ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
Universita San Raffaele di Milano, Milano, Italy.
Clin Oral Implants Res. 2017 Nov;28(11):1466-1476. doi: 10.1111/clr.13014. Epub 2017 Mar 27.
The aim of this pre-clinical in vivo study was to analyse different stages of wound healing after guided bone regeneration in non-contained mandibular buccal bone defects.
Eighteen female beagle dogs, between 1.5 and 2 years old, were used. Buccal bone defects were created in the mandible following extraction of the mesial roots of M1, P4, the distal root of P3 and booth roots of P2. Augmentation procedures of the healed defects were performed 3 months later using a bone replacement graft (T1), an absorbable collagen membrane (T2) or a combination of both procedures (T3). Using a randomized block study design, four stages of healing in two groups of dogs were examined (4 days, 2, 6 weeks and 3 months). The animals were euthanized, and biopsies obtained at the end of each of the study periods were prepared for histological examination.
The different reconstructive procedures resulted in regenerated tissue compartments of varying size that contained newly formed bone, non-mineralized tissue and bone augmentation biomaterial when a bone replacement graft was used. While the proportions of mineralized tissue increased and non-mineralized tissue decreased over time in the three groups, the changes in proportions of the DBBM material were small. Initial defect depth, healing time and treatment group significantly influenced the percentage of mineralized tissue obtained. The multivariate multilevel analysis showed that significantly larger area proportions of mineralized tissue were obtained when the T2 sites were compared with T1 and T3 sites, what highlights the importance of the barrier membrane effect for attaining new bone formation. Only in the larger size defects (M1) total ROI at T3 and T1 sites was significantly larger than at T2, what highlights the importance of using a bone replacement graft as a space maintenance scaffold.
It is suggested that healing following augmentation of non-contained buccal bone defects was characterized by a gradual shift in the relative proportions of non-mineralized and mineralized tissue components.
本临床前体内研究旨在分析非包裹性下颌颊骨缺损中引导骨再生后不同愈合阶段的情况。
使用 18 只 1.5 至 2 岁的雌性比格犬。在拔除 M1、P4、P3 的远中根和 P2 的双根后，在下颌骨上创建颊骨缺损。在 3 个月后，使用骨替代移植物（T1）、可吸收胶原膜（T2）或两者结合（T3）对愈合的缺损进行增强程序。使用随机块研究设计，在两组犬中检查了愈合的四个阶段（4 天、2、6 周和 3 个月）。在每个研究期结束时，处死动物并获得活检，用于组织学检查。
不同的重建程序导致再生组织腔的大小不同，当使用骨替代移植物时，这些组织腔包含新形成的骨、未矿化组织和骨增强生物材料。虽然在三组中，随着时间的推移，矿化组织的比例增加，未矿化组织减少，但 DBBM 材料的比例变化较小。初始缺损深度、愈合时间和治疗组显著影响获得的矿化组织百分比。多元多水平分析表明，与 T1 和 T3 部位相比，T2 部位获得的矿化组织面积比例显著更大，这突出了屏障膜效应对于获得新骨形成的重要性。仅在较大尺寸的缺损（M1）中，T3 和 T1 部位的总 ROI 明显大于 T2 部位，这突出了使用骨替代移植物作为空间维持支架的重要性。
建议非包裹性颊骨缺损增强后的愈合过程以未矿化和矿化组织成分的相对比例逐渐变化为特征。
