Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Clin Oral Implants Res. 2022 Apr;33(4):413-423. doi: 10.1111/clr.13901. Epub 2022 Feb 14.
The aim of this study was to identify the additional effects of collagen membrane (CM) and of synthetic bone substitute (BS) on lateral bone augmentation of chronic peri-implant defect with titanium mesh (TM).
Atrophic alveolar ridge was induced in six canine mandibles, and 5 peri-implant defects were achieved in each hemi-mandible. Bone augmentation was attempted using the following randomly allocated modalities: (1) Control: no treatment, (2) TM only group: blood clot covered by TM, (3) TM+BS group: BS covered by TM, (4) TM+CM group: blood clot covered by TM and CM, and (5) TM+BS+CM group: BS covered by TM and CM. After 16 weeks of submerged healing, micro-CT and histomorphometric analyses were performed.
TM exposure occurred in one case in the TM only group, one case in the TM+CM group, and two cases in the TM+BS+CM group. Histologically, pseudo-periosteum was observed along the inner and outer surfaces of TM, and the directions of the collagen fiber within the pseudo-periosteum differed according to the additional use of CM. In general, the TM only group rendered higher values in vertical defect fill and dimension of the augmented hard tissue in comparison with the other treatment groups.
Due to the small sample size, this pilot study remains inconclusive. Within the limitations of the study, the use of CM and/or BS did not appear to have an additional benefit on lateral bone augmentation of peri-implant defect with TM.
本研究旨在确定胶原膜(CM)和合成骨替代物(BS)对钛网(TM)辅助慢性种植体周缺损侧向骨增量的额外作用。
在 6 只犬下颌骨中诱导萎缩牙槽嵴,并在每个半下颌骨中获得 5 个种植体周缺损。采用以下随机分配的方式进行骨增量:(1)对照组:无治疗,(2)TM 组:TM 覆盖的血凝块,(3)TM+BS 组:TM 覆盖的 BS,(4)TM+CM 组:TM 覆盖的血凝块和 CM,(5)TM+BS+CM 组:TM 覆盖的 BS 和 CM。在水下愈合 16 周后,进行 micro-CT 和组织形态计量学分析。
TM 仅组有 1 例、TM+CM 组有 1 例和 TM+BS+CM 组有 2 例发生 TM 暴露。组织学上,在 TM 的内、外表面观察到假性骨膜,并且在假性骨膜内胶原纤维的方向根据 CM 的额外使用而不同。一般来说,与其他治疗组相比,TM 仅组在垂直缺损填充和增强硬组织的尺寸方面呈现出更高的值。
由于样本量小,本初步研究尚无定论。在研究的限制范围内,CM 和/或 BS 的使用似乎对 TM 辅助种植体周缺损的侧向骨增量没有额外的益处。