Kämmerer P W, Palarie V, Schiegnitz E, Nacu V, Draenert F G, Al-Nawas B
Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Clin Oral Implants Res. 2013 Nov;24(11):1222-30. doi: 10.1111/j.1600-0501.2012.02534.x. Epub 2012 Jul 4.
Combinations of bone substitute block materials with membrane techniques as well as with growth factors are possible options to enhance the prognosis of vertical bone augmentation. Therefore, the aim of the pilot study was to compare the influence of a collagen membrane and a signal protein (rhPDGF-BB) on vertical bone augmentation with a stable fixed block material (deproteinized bovine bone [DBB]).
In 12 rabbits, a DBB-block was implant-fixed on the tibia in a split-leg-design. Included were: DBB only (control), DBB + collagen membrane (test), DBB + rhPDGF-BB (test) and DBB + rhPDGF-BB + collagen membrane (test). 24 samples were examined after 3 (n = 12) and 6 weeks (n = 12). Calculated parameters were new bone area (NBA;%), new vertical bone height (VBH; mm). Due to the pilot character of this study, single values are shown descriptively only.
After 3 weeks, there were constant higher NBA values in the rhPDGF-BB-group without membrane (NBA (%) DBB: 30/16/4; DBB + membrane: 25/17/7, DBB + rhPDGF-BB: 40/33/34, DBB + rhPDGF-BB + membrane: 0/30/16; VBH (mm) DBB: 1.2/1.2/1, DBB + membrane: 0.7/0.9/1, DBB + rhPDGF-BB: 0.7/0.9/1, DBB + rhPDGF-BB + membrane: 0/1.1/1). After 6 weeks, both membrane groups showed a constant higher NBA and VBH independent to the use of rhPDGF-BB (NBA DBB: 3/0/5, DBB + membrane: 20/35/31, DBB + rhPDGF-BB: 5/8/4, DBB + rhPDGF-BB + membrane: 31/35/40; VBH DBB: 0.3/0.3/0.6, DBB + membrane: 1.6/2.4/2.1, DBB + rhPDGF-BB: 0.4/0.7/0.8, DBB + rhPDGF-BB + membrane: 1.8/2/1.8).
For vertical augmentation, the addition of rhPDGF-BB to DBB-blocks may increase early bone growth. In the later phase, the use of a collagen membrane enhances new bone volume and height to a significant greater extend. Even if the results are higher than those in the non-membrane groups, the low gain of bone after the short time periods still needs improvement.
骨替代块状材料与膜技术以及生长因子相结合,可能是提高垂直骨增量预后的可行选择。因此,本初步研究的目的是比较胶原膜和信号蛋白(重组人血小板衍生生长因子-BB [rhPDGF-BB])对使用稳定固定块状材料(脱蛋白牛骨 [DBB])进行垂直骨增量的影响。
在12只兔子中,采用分腿设计将DBB块植入固定于胫骨。分组包括:仅DBB(对照组)、DBB + 胶原膜(试验组)、DBB + rhPDGF-BB(试验组)和DBB + rhPDGF-BB + 胶原膜(试验组)。3周(n = 12)和6周(n = 12)后检查24个样本。计算参数为新骨面积(NBA;%)、新垂直骨高度(VBH;mm)。由于本研究的初步性质,仅以描述性方式展示单个值。
3周后,无膜的rhPDGF-BB组的NBA值持续较高(NBA(%)DBB:30/16/4;DBB + 膜:25/17/7,DBB + rhPDGF-BB:40/33/34,DBB + rhPDGF-BB + 膜:0/30/16;VBH(mm)DBB:1.2/1.2/1,DBB + 膜:0.7/0.9/1,DBB + rhPDGF-BB:0.7/0.9/1,DBB + rhPDGF-BB + 膜:0/1.1/1)。6周后,两个膜组的NBA和VBH均持续较高,与rhPDGF-BB的使用无关(NBA DBB:3/0/5,DBB + 膜:20/35/31,DBB + rhPDGF-BB:5/8/4,DBB + rhPDGF-BB + 膜:31/35/40;VBH DBB:0.3/0.3/0.6,DBB + 膜:1.6/2.4/2.1,DBB + rhPDGF-BB:0.4/0.7/0.8,DBB + rhPDGF-BB + 膜:1.8/2/1.8)。
对于垂直增量,在DBB块中添加rhPDGF-BB可能会增加早期骨生长。在后期,使用胶原膜可显著提高新骨体积和高度。即使结果高于无膜组,但短时间内骨增量较低仍需改善。