas of direct contact with bone, all GLYM sites were progressively ossified with time and augmented the original alveolar ridge. To the best of our knowledge, this is the first report of complete ossification of a collagen barrier membrane in GBR procedures.
用于引导骨再生(GBR)和引导组织再生(GTR)的胶原膜被广泛用作生物可吸收屏障。胶原的交联增加了其生物耐久性,并能够控制其降解动力学和屏障功能。一种新型交联技术被用于生产猪I型胶原膜(GLYM)。本研究的目的是在犬手术造成的缺损中,评估GLYM与非交联的双层I型和III型猪胶原膜(BCM)相比的安全性、有效性和降解动力学。
拔牙后,在12只比格犬中制造两个下颌双侧临界尺寸缺损,并将其随机分配到五组之一:GLYM + 牛骨矿物质(BBM)、BCM + BBM、单独使用BBM、假手术或单独使用GLYM。在8周、16周和24周后对犬实施安乐死,并对手术部位进行定性、半定量和定量光学显微镜分析。
膜保护部位在BBM颗粒之间显示出骨填充,原始牙槽嵴形态几乎完全恢复,这种恢复在16周时随时间增加,并在24周时保持不变。两种膜在16至24周内均显示出明显降解,BCM存在不一致性,在8周、16周和24周时,四个部位之一未检测到BCM。在所有GLYM部位以及仅一个BCM部位观察到膜骨化,其随时间进展至24周。在GLYM膜与骨直接接触的舌侧,骨增加了约1毫米。
两种膜在支持犬临界尺寸牙槽嵴缺损的骨再生方面都是安全有效的,并且在24周内完全降解,BCM存在明显的不一致性。在与骨直接接触的区域,所有GLYM部位随时间逐渐骨化并增大了原始牙槽嵴。据我们所知,这是GBR手术中胶原屏障膜完全骨化的首次报道。