Hürzeler M B, Quiñones C R, Caffesse R G, Schüpbach P, Morrison E C
Department of Prosthodontics, Albert-Ludwigs-University, Freiburg, Germany.
J Periodontol. 1997 May;68(5):498-505. doi: 10.1902/jop.1997.68.5.498.
The purpose of this study was to evaluate guided periodontal tissue regeneration (GPTR) wound healing in Class II furcation defects following surgical treatment with a synthetic bioabsorbable barrier manufactured from a copolymer of glycolide and lactide. Periodonal lesions were induced in four adult male rhesus monkeys around the mandibular first, second, and third molar teeth using orthodontic elastics. After obtaining approximately 30% bone loss, the elastics were replaced by a stainless steel wire which had a projection extending into the furcation. Once similar contralateral Class II furcation defects had been created, the wires were removed, and an oral hygiene program was initiated and maintained until completion of the study. Three weeks after commencing oral hygiene, flap surgery was performed in the mandibular molar region and the root surfaces were thoroughly scaled and root planed to the apical portion of the defects. A bioabsorbable barrier was then placed to cover the furcation defects on one side of the jaw (i.e., test sites). No barriers were placed on the contralateral molars (i.e., control sites). Five months after surgery, the animals were sacrificed and the teeth with their supporting periodontium were processed for light microscopic evaluation. Clinical healing progressed normally and was similar in both groups. Histologic observations from control specimens indicated repair with epithelium and connective tissue occupying the majority of the furcation defects. Test specimens exhibited definitive evidence of regeneration with significantly greater new connective tissue attachment, cementum deposition, and bone formation than the control sites (P < 0.001). It was concluded that this bioabsorbable barrier facilitated GPTR wound healing in Class II furcation defects.
本研究的目的是评估使用由乙交酯和丙交酯共聚物制成的合成生物可吸收屏障进行手术治疗后,II类根分叉缺损处引导性牙周组织再生(GPTR)的伤口愈合情况。使用正畸弹力线在4只成年雄性恒河猴的下颌第一、第二和第三磨牙周围诱导牙周病变。在获得约30%的骨质流失后,将弹力线换成一根不锈钢丝,该钢丝有一个延伸至根分叉的突起。一旦在对侧创建了类似的II类根分叉缺损,就移除钢丝,并启动并维持口腔卫生计划直至研究结束。开始口腔卫生措施3周后,在下颌磨牙区域进行翻瓣手术,彻底刮治根面并将其平整至缺损的根尖部分。然后放置一个生物可吸收屏障以覆盖颌骨一侧的根分叉缺损(即试验部位)。对侧磨牙(即对照部位)不放置屏障。手术后5个月,处死动物,将带有支持性牙周组织的牙齿进行处理以进行光镜评估。临床愈合进展正常,两组相似。对照标本的组织学观察表明,上皮和结缔组织修复占据了大部分根分叉缺损。试验标本显示出明确的再生证据,与对照部位相比,新结缔组织附着、牙骨质沉积和骨形成明显更多(P < 0.001)。得出的结论是,这种生物可吸收屏障促进了II类根分叉缺损处的GPTR伤口愈合。