Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.
Clin Oral Implants Res. 2011 Dec;22(12):1346-53. doi: 10.1111/j.1600-0501.2010.02120.x. Epub 2011 Mar 8.
To evaluate the effect of immortalized hypertrophic chondrocytes extracellular matrix (HCM) with or without the use of guided bone regeneration (GBR) on the healing of critical-size calvarial defects.
In 42 rats, 5 mm critical-size calvarial defects were surgically created. The animals were randomly allocated to six groups of seven rats each: Group A1: one defect was left untreated (control), while the contralateral defect was covered by a double non-resorbable membrane (GBR). Group B1: one defect was filled with calcium phosphate cement (CP), while the contralateral defect was treated with GBR and CP. Group C1: one defect was filled with a mixture of CP and HCM, while the contralateral defect was treated with GBR and CP+HCM. The healing period for all three groups was 30 days. The remaining three groups were treated in a similar manner but the healing period was 60 days. Five animals from each group were evaluated by maceration and two animals were analysed histologically.
At 30 days, all the control-treated defects did not present complete closure. When GBR was applied alone or combined with CP, 3/5 and 5/5 defects, respectively, presented complete closure. At 60 days, one defect from the control group presented complete closure. All the defects treated with GBR alone presented complete closure, whereas the combined use of GBR with CP or CP+HCM resulted in 4/5 and 3/5 defects with complete closure, respectively. The only treatment modality that did not present any specimen with defect closure at both 30 and 60 days was the combination of CP+HCM. The histological analysis indicated that when GBR was not used alone, the healing consisted of an amorphous acellular structure and loose granulation tissue, which, even though clinically resembled hard tissue, did not demonstrate the histological characteristics of bone.
The predictability of bone formation in critical-size defects depends mainly on the presence or absence of barrier membranes. The combined use of GBR with calcium phosphate alone or in combination with immortalized human HCM did not enhance the potential for osseous healing provided by the GBR procedure.
评估永生肥大软骨细胞细胞外基质（HCM）与或不使用引导骨再生（GBR）对临界大小颅骨缺损愈合的影响。
在 42 只大鼠中，手术创建了 5mm 的临界大小颅骨缺损。动物被随机分配到六个 7 只大鼠的组中：A1 组：一个缺损未治疗（对照），而对侧缺损用双层不可吸收膜（GBR）覆盖。B1 组：一个缺损用磷酸钙水泥（CP）填充，而对侧缺损用 GBR 和 CP 处理。C1 组：一个缺损用 CP 和 HCM 的混合物填充，而对侧缺损用 GBR 和 CP+HCM 处理。所有三组的愈合期均为 30 天。其余三组以类似的方式处理，但愈合期为 60 天。每组有 5 只动物通过浸提进行评估，有 2 只动物进行组织学分析。
在 30 天，所有对照治疗的缺损均未完全闭合。当 GBR 单独或与 CP 联合使用时，分别有 3/5 和 5/5 的缺损完全闭合。在 60 天，对照组的一个缺损完全闭合。单独使用 GBR 的所有缺损均完全闭合，而单独使用 GBR 联合 CP 或 CP+HCM 的结果分别有 4/5 和 3/5 的缺损完全闭合。在 30 天和 60 天都没有任何标本显示缺损闭合的唯一治疗方式是 CP+HCM 的联合使用。组织学分析表明，当 GBR 不单独使用时，愈合由无定形的无细胞结构和疏松的肉芽组织组成，尽管临床上类似于硬组织，但没有表现出骨的组织学特征。
临界大小缺损中成骨的可预测性主要取决于屏障膜的存在与否。GBR 单独使用钙磷酸盐或与永生人 HCM 联合使用并不能增强 GBR 程序提供的成骨愈合潜力。
