Fiorellini Joseph P, Kim David M, Nakajima Yasushi, Weber Hans P
Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA.
Int J Periodontics Restorative Dent. 2007 Jun;27(3):287-94.
The purpose of this study was to evaluate the percentage of bone-to-implant contact following guided bone regeneration using expanded polytetrafluoroethylene (e-PTFE) membranes and various bone fillers in a beagle dog model. A staged approach was used for initial bone regeneration of surgically created defects and subsequent implant placement in newly regenerated ridges. Three months after bilateral extraction of the mandibular premolars and first molars, rectangular, distal-extension defects that included the entire width of the ridge buccolingually were surgically created in the alveolar processes. All defects were covered with an e-PTFE membrane, and several bone fillers were placed, in a randomized fashion, under the membrane: autogenous bone, demineralized freeze-dried bone, anorganic bovine bone, tricalcium phosphate granules, and collagen sponge. One site in each animal was treated with e-PTFE barrier membrane alone as control. Following an 8-month healing period, nonsubmerged titanium implants (36 total) were placed in regenerated bone following membrane removal. Three months later, the animals were sacrificed, and nondecalcified buccolingual sections were evaluated histometrically for bone-to-implant contact. All sites demonstrated high percentages (50% to 65%) of bone-to-implant contact, with no significant differences across the various treatment groups. In addition, all tested bone fillers formed a complex that supported and maintained the osseointegrated implants in a healthy state, with no apparent signs of peri-implantitis. Using a staged approach, the present study provided histologic and histometric evidence that implants placed in entirely regenerated bone can achieve and maintain osseointegration, regardless of the type of bone fillers used.
本研究的目的是在比格犬模型中，评估使用膨体聚四氟乙烯（e-PTFE）膜和各种骨填充材料进行引导骨再生后骨与种植体的接触百分比。采用分阶段方法，先对手术造成的缺损进行初始骨再生，随后在新再生的牙槽嵴中植入种植体。双侧拔除下颌前磨牙和第一磨牙三个月后，在牙槽突中手术制造矩形、远中延伸缺损，缺损包括牙槽嵴颊舌侧的整个宽度。所有缺损均用e-PTFE膜覆盖，并将几种骨填充材料随机置于膜下：自体骨、脱矿冻干骨、无机牛骨、磷酸三钙颗粒和胶原海绵。每只动物的一个部位仅用e-PTFE屏障膜治疗作为对照。经过8个月的愈合期后，在去除膜后将非潜入式钛种植体（共36枚）植入再生骨中。三个月后，处死动物，对未脱钙的颊舌侧切片进行组织计量学评估，以确定骨与种植体的接触情况。所有部位的骨与种植体接触百分比均较高（50%至65%），各治疗组之间无显著差异。此外，所有测试的骨填充材料均形成了一种复合物，可支持并维持骨结合种植体处于健康状态，无种植体周围炎的明显迹象。本研究采用分阶段方法，提供了组织学和组织计量学证据，表明无论使用何种骨填充材料，植入完全再生骨中的种植体均可实现并维持骨结合。
