Byun Soo-Hwan, Lim Ho-Kyung, Kim Soung-Min, Lee Sung-Mi, Kim Hyoun-Ee, Lee Jong-Ho
*Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul †Department of Oral and Maxillofacial Surgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do ‡Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital §Oral Cancer Center and Clinical Trial Center, Seoul National University Dental Hospital ||Department of Materials Science and Engineering, Seoul National University ¶Biomedical Implant Convergence Research Lab, Advanced Institutes of Convergence Technology #Dental Research Institute, Seoul National University, Seoul, Korea.
J Craniofac Surg. 2017 Mar;28(2):518-523. doi: 10.1097/SCS.0000000000003383.
Nonabsorbable metallic membrane for guided bone regeneration is remained permanently even though after complete healing. There would be metallic exposure followed by the risk of infection; the membrane should be removed for the additional procedure such as implant installation. Since absorbable nonmetallic mesh is absorbed within 3 to 6 months, it is unnecessary to be removed. However, the absorbable membrane shows lower retention, lower mechanical strength, and difficulty of manipulation than the nonabsorbable ones.The purpose of this study is to evaluate the ability of absorbable metallic mesh (hydroxyapatite-coated magnesium mesh) with acceptable mechanical properties and satisfying biocompatibility.
The bioresorption and fate of magnesium were evaluated in Sprague Dawley rat (SD rat) with critical defect of calvarium. The critical defect with a diameter of 8 mm was made on calvarium using trephine bur in 18 SD rats. The defected models were divided into 2 groups: the control group (9 SD rat) without mesh and the experimental group (9 SD rat) with the insertion of prototype HA-coated magnesium mesh. The 3 SD rats were sacrificed at 6, 12, and 18 weeks. The histopathological and radiographic examinations were performed afterward.
In the control group, there was no specific symptom. The experimental group also showed no specific symptom including swelling and dehiscence related to hydrogen gas formation. From 6 to 18 weeks, the experimental group showed the progressive absorption and fracture of magnesium mesh. However, there was no specific effectiveness of guided bone regeneration in both groups. There was no significant difference in bone volume, bone surface, and bone volume fraction between the negative control group and the group with magnesium mesh (P >0.05).
Hydroxyapatite-coated magnesium mesh showed reasonable process of bioresorption and bony reaction; however, the effectiveness of guided bone regeneration and management of the bioresorption rate should be reconsidered.
用于引导骨再生的不可吸收金属膜即使在完全愈合后仍会永久留存。这会导致金属暴露，进而有感染风险；为进行诸如植入种植体等额外操作，需要移除该膜。由于可吸收非金属网在3至6个月内会被吸收，因此无需移除。然而，与不可吸收膜相比，可吸收膜的保留性较低、机械强度较低且操作难度较大。本研究的目的是评估具有可接受机械性能和令人满意生物相容性的可吸收金属网（羟基磷灰石涂层镁网）的性能。
在患有颅骨临界骨缺损的Sprague Dawley大鼠（SD大鼠）中评估镁的生物吸收和转归情况。使用环钻在18只SD大鼠的颅骨上制造直径为8毫米的临界骨缺损。将缺损模型分为2组：无网的对照组（9只SD大鼠）和插入原型羟基磷灰石涂层镁网的实验组（9只SD大鼠）。在第6、12和18周处死3只SD大鼠。随后进行组织病理学和影像学检查。
对照组未出现特定症状。实验组也未出现包括与氢气形成相关的肿胀和裂开等特定症状。从第6周直至第18周，实验组的镁网呈现出逐渐吸收和断裂的情况。然而，两组在引导骨再生方面均未显示出特定效果。阴性对照组与镁网组在骨体积、骨表面积和骨体积分数方面无显著差异（P>0.05）。
羟基磷灰石涂层镁网显示出合理的生物吸收过程和骨反应；然而，引导骨再生的有效性和生物吸收率的控制应重新考虑。
