Haney J M, Nilvéus R E, McMillan P J, Wikesjö U M
Advanced Education Program in Periodontics, Loma Linda University, CA.
J Periodontol. 1993 Sep;64(9):883-90. doi: 10.1902/jop.1993.64.9.883.
A wound stabilizing effect of expanded polytetrafluoroethylene (ePTFE) membranes was evaluated in supra-alveolar periodontal defects in 5 beagle dogs. The defects, 5 to 6 mm in height, were surgically created around the 2nd, 3rd, and 4th mandibular premolar teeth in contralateral jaw quadrants. The root surfaces were conditioned with heparin, which, in this model, has been demonstrated to compromise periodontal healing and result in formation of a long junctional epithelium. Wound closure included application of ePTFE membranes around each premolar tooth in one jaw quadrant in each dog and flap positioning coronal to the cemento-enamel junction in both jaw quadrants. Healing progressed uneventfully except for 3 teeth in 2 dogs, which experienced membrane exposure. The dogs were sacrificed after a 4-week healing period and tissue blocks were prepared for histometric analysis. Connective tissue repair in heparin+membrane-treated teeth averaged 98% of the defect height compared to 84% in control heparin-treated teeth (P < or = 0.05). Junctional epithelium formation was smaller in membrane-treated teeth than in control teeth (P < or = 0.05) and was usually terminated coronal to the membrane. Bone regeneration was enhanced in membrane-treated teeth compared to controls (P < or = 0.01) and was strongly correlated to the area under the membrane in teeth without membrane exposure (r2 = 0.993; P = 0.002). This correlation was reduced when teeth with membrane exposure were included in the analysis (P < or = 0.05). Cementum regeneration was minimal under both treatment conditions. Root resorption was increased in membrane-treated compared to control teeth (P < or = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
在5只比格犬的牙槽嵴顶牙周缺损处评估了膨体聚四氟乙烯(ePTFE)膜的伤口稳定作用。在对侧颌骨象限的第2、3和4颗下颌前磨牙周围通过手术制造高度为5至6毫米的缺损。用肝素处理牙根表面,在该模型中,已证明肝素会损害牙周愈合并导致长结合上皮的形成。伤口闭合包括在每只狗的一个颌骨象限的每颗前磨牙周围应用ePTFE膜,并在两个颌骨象限将瓣片定位在牙骨质-釉质界的冠方。除了2只狗的3颗牙齿出现膜暴露外,愈合过程顺利。在4周的愈合期后处死这些狗,并制备组织块用于组织计量分析。肝素+膜处理牙齿的结缔组织修复平均为缺损高度的98%,而对照肝素处理牙齿为84%(P≤0.05)。膜处理牙齿的结合上皮形成比对照牙齿小(P≤0.05),并且通常在膜的冠方终止。与对照相比,膜处理牙齿的骨再生增强(P≤0.01),并且在没有膜暴露的牙齿中与膜下方的面积密切相关(r2 = 0.993;P = 0.002)。当分析中包括有膜暴露的牙齿时,这种相关性降低(P≤0.05)。在两种治疗条件下,牙骨质再生都很少。与对照牙齿相比,膜处理牙齿的牙根吸收增加(P≤0.01)。(摘要截断于250字)