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引导组织再生术与骨移植治疗根分叉病变

Guided tissue regeneration and bone grafts in the treatment of furcation defects.

作者信息

Caffesse R G, Nasjleti C E, Plotzke A E, Anderson G B, Morrison E C

机构信息

Department of Periodontics, University of Texas Health Science Center, Houston.

出版信息

J Periodontol. 1993 Nov;64(11 Suppl):1145-53. doi: 10.1902/jop.1993.64.11s.1145.

Abstract

The present study evaluated the effects of guided tissue regeneration (GTR), with and without demineralized freeze-dried cortical bone grafts, in the treatment of furcation defects in 4 female beagle dogs with naturally occurring periodontal disease. The root surfaces were thoroughly debrided. Four weeks later, full thickness facial and lingual mucoperiosteal flaps were reflected using inverse bevel incisions on both sides of the mandible involving the 2nd, 3rd, and 4th premolar, and the 1st molar teeth. Following debridement, notches were placed on the roots at the level of supporting bone. Test quadrants were randomly selected and furcations were filled with reconstituted, demineralized, freeze-dried human cortical bone grafts. Following bone grafting, all defects were covered with an expanded polytetrafluoroethylene (ePTFE) membrane, which was sutured with 4-0 sutures. Afterward, interproximal sutures were placed through the flaps, assuring the flaps covered the membranes completely. The contralateral side, serving as control, was treated by debridement only and application of ePTFE membrane. All membranes were removed 6 weeks after surgery. Dogs were sacrificed at 4 months after surgery. Both mesio-distal and bucco-lingual histologic sections were evaluated by descriptive histology. Linear measurements and surface area determination of the furcal tissues were carried out using the microscope attached to a digitizer. Twelve to 20 nonserial sections were made of the mid-buccal aspects of each root of each treated tooth. Half of these sections were stained with Harris' hematoxylin and eosin (H&E) and the other half stained with Mallory's trichrome stain.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究评估了引导组织再生术(GTR)联合或不联合脱矿冻干皮质骨移植,对4只患有自然发生牙周病的雌性比格犬根分叉病变的治疗效果。对牙根表面进行彻底清创。四周后,在下颌两侧涉及第2、3、4前磨牙和第1磨牙处,采用反斜切口翻起全厚颊侧和舌侧粘骨膜瓣。清创后,在支持骨水平的牙根上制作切口。随机选择测试象限,用重组的、脱矿的、冻干的人皮质骨移植材料填充根分叉。植骨后,所有缺损均用膨体聚四氟乙烯(ePTFE)膜覆盖,并用4-0缝线缝合。然后,通过瓣放置邻间缝线,确保瓣完全覆盖膜。对侧作为对照,仅进行清创并应用ePTFE膜。术后6周取出所有膜。术后4个月处死犬。通过描述性组织学评估近远中向和颊舌向组织学切片。使用连接数字转换器的显微镜对根分叉组织进行线性测量和表面积测定。对每颗治疗牙齿的每个牙根的颊侧中部制作12至20个非连续切片。这些切片的一半用哈里斯苏木精和伊红(H&E)染色,另一半用马洛里三色染色。(摘要截断于250字)

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