Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Clin Oral Implants Res. 2017 Nov;28(11):1368-1380. doi: 10.1111/clr.12996. Epub 2016 Dec 25.
To evaluate the effect of a resorbable collagen membrane and autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) on the healing of buccal dehiscence-type defects.
The second incisors and the first premolars were extracted in the maxilla of eight mongrels. Reduced diameter, bone-level implants were placed 5 weeks later. Standardized buccal dehiscence-type defects were created and grafted at implant surgery. According to an allocation algorithm, the graft composition of each of the four maxillary sites was DBBM + membrane (group D + M), autogenous bone chips + DBBM + membrane (group A + D + M), DBBM alone (group D) or autogenous bone chips + DBBM (group A + D). Four animals were sacrificed after 3 weeks of healing and four animals after 12 weeks. Histological and histomorphometric analyses were performed on oro-facial sections.
The pattern of bone formation and resorption within the grafted area showed high variability among the same group and healing time. The histomorphometric analysis of the 3-week specimens showed a positive effect of autogenous bone chips on both implant osseointegration and bone formation into the grafted region (P < 0.05). The presence of the collagen membrane correlated with greater bone formation around the DBBM particles and greater bone formation in the grafted region after 12 weeks of healing (P < 0.05). The oro-facial width of the augmented region at the level of the implant shoulder was significantly reduced in cases where damage of the protection splints occurred in the first week of healing (P < 0.05).
The addition of autogenous bone chips and the presence of the collagen membrane increased bone formation around DBBM particles. Wound protection from mechanical noxa during early healing may be critical for bone formation within the grafted area.
评估可吸收胶原膜和自体骨屑联合脱蛋白牛骨矿物质（DBBM）对颊侧裂开型缺损愈合的影响。
在 8 只杂种犬的上颌中拔出第二切牙和第一前磨牙。5 周后放置缩小直径的骨水平种植体。在种植手术时创建并移植标准化的颊侧裂开型缺损。根据分配算法，每个上颌四个部位的移植物组成分别为 DBBM+膜（组 D+M）、自体骨屑+DBBM+膜（组 A+D+M）、DBBM 单独（组 D）或自体骨屑+DBBM（组 A+D）。4 只动物在愈合 3 周后处死，4 只动物在愈合 12 周后处死。对口腔面切片进行组织学和组织形态计量学分析。
同一组和愈合时间内，移植区骨形成和吸收的模式表现出高度的可变性。3 周标本的组织形态计量学分析表明，自体骨屑对种植体骨整合和骨形成到移植区均有积极影响（P<0.05）。胶原膜的存在与 DBBM 颗粒周围更大的骨形成以及 12 周愈合后移植区更大的骨形成相关（P<0.05）。在愈合的第一周发生保护夹板损伤的情况下，种植体肩水平增强区域的口腔面宽度显著减小（P<0.05）。
自体骨屑的添加和胶原膜的存在增加了 DBBM 颗粒周围的骨形成。早期愈合时对机械损伤的伤口保护可能对移植区的骨形成至关重要。
