Caplanis N, Lee M B, Zimmerman G J, Selvig K A, Wikesjö U M
Section of Implant Dentistry, Loma Linda University, CA, USA.
J Clin Periodontol. 1998 Oct;25(10):801-6. doi: 10.1111/j.1600-051x.1998.tb02373.x.
This split-mouth study was designed to evaluate regeneration of alveolar bone and periodontal attachment following implantation of allogeneic, freeze-dried, demineralized bone matrix (DBM). Buccal fenestration defects (6x4 mm) were created on the maxillary canine teeth in 6 beagle dogs. DBM was implanted into one randomly selected defect in each animal. The contralateral defect served as surgical control. Tissue blocks were harvested following a 4-week healing interval and prepared for histometric analysis. DBM was discernible in all implanted defects with limited evidence of bone metabolic activity. The DBM particles appeared invested within a dense connective tissue, often in close contact to the instrumented root. Fenestration defect height averaged 3.8+/-0.1 and 3.7+/-0.3 mm, total bone regeneration 0.9+/-0.9 and 0.4+/-1.2 mm, and total cementum regeneration 2.3+/-1.5 and 0.6+/-0.7 mm for DBM and control defects, respectively. Differences with regards to cementum regeneration were statistically significant (p=0.03). In summary, the results of this study suggest that DBM implants may enhance cementum regeneration in this defect model, and that they have no apparent effect on alveolar bone regeneration. Enhanced cementum regeneration may be possibly be explained by provisions for guided tissue regeneration from the implant suppressing a significant influence of the gingival connective tissue on the healing process. Moreover, a 4-week healing interval appears insufficient for turnover of DBM.
本双侧对照研究旨在评估同种异体冻干脱矿骨基质(DBM)植入后牙槽骨和牙周附着的再生情况。在6只比格犬的上颌尖牙上制造颊侧开窗缺损(6×4毫米)。将DBM植入每只动物随机选择的一个缺损中。对侧缺损作为手术对照。在4周的愈合期后采集组织块并准备进行组织计量学分析。在所有植入的缺损中均可辨别出DBM,骨代谢活性证据有限。DBM颗粒似乎包埋在致密结缔组织内,通常与处理过的牙根紧密接触。DBM和对照缺损的开窗缺损高度平均分别为3.8±0.1和3.7±0.3毫米,总骨再生分别为0.9±0.9和0.4±1.2毫米,总牙骨质再生分别为2.3±1.5和0.6±0.7毫米。牙骨质再生方面的差异具有统计学意义(p = 0.03)。总之,本研究结果表明,DBM植入物可能会增强该缺损模型中的牙骨质再生,并且对牙槽骨再生没有明显影响。牙骨质再生增强可能是由于植入物提供了引导组织再生,抑制了牙龈结缔组织对愈合过程的重大影响。此外,4周的愈合期似乎不足以使DBM周转。