Petit J C, Ripamonti U
MRC/Univ of the Witwatersrand, Bone Research Laboratory, Dept of Orthopaedic Surgery, Johannesburg, South Africa.
J Craniofac Surg. 1994 Feb;5(1):34-43. doi: 10.1097/00001665-199402000-00009.
Calvarial defects of adult mammals have a limited potential for regeneration. Osteogenesis may be impaired by the intrusion within the defect of nonosteogenic tissues during healing, which inhibits centripetal bone deposition from the margins of the defects. Using a primate model, we evaluated bone regeneration in calvarial defects treated with demineralized bone matrix versus defects treated according to the strategy of guided tissue regeneration. Sixty-four defects, 25 mm in diameter, were prepared in 16 adult male baboons (Papio ursinus). In each animal, 2 contralateral defects were covered with a template of porous polymer, 35 mm in diameter. Templates were positioned over the calvarial margins to prevent penetration of the pericranium and the temporalis muscle within the defects, thus maintaining tissue segregation during healing. The third defect was implanted with allogeneic demineralized bone matrix, as positive control. The fourth defect was left untreated and was used as negative control. Undecalcified bone sections (7 microns thick) were prepared from the harvested specimens 3 and 6 months after surgery. Although untreated defects showed limited osteogenesis after fusion of the pericranium with the dura, defects covered with the polymeric template often showed extensive bone deposition extending centripetally from the margins of the craniotomies. Histomorphometry demonstrated that defects treated with demineralized bone matrix and defects covered with the polymeric template had greater amounts of bone and osteoid when compared with untreated defects (p < 0.01). At 6 months, greater amounts of bone formed in demineralized bone matrix-treated defects when compared with defects covered with the polymeric template (p < 0.01). The results of this study show that calvarial membranous bones of adult primates retain the potential to regenerate when segregation between the different tissue components participating in the healing of the wound is maintained. In the same model, however, implantation of allogeneic demineralized bone matrix, used as a positive control provided the most effective treatment for the defects.
成年哺乳动物的颅骨缺损再生潜力有限。在愈合过程中，非成骨组织侵入缺损内部可能会损害骨生成，这会抑制从缺损边缘向心的骨沉积。我们使用灵长类动物模型，评估了用脱矿骨基质治疗的颅骨缺损与根据引导组织再生策略治疗的缺损的骨再生情况。在16只成年雄性狒狒（山魈）身上制备了64个直径为25毫米的缺损。在每只动物身上，2个对侧缺损用直径为35毫米的多孔聚合物模板覆盖。模板放置在颅骨边缘上方，以防止颅骨膜和颞肌穿透缺损，从而在愈合过程中保持组织隔离。第三个缺损植入同种异体脱矿骨基质作为阳性对照。第四个缺损不进行处理，用作阴性对照。在术后3个月和6个月从收获的标本制备未脱钙骨切片（7微米厚）。尽管未处理的缺损在颅骨膜与硬脑膜融合后显示出有限的骨生成，但用聚合物模板覆盖的缺损通常显示出从开颅边缘向心延伸的广泛骨沉积。组织形态计量学表明，与未处理的缺损相比，用脱矿骨基质处理的缺损和用聚合物模板覆盖的缺损有更多的骨和类骨质（p<0.01）。在6个月时，与用聚合物模板覆盖的缺损相比，脱矿骨基质处理的缺损形成了更多的骨（p<0.01）。本研究结果表明，当参与伤口愈合过程的不同组织成分之间保持隔离时，成年灵长类动物的颅骨膜性骨保留再生潜力。然而，在同一模型中，用作阳性对照的同种异体脱矿骨基质植入为缺损提供了最有效的治疗方法。
