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两种不同屏障膜引导骨再生后软硬组织变化:一项体内实验研究。

Hard and soft tissue changes after guided bone regeneration using two different barrier membranes: an experimental in vivo investigation.

机构信息

Postgraduate Periodontology Clinic, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.

ETEP (Etiology and Therapy of Periodontal and Periimplant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.

出版信息

Clin Oral Investig. 2021 Apr;25(4):2213-2227. doi: 10.1007/s00784-020-03537-5. Epub 2020 Aug 26.

Abstract

OBJECTIVE

To assess the contour and volumetric changes of hard and soft tissues after guided bone regeneration (GBR) using two types of barrier membranes together with a xenogeneic bone substitute in dehiscence-type defects around dental implants.

MATERIAL AND METHODS

In 8 Beagle dogs, after tooth extraction, two-wall chronified bone defects were developed. Then, implants were placed with a buccal dehiscence defect that was treated with GBR using randomly: (i) deproteinized bovine bone mineral (DBBM) covered by a synthetic polylactic membrane (test group), (ii) DBBM plus a porcine natural collagen membrane (positive control) and (iii) defect only covered by the synthetic membrane (negative control group). Outcomes were evaluated at 4 and 12 weeks. Micro-CT was used to evaluate the hard tissue volumetric changes and STL files from digitized cast models were used to measure the soft tissues contour linear changes.

RESULTS

Test and positive control groups were superior in terms of volume gain and contour changes when compared with the negative control. Soft tissue changes showed at 4 weeks statistically significant superiority for test and positive control groups compared with negative control. After 12 weeks, the results were superior for test and positive control groups but not statistically significant, although, with a lesser magnitude, the negative control group exhibited gains in both, soft and hard tissues.

CONCLUSIONS

Both types of membranes (collagen and synthetic) attained similar outcomes, in terms of hard tissue volume gain and soft tissue contours when used in combination with DBBM CLINICAL RELEVANCE: Synthetic membranes were a valid alternative to the "gold standard" natural collagen membrane for treating dehiscence-type defects around dental implants when used with a xenogeneic bone substitute scaffold.

摘要

目的

评估两种屏障膜联合异种骨替代物在种植体周围裂开型缺损中应用于引导骨再生(GBR)后硬组织和软组织的轮廓和体积变化。

材料和方法

在 8 只比格犬中,拔牙后,形成两壁慢性骨缺损。然后,在颊侧裂开缺损处放置种植体,并用 GBR 治疗,随机使用以下方法:(i)脱蛋白牛骨矿物质(DBBM)覆盖合成聚乳酸膜(实验组),(ii)DBBM 加猪天然胶原膜(阳性对照组)和(iii)仅用合成膜覆盖的缺损(阴性对照组)。在 4 和 12 周时评估结果。使用微 CT 评估硬组织体积变化,使用数字化模型的 STL 文件测量软组织轮廓线性变化。

结果

与阴性对照组相比,实验组和阳性对照组在体积增加和轮廓变化方面具有优势。与阴性对照组相比,在 4 周时,实验组和阳性对照组的软组织变化具有统计学上的显著优势。在 12 周时,实验组和阳性对照组的结果更优,但无统计学意义,尽管如此,阴性对照组在软、硬组织方面均有获益,但其程度较小。

结论

在与 DBBM 联合使用时,两种类型的膜(胶原和合成)在获得硬组织体积增加和软组织轮廓方面取得了相似的结果。

临床相关性

在使用异种骨替代物支架治疗种植体周围裂开型缺损时,合成膜是天然胶原膜的有效替代物。

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