Caplanis N, Lee M B, Zimmerman G J, Selvig K A, Wikesjö U M
Section of Implant Dentistry, Loma Linda University, CA 92350, USA.
J Periodontol. 1998 Aug;69(8):851-6. doi: 10.1902/jop.1998.69.8.851.
This randomized, split-mouth study was designed to evaluate the adjunctive effect of allogenic, freeze-dried, demineralized bone matrix (DBM) to guided tissue regeneration (GTR). Contralateral fenestration defects (6 x 4 mm) were created 6 mm apical to the buccal alveolar crest on maxillary canine teeth in 6 beagle dogs. DBM was implanted into one randomly selected fenestration defect. Expanded polytetrafluoroethylene (ePTFE) membranes were used to provide bilateral GTR. Tissue blocks including defects with overlying membranes and soft tissues were harvested following a four-week healing interval and prepared for histometric analysis. Differences between GTR+DBM and GTR defects were evaluated using a paired t-test (N = 6). DBM was discernible in all GTR+DBM defects with limited, if any, evidence of bone metabolic activity. Rather, the DBM particles appeared solidified within a dense connective tissue matrix, often in close contact to the instrumented root. There were no statistically significant differences between the GTR+DBM versus the GTR condition for any histometric parameter examined. Fenestration defect height averaged 3.7+/-0.3 and 3.9+/-0.3 mm, total bone regeneration 0.8+/-0.6 and 1.5+/-0.8 mm, and total cementum regeneration 2.0+/-1.3 and 1.6+/-1.7 mm for GTR+DBM and GTR defects, respectively. The histologic and histometric observations, in concert, suggest that allogenic freeze-dried DBM has no adjunctive effect to GTR in periodontal fenestration defects over a four-week healing interval. The critical findings were 1) the DBM particles remained, embedded in dense connective tissue without evidence of bone metabolic activity; and 2) limited and similar amounts of bone and cementum regeneration were observed for both the GTR+DBM and GTR defects.
本随机、双侧对照研究旨在评估同种异体冻干脱矿骨基质(DBM)对引导组织再生(GTR)的辅助作用。在6只比格犬的上颌尖牙颊侧牙槽嵴顶下方6mm处制备对侧开窗缺损(6×4mm)。将DBM植入随机选择的一个开窗缺损处。使用膨体聚四氟乙烯(ePTFE)膜进行双侧GTR。在4周的愈合期后,采集包括缺损及覆盖膜和软组织的组织块,准备进行组织计量学分析。使用配对t检验(N = 6)评估GTR+DBM组和GTR组缺损之间的差异。在所有GTR+DBM缺损中均可辨认出DBM,几乎没有骨代谢活动的证据。相反,DBM颗粒在致密结缔组织基质中凝固,常与器械处理过的牙根紧密接触。在任何检测的组织计量学参数方面,GTR+DBM组与GTR组之间均无统计学显著差异。GTR+DBM组和GTR组的开窗缺损高度平均分别为3.7±0.3mm和3.9±0.3mm,总骨再生分别为0.8±0.6mm和1.5±0.8mm,总牙骨质再生分别为2.0±1.3mm和1.6±1.7mm。组织学和组织计量学观察结果一致表明,在为期4周的愈合期内,同种异体冻干DBM对牙周开窗缺损的GTR无辅助作用。关键发现为:1)DBM颗粒保留在致密结缔组织中,无骨代谢活动证据;2)GTR+DBM组和GTR组观察到的骨和牙骨质再生量有限且相似。