Kim C K, Cho K S, Choi S H, Prewett A, Wikesjö U M
Department of Periodontology, College of Dentistry, Yonsei University, Seoul, Korea.
J Periodontol. 1998 Jan;69(1):26-33. doi: 10.1902/jop.1998.69.1.26.
The objective of this study was to evaluate alveolar bone and cementum regeneration following surgical placement of an allogenic, freeze-dried, demineralized bone matrix (DBM) cortical strip implant. Critical size, supraalveolar periodontal defects were surgically created around the second, third, and fourth mandibular premolar teeth in eight mongrel dogs. Contralateral jaw quadrants in six animals were randomly assigned to receive the DBM implant, or serve as surgical control. Two additional animals received bilateral DBM implants. Flaps were coronally advanced to submerge teeth and implants, and sutured. Three animals were exited from the study due to extensive early wound failure. Remaining animals were sacrificed at 8 weeks postsurgery. Histometric recordings included defect height, bone regeneration/DBM implant height, cementum regeneration height, root resorption, and ankylosis. Large areas of unresorbed DBM exhibiting fragmentation and empty osteocyte lacunae were observed adjacent to new bone formation, or bone formation was observed adjacent to or within the implant, often exhibiting ankylosis. Cementum regeneration appeared enhanced in shelter of the DBM implant. Histometric recordings (mean+/-SD) for DBM and control defects, respectively, were: defect height, 4.8+/-0.2 mm and 4.4+/-0.2 mm; bone regeneration/DBM implant height, 4.0+/-1.3 mm and 1.2+/-0.6 mm; cementum regeneration height, 1.4+/-0.4 mm and 0.7+/-0.2 mm; root resorption, 0.5+/-0.3 mm and 1.2+/-0.3 mm; and ankylosis, 0.5+/-0.2 mm and 0.1+/-0.1 mm without statistically significant differences between experimental conditions (N=3). Within the limitations of this study, the histologic observations suggest that surgical implantation of allogenic, freeze-dried DBM cortical strip implants may have a potential to support cementum regeneration, possibly by providing conditions for guided tissue regeneration, however, alveolar regeneration appears unpredictable.
本研究的目的是评估同种异体冻干脱矿骨基质(DBM)皮质条植入物手术植入后牙槽骨和牙骨质的再生情况。在8只杂种犬的下颌第二、第三和第四前磨牙周围手术制造临界大小的牙槽嵴上牙周缺损。6只动物的对侧颌象限被随机分配接受DBM植入物,或作为手术对照。另外2只动物接受双侧DBM植入物。将皮瓣向冠方推进以覆盖牙齿和植入物,并进行缝合。3只动物因早期伤口广泛失败而退出研究。其余动物在术后8周处死。组织计量学记录包括缺损高度、骨再生/DBM植入物高度、牙骨质再生高度、牙根吸收和骨粘连。在新骨形成附近观察到大片未吸收的DBM,表现为碎片和空的骨细胞陷窝,或者在植入物附近或内部观察到骨形成,常表现为骨粘连。在DBM植入物的保护下,牙骨质再生似乎增强。DBM和对照缺损的组织计量学记录(平均值±标准差)分别为:缺损高度,4.8±0.2mm和4.4±0.2mm;骨再生/DBM植入物高度,4.0±1.3mm和1.2±0.6mm;牙骨质再生高度,1.4±0.4mm和0.7±0.2mm;牙根吸收,0.5±0.3mm和1.2±0.3mm;骨粘连,0.5±0.2mm和0.1±0.1mm,各实验条件之间无统计学显著差异(N=3)。在本研究的局限性内,组织学观察表明,同种异体冻干DBM皮质条植入物的手术植入可能有支持牙骨质再生的潜力,可能是通过提供引导组织再生的条件,然而,牙槽骨再生似乎不可预测。