Friedmann Anton, Fickl Stefan, Fischer Kai R, Dalloul Milad, Goetz Werner, Kauffmann Frederic
Department of Periodontology, Faculty of Health, School of Dentistry, Witten/Herdecke University, 58455 Witten, Germany.
Department of Periodontology, University of Würzburg, 97070 Würzburg, Germany.
Materials (Basel). 2021 Dec 29;15(1):238. doi: 10.3390/ma15010238.
Various biomaterial combinations have been studied focusing on their ability to stabilize blood clots and maintain space under soft tissue to support new bone formation. A popular combination is Deproteinized Bovine Bone Mineral (DBBM) placed with a native collagen membrane (NCM) tacked to native bone. In this study, we compared the outcome of this treatment option to those achieved with three different graft/membrane combinations with respect to total newly occupied area and the mineralized compound inside. After bi-lateral extraction of two mandibular premolars in five adult beagles L-shaped alveolar defects were created. A total of 20 defects healed for 6 weeks resulting in chronic type bone defects. At baseline, four options were randomly allocated to five defects each: a. DBBM + NCM with a four-pin fixation across the ridge; b. DBBM + RCLC (ribose cross-linked collagen membrane); c. DBBM + NPPM (native porcine pericardium membrane); and d. Ca-sulfate (CS) + RCLC membrane. Membranes in b/c/d were not fixed; complete tensionless wound closure was achieved by CAF. Termination after 3 months and sampling followed, and non-decalcified processing and toluidine blue staining were applied. Microscopic images obtained at standardized magnification were histomorphometrically assessed by ImageJ software (NIH). An ANOVA post hoc test was applied; histomorphometric data are presented in this paper as medians and interquartile ranges (IRs). All sites healed uneventfully, all sites were sampled and block separation followed before Technovit embedding. Two central sections per block for each group were included. Two of five specimen were lost due to processing error and were excluded from group b. New bone area was significantly greater for option b. compared to a. ( = 0.001), c. ( = 0.002), and d. ( = 0.046). Residual non-bone graft area was significantly less for option d. compared to a. ( = 0.026) or c. ( = 0.021). We conclude that collagen membranes with a prolonged resorption/barrier profile combined with bone substitutes featuring different degradation profiles sufficiently support new bone formation. Tacking strategy/membrane fixation appears redundant when using these biomaterials.
已经对各种生物材料组合进行了研究，重点关注它们稳定血凝块以及在软组织下维持空间以支持新骨形成的能力。一种常见的组合是脱蛋白牛骨矿物质（DBBM）与固定在天然骨上的天然胶原膜（NCM）一起使用。在本研究中，我们将这种治疗方案的结果与三种不同的移植物/膜组合的结果进行了比较，比较内容包括总的新占据面积和内部的矿化化合物。在五只成年比格犬双侧拔除两颗下颌前磨牙后，制造L形牙槽骨缺损。总共20个缺损愈合6周，形成慢性骨缺损。在基线时，将四种方案随机分配到每个五个缺损中：a. DBBM + NCM，通过横跨牙槽嵴的四根针固定；b. DBBM + RCLC（核糖交联胶原膜）；c. DBBM + NPPM（天然猪心包膜）；d. 硫酸钙（CS）+ RCLC膜。b/c/d中的膜不固定；通过CAF实现完全无张力伤口闭合。3个月后终止并取样，进行非脱钙处理和甲苯胺蓝染色。通过ImageJ软件（美国国立卫生研究院）对在标准化放大倍数下获得的显微镜图像进行组织形态计量学评估。应用方差分析事后检验；本文中的组织形态计量学数据以中位数和四分位间距（IR）表示。所有部位均顺利愈合，所有部位均取样并在Technovit包埋前进行块分离。每组每个块包含两个中央切片。由于处理错误，五个标本中有两个丢失，并从b组中排除。与a.（P = 0.001）、c.（P = 0.002）和d.（P = 0.046）相比，方案b的新骨面积显著更大。与a.（P = 0.026）或c.（P = 0.021）相比，方案d的残余非骨移植物面积显著更小。我们得出结论，具有延长吸收/屏障特性的胶原膜与具有不同降解特性的骨替代物相结合，足以支持新骨形成。使用这些生物材料时，固定策略/膜固定似乎是多余的。
