Caplanis N, Sigurdsson T J, Rohrer M D, Wikesjö U M
Section of Implant Dentistry, Loma Linda University, California 92350, USA.
Int J Oral Maxillofac Implants. 1997 Sep-Oct;12(5):634-42.
This randomized, split-mouth design study evaluated the adjunctive effect of allogeneic, freeze-dried, demineralized bone matrix on guided bone regeneration in a critical-size, supra-alveolar, peri-implant defect model. Contralateral supra-alveolar peri-implant defects, 5 mm in height, each including two titanium implants, were surgically created in five beagle dogs. Demineralized bone matrix in autologous blood was placed over the implants in one randomly selected mandibular jaw quadrant. A space-making expanded-polytetrafluoroethylene membrane was used to provide guided bone regeneration bilaterally. Following a 16-week healing interval, tissue blocks were harvested and prepared for histometric analysis. Differences between experimental conditions (guided bone regeneration sites with and without demineralized bone) were evaluated using paired t tests (n = 4). Demineralized bone particles were discernible, with limited signs of resorption. The bone matrix particles appeared to be solidified within a dense connective tissue matrix and in close contact with the implants. Limited matrix remineralization was apparent adjacent to the alveolar crest. No statistically significant differences were found between experimental conditions for any parameter examined. Peri-implant defect height averaged 5.0 +/- 0.2 mm and 4.9 +/- 0.4 mm, vertical bone regeneration 1.5 +/- 0.9 mm and 1.1 +/- 0.4 mm, osseointegration within the extent of the defect 10.0 +/- 3.9% and 15.3 +/- 5.3%, osseointegration within the extent of regenerated bone 30.4 +/- 13.7% and 52.1 +/- 17.9%, and osseointegration within the alveolar base 68.8 +/- 13.1% and 74.4 +/- 7.1% for guided bone sites with and without demineralized bone, respectively (P > .05). The results suggest that freeze-dried demineralized bone has no adjunctive effect on guided bone regeneration in supra-alveolar peri-implant defects, that guided bone regeneration has a limited potential to enhance alveolar regeneration in this defect model, and that a 16-week healing interval appears insufficient for turnover and maturation of demineralized bone under provisions for guided bone regeneration.
本随机、双侧对照设计研究评估了同种异体冻干脱矿骨基质在临界大小的牙槽嵴上方种植体周围缺损模型中对引导性骨再生的辅助作用。在5只比格犬身上通过手术制造对侧牙槽嵴上方种植体周围缺损，缺损高度为5毫米，每个缺损包含两颗钛种植体。将自体血液中的脱矿骨基质置于随机选择的一侧下颌象限的种植体上。使用空间制造型膨体聚四氟乙烯膜在双侧提供引导性骨再生。经过16周的愈合期后，采集组织块并准备进行组织计量学分析。使用配对t检验（n = 4）评估实验条件（有和没有脱矿骨的引导性骨再生部位）之间的差异。脱矿骨颗粒清晰可见，吸收迹象有限。骨基质颗粒似乎凝固在致密的结缔组织基质中，并与种植体紧密接触。在牙槽嵴附近可见有限的基质再矿化。在所检查的任何参数的实验条件之间未发现统计学上的显著差异。有和没有脱矿骨的引导性骨部位的种植体周围缺损高度平均分别为5.0±0.2毫米和4.9±0.4毫米，垂直骨再生分别为1.5±0.9毫米和1.1±0.4毫米，缺损范围内的骨结合分别为10.0±3.9%和15.3±5.3%，再生骨范围内的骨结合分别为30.4±13.7%和52.1±17.9%，牙槽嵴基部的骨结合分别为68.8±13.1%和74.4±7.1%（P>.05）。结果表明，冻干脱矿骨对牙槽嵴上方种植体周围缺损的引导性骨再生没有辅助作用，在该缺损模型中引导性骨再生增强牙槽嵴再生的潜力有限，并且在引导性骨再生条件下，16周的愈合期似乎不足以使脱矿骨周转和成熟。
