Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
J Clin Periodontol. 2017 Dec;44(12):1264-1273. doi: 10.1111/jcpe.12825. Epub 2017 Nov 10.
To investigate the effect of a novel enamel matrix derivative formulation (EMD-liquid or Osteogain) combined with an absorbable collagen sponge (ACS) on periodontal wound healing in intra-bony defects in monkeys.
Chronic two-wall intra-bony defects were created at the distal aspect of eight teeth in three monkeys (Macaca fascicularis). The 24 defects were randomly assigned to one of the following treatments: (i) open flap debridement (OFD) + ACS alone, (ii) OFD + Emdogain + ACS (Emdogain/ACS), (iii) OFD + Osteogain + ACS (Osteogain/ACS) or (iv) OFD alone. At 4 months, the animals were euthanized for histologic evaluation.
Osteogain/ACS resulted in more consistent formation of cementum, periodontal ligament and bone with limited epithelial proliferation compared to OFD alone, Emdogain/ACS and OFD + ACS. Among the four treatment groups, the Osteogain/ACS group demonstrated the highest amount of regenerated tissues. However, complete periodontal regeneration was not observed in any of the defects in the four groups.
The present findings indicate that in two-wall intra-bony defects, reconstructive surgery with Osteogain/ACS appears to be a promising novel approach for facilitating periodontal wound healing/regeneration, thus warranting further clinical testing.
研究一种新型釉基质衍生物配方(EMD-液体或骨形成蛋白)联合可吸收胶原海绵(ACS)对猴牙槽骨内缺损牙周创面愈合的影响。
在 3 只猕猴(食蟹猴)的 8 颗牙齿的远中颊面创建 24 个慢性双壁牙槽骨内缺损。将这 24 个缺损随机分为以下 4 种处理组:(i)翻瓣清创术(OFD)+单独 ACS,(ii)OFD+Emdogain+ACS(Emdogain/ACS),(iii)OFD+Osteogain+ACS(Osteogain/ACS)或(iv)单独 OFD。4 个月后,处死动物进行组织学评估。
与单独 OFD 相比,Osteogain/ACS 组在形成牙骨质、牙周膜和骨方面更为一致,且上皮增殖有限。与单独 OFD、Emdogain/ACS 和 OFD+ACS 相比,Osteogain/ACS 组的再生组织量最多。然而,在 4 个治疗组的任何一个缺损中,均未观察到完全的牙周再生。
本研究结果表明,在双壁牙槽骨内缺损中,使用 Osteogain/ACS 进行重建手术似乎是一种很有前途的促进牙周创面愈合/再生的新方法,值得进一步的临床研究。