Li Xiang, Chen Song-Ling, Zhu Shuang-Xi, Zha Guo-Qing
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou 510080, People's Republic of China.
Br J Oral Maxillofac Surg. 2012 Jan;50(1):69-73. doi: 10.1016/j.bjoms.2010.10.013. Epub 2011 Jan 11.
We investigated the effect of guided bony regeneration using collagen membranes for sinus augmentation in the first maxillary molars of 18 adult female beagle dogs. The teeth were extracted bilaterally and the sinus floors were lifted with simultaneous implantation. The grafted material composed of a combination of autografts and Bio-oss in a 2:1 ratio. On the experimental side in each dog, collagen membrane was folded at the lateral osteotomy window, at the apex of the implants, and at a certain part of the palatal bone. On the opposite (control) side, the collagen membrane covered the osteotomy window. Six animals were killed at each of 4, 12, and 24 weeks postoperatively. Gross observation, biomechanical testing, and histological examinations were made. On the experimental side, grafted materials showed no obvious resorption or subsidence, and a new bone had formed at the apex of the implants. On the control side, the grafted materials had been shifted and absorbed. Histological examination showed increased formation of a new bone in the experimental group, which matured over time. At 4 weeks, inflammatory cells were present in the control group, which showed less maturation of the new bone. The pull-out force increased with time and, at week 24, there was a significant difference in pull-out force between the two groups (p<0.01). Guided bony regeneration with the enfolded coverage of membrane can effectively reduce resorption of grafted bone on the apical surface of implants and stimulate formation of the new bone in sinus augmentation.
我们研究了使用胶原膜引导骨再生对上颌第一磨牙缺失的18只成年雌性比格犬进行窦底提升术的效果。双侧拔除牙齿并在同时植入时提升窦底。移植材料由自体骨和Bio-oss以2:1的比例混合组成。在每只犬的实验侧，胶原膜在外侧截骨窗、种植体顶端和腭骨的特定部位折叠。在对侧（对照），胶原膜覆盖截骨窗。术后4周、12周和24周分别处死6只动物。进行大体观察、生物力学测试和组织学检查。在实验侧，移植材料没有明显的吸收或下沉，并且在种植体顶端形成了新骨。在对照侧，移植材料发生了移位和吸收。组织学检查显示实验组新骨形成增加，并随时间成熟。在4周时，对照组存在炎性细胞，新骨成熟度较低。拔出力随时间增加，在24周时，两组之间的拔出力有显著差异（p<0.01）。采用折叠覆盖膜引导骨再生可有效减少种植体根尖表面移植骨的吸收，并促进窦底提升术中新骨的形成。
