Fiorellini J P, Engebretson S P, Donath K, Weber H P
Department of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
J Periodontol. 1998 May;69(5):528-35. doi: 10.1902/jop.1998.69.5.528.
Treatment of partial and total edentulism with submerged and nonsubmerged dental implants which follows the concept of osseointegration has become an accepted treatment modality. With compromised implant sites, practitioners have begun to combine one-stage implants with established techniques including guided bone regeneration. However, the clinical evaluation of this technique is limited. Therefore, the purpose of this study was to evaluate osseointegration and bone regeneration around nonsubmerged or submerged implants placed directly into surgically created osseous defects with or without expanded polytetrafluoroethylene (ePTFE) membranes. A total of 24 implants were placed in the mandibles of 4 beagle dogs and randomly assigned to 1 of 3 treatment groups. In group A, nonsubmerged implants were placed into osseous defects and treated with a poncho style ePTFE membrane. These membranes had a hole punched into the center and were slipped over the nonsubmerged implants. In group B, nonsubmerged implants were placed into osseous defects without an ePTFE membrane. In group C, submerged implants were placed into osseous defects and covered with an ePTFE membrane. Histometric measurements of each treatment group were made to determine percent bone gain or loss along the implant surface. Although a number of membrane removals occurred during the healing period, histological analysis indicated osseous ingrowth and osseointegration around nonsubmerged and submerged implants. An overall comparison of the treatment groups with ANOVA revealed that there were no significant differences between treatment groups, P > or = 0.05. However, when the data were stratified into sites which retained or lost the ePTFE membrane, the percent of bone regeneration was reduced in group A. Therefore, it may be recommended that nonsubmerged implants be placed with a submerged or "semi-submerged" protocol when utilized in conjunction with ePTFE membranes.
遵循骨结合概念，采用潜入式和非潜入式牙种植体治疗部分和全部无牙颌已成为一种被认可的治疗方式。对于种植位点条件不佳的情况，从业者已开始将一期种植体与包括引导骨再生在内的成熟技术相结合。然而，该技术的临床评估有限。因此，本研究的目的是评估直接植入手术造成的骨缺损内、有无膨体聚四氟乙烯（ePTFE）膜的非潜入式或潜入式种植体周围的骨结合和骨再生情况。总共24枚种植体植入4只比格犬的下颌骨，并随机分配到3个治疗组中的1组。A组中，将非潜入式种植体植入骨缺损并用雨披式ePTFE膜处理。这些膜在中心打孔，套在非潜入式种植体上。B组中，将非潜入式种植体植入骨缺损但不使用ePTFE膜。C组中，将潜入式种植体植入骨缺损并用ePTFE膜覆盖。对每个治疗组进行组织计量学测量，以确定沿种植体表面的骨增量或骨丢失百分比。尽管在愈合期有一些膜被移除，但组织学分析表明非潜入式和潜入式种植体周围有骨长入和骨结合。用方差分析对治疗组进行总体比较显示，治疗组之间无显著差异，P≥0.05。然而，当数据按保留或丢失ePTFE膜的位点分层时，A组的骨再生百分比降低。因此，当与ePTFE膜联合使用时，建议采用潜入式或“半潜入式”方案植入非潜入式种植体。
