Robert P M, Frank R M
Centre de Recherches, Faculté de Chirurgie Dentaire, Université Louis Pasteur, Strasbourg, France.
J Periodontol. 1994 May;65(5):414-22. doi: 10.1902/jop.1994.65.5.414.
The aim of the present study was to evaluate the use of 3 types of biodegradable, high molecular weight DL-lactic acid (PLA) membranes containing respectively 0%, 10%, and 30% low molecular weight oligomers for obtaining guided tissue regeneration following treatment of experimental buccal periodontal defects created surgically in 6 young adult beagle dogs. On the buccal aspects of test and control teeth, a mucoperiostal flap was raised and the buccal alveolar bone removed. The exposed root surfaces were scaled and a notch was prepared in the root surface at the level of the reduced crest. PLA membranes containing respectively 0%, 10% and 30% oligomers, drawn at random, were placed over the experimental defects, while no membrane was placed over the control roots. The animals were sacrificed 2, 4, and 6 months after surgery. For comparison between control sites (without membrane) and experimental sites (with 3 types of membrane), serial bucco-lingual sections were made of the experimental and control sites and studied histologically and histometrically. It appeared that a satisfactory regeneration of the periodontal tissues could be obtained with all 3 types of experimental PLA membranes and statistically significant differences could be observed for epithelial attachment, alveolar bone regrowth, connective tissue attachment, and new cementum formation in the experimental group when compared with the controls. All 3 types of membranes were well tolerated. The resorption of the membranes started in the coronal portions and extended progressively in an apical direction and the resorption time seemed to be related to the content of oligomers. PLA membranes could be used as interesting alternatives for GTR in advanced human periodontal lesions.
本研究的目的是评估3种分别含有0%、10%和30%低分子量低聚物的可生物降解的高分子量DL-乳酸(PLA)膜在6只成年比格犬手术造成的实验性颊侧牙周缺损治疗后引导组织再生中的应用。在测试牙和对照牙的颊侧,掀起黏骨膜瓣并去除颊侧牙槽骨。对暴露的根面进行刮治,并在牙槽嵴顶水平的根面上制备一个切口。随机抽取分别含有0%、10%和30%低聚物的PLA膜覆盖在实验性缺损处,而对照牙根上不覆盖膜。在术后2、4和6个月处死动物。为了比较对照部位(无膜)和实验部位(有3种膜),对实验部位和对照部位制作连续的颊舌向切片,并进行组织学和组织计量学研究。结果显示,所有3种实验性PLA膜均能使牙周组织获得满意的再生,与对照组相比,实验组在上皮附着、牙槽骨再生、结缔组织附着和新牙骨质形成方面有统计学显著差异。所有3种膜的耐受性良好。膜的吸收从冠部开始,逐渐向根尖方向延伸,吸收时间似乎与低聚物的含量有关。PLA膜可作为晚期人类牙周病变中引导组织再生的有趣替代物。