Bornstein Michael M, Bosshardt Dieter, Buser Daniel
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Periodontol. 2007 Oct;78(10):1943-53. doi: 10.1902/jop.2007.070102.
This study compared bone regeneration following guided bone regeneration with two bioabsorbable collagen membranes in saddle-type bone defects in dog mandibles.
Three standardized defects were created, filled with bone chips and deproteinized bovine bone mineral (DBBM), and covered by three different methods: control = no membrane; test 1 = collagen membrane; and test 2 = cross-linked collagen membrane (CCM). Each side of the mandible was allocated to one of two healing periods (8 or 16 weeks). The histomorphometric analysis assessed the percentage of bone, soft tissue, and DBBM in the regenerate; the absolute area in square millimeters of the bone regenerate; and the distance in millimeters from the bottom of the defect to the highest point of the regenerate.
In the 8-week healing group, two dehiscences occurred with CCM. After 8 weeks, all treatment modalities showed no significant differences in the percentage of bone regenerate. After 16 weeks, the percentage of bone had increased for all treatment modalities without significant differences. For all groups, the defect fill height increased between weeks 8 and 16. The CCM group showed a statistically significant (P = 0.0202) increase over time and the highest value of all treatment modalities after 16 weeks of healing,
The CCM showed a limited beneficial effect on bone regeneration in membrane-protected defects in dog mandibles when healing was uneventful. The observed premature membrane exposures resulted in severely compromised amounts of bone regenerate. This increased complication rate with CCM requires a more detailed preclinical and clinical examination before any clinical recommendations can be made.
本研究比较了在犬下颌骨鞍型骨缺损中使用两种生物可吸收胶原膜引导骨再生后的骨再生情况。
制造三个标准化缺损，填充骨屑和脱蛋白牛骨矿物质（DBBM），并采用三种不同方法覆盖：对照组 = 不使用膜；试验1 = 胶原膜；试验2 = 交联胶原膜（CCM）。下颌骨的每一侧被分配到两个愈合期（8周或16周）之一。组织形态计量学分析评估再生组织中骨、软组织和DBBM的百分比；骨再生的绝对面积（平方毫米）；以及从缺损底部到再生组织最高点的距离（毫米）。
在8周愈合组中，CCM出现了两处裂开。8周后，所有治疗方式在骨再生百分比方面均无显著差异。16周后，所有治疗方式的骨百分比均增加，且无显著差异。对于所有组，缺损填充高度在第8周和第16周之间增加。CCM组随时间有统计学显著增加（P = 0.0202），且在愈合16周后是所有治疗方式中值最高的。
在愈合过程顺利时，CCM对犬下颌骨膜保护缺损中的骨再生显示出有限的有益作用。观察到的过早膜暴露导致骨再生量严重受损。CCM这种增加的并发症发生率需要在做出任何临床建议之前进行更详细的临床前和临床检查。
