Cho Eun-Hee, Park Jung-Chul, Cha Jae-Kook, Kim Yong-Tae, Jung Ui-Won, Kim Chang-Sung, Choi Seong-Ho, Kim Chong-Kwan
Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2011 Aug;41(4):176-84. doi: 10.5051/jpis.2011.41.4.176. Epub 2011 Aug 31.
The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation.
Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks.
THE RESULTS FROM THIS STUDY ARE AS FOLLOWS: 1) thickness of periosteum showed difference as follows (P<0.05): control group (0.45±0.22 mm)>flap-elevation group (0.36±0.07 mm)>defect formation group (0.26±0.03 mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group (3.15±0.40 mm)>flap-elevation group (2.02±0.25 mm)>control group (1.88±0.27 mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group.
In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.
再生性牙周治疗的最终目标是恢复因牙周炎而破坏或丧失的牙周组织的结构和功能。然而,在骨骼的骨修复过程中骨膜发挥了重要作用,而骨膜在牙周再生中的作用却相对被忽视。本研究的目的是了解骨膜的组织学特征,并比较天然骨膜与翻瓣或翻瓣手术干预后修复的骨膜。
在左右下颌象限的第二前磨牙远中面和第四前磨牙近中面手术制作临界尺寸的“盒式”(宽4mm,深5mm)单壁骨内缺损,翻起颊侧和舌侧粘骨膜瓣。24周后处死动物。
本研究结果如下:1)骨膜厚度差异如下(P<0.05):对照组(0.45±0.22mm)>翻瓣组(0.36±0.07mm)>缺损形成组(0.26±0.03mm);2)牙龈组织厚度差异如下(P<0.05):缺损形成组(3.15±0.40mm)>翻瓣组(2.02±0.25mm)>对照组(1.88±0.27mm);3)缺损形成组和翻瓣组的细胞活性高于对照组;4)缺损形成组的血管数量多于对照组。
总之,手术创伤增加的长时间手术似乎会降低修复骨膜的厚度并增加牙龈厚度。缺损形成组观察到更多的血管和高细胞活性。