Nguyen Charles, Young Simon, Kretlow James D, Mikos Antonios G, Wong Mark
Resident in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
J Oral Maxillofac Surg. 2011 Jan;69(1):11-8. doi: 10.1016/j.joms.2010.02.026. Epub 2010 Nov 4.
The purpose of the present study was to evaluate the effect of implant porosity on wound healing between solid and porous implants placed within a bony mandibular defect with intraoral exposure.
Solid poly(methyl methacrylate) (PMMA) implants similar to those used currently in clinical space maintenance applications in maxillofacial surgery were compared with poly(propylene fumarate) implants that contained a porous outer surface surrounding a solid core. A 10-mm diameter nonhealing bicortical defect with open communication into the oral cavity was created in the molar mandibular region of 12 adult male New Zealand white rabbits. Of the 12 rabbits, 6 received the hybrid poly(propylene fumarate) implants and 6 received the solid PMMA implants. At 12 weeks, the rabbit mandibles were harvested and sent for histologic staining and sectioning.
Gross inspection and histologic examination showed all 6 poly(propylene fumarate) implants to be intact within the defect site at the termination of the study period, with 3 of the 6 specimens exhibiting a continuous circumferential soft tissue margin. In contrast, 5 of the 6 PMMA-implanted specimens were exposed intraorally with an incomplete cuff of soft tissue around the implant. One of the PMMA-implanted specimens exhibited complete extrusion and subsequent loss of the implant. Fisher's exact test was used to compare the occurrence of oral cavity wound healing between the 2 groups (P = .09).
Although statistically significant differences between the 2 groups were not seen, our results have indicated that advantages might exist to using porous implants for space maintenance. Additional study is needed to evaluate these findings.
本研究旨在评估种植体孔隙率对置于下颌骨骨缺损且口腔暴露的实心和多孔种植体周围伤口愈合的影响。
将类似于目前用于颌面外科临床间隙维持应用的实心聚甲基丙烯酸甲酯（PMMA）种植体与含有围绕实心核心的多孔外表面的聚富马酸丙二醇酯种植体进行比较。在12只成年雄性新西兰白兔的下颌磨牙区制造一个直径10毫米的双皮质不愈合缺损，并与口腔相通。12只兔子中，6只接受混合聚富马酸丙二醇酯种植体，6只接受实心PMMA种植体。12周时，采集兔下颌骨并送去进行组织学染色和切片。
大体检查和组织学检查显示，在研究期结束时，所有6个聚富马酸丙二醇酯种植体在缺损部位均完好无损，6个标本中有3个呈现连续的圆周软组织边缘。相比之下，6个植入PMMA的标本中有5个口腔内暴露种植体周围软组织袖口不完整。1个植入PMMA的标本出现完全挤出并随后丢失种植体。采用Fisher精确检验比较两组口腔伤口愈合的发生率（P = 0.09）。
虽然两组之间未观察到统计学上的显著差异，但我们的结果表明使用多孔种植体进行间隙维持可能存在优势。需要进一步研究来评估这些发现。
