Palmer R M, Smith B J, Palmer P J, Floyd P D, Johannson C B, Albrektsson T
UMDS Guy's Hospital, London, England.
Clin Oral Implants Res. 1998 Oct;9(5):283-91. doi: 10.1034/j.1600-0501.1998.090501.x.
Few investigations have studied the long-term fate of bone formed following the technique of guided tissue regeneration. The aim of the present study was to evaluate bone fill around implant fixtures with dehiscence defects and to study its response to loading. Ten patients were treated with overdentures supported by 2 fixtures ad modum Brånemark. A third 7 mm x 3.75 mm diameter fixture was placed for the purposes of the study in the most anterior part of the mandible with a dehiscence defect of 4 to 5 mm on the buccal aspect (and 3 to 4 threads exposed) which was covered with a Gore-Tex membrane and buried beneath the mucosa. Fixtures were exposed after 5 months (stage 2), ball abutments connected and loaded through an overdenture for 1 year. Nine fixtures were functioning well after 1 year of loading, 6 of which were retrieved with a trephine for histological examination and compared with 6 unloaded fixtures retrieved in our previously reported study. The bone area filling the thread profiles (BA%) and the bone to metal contact (BMC%) were measured in the 3 most apical and 3 most coronal thread profiles on the buccal and lingual surfaces. Statistically significant higher BMC% (P < 0.01) were observed in loaded fixtures in the apical regions (buccal: loaded 51%, unloaded 25%; lingual: loaded 49%, unloaded 24%). Differences approached significance for the regeneration site (loaded 22%, unloaded 6%) but were no different for the coronal lingual region (loaded 28%, unloaded 20%). There were no differences for BA%. This study confirms that there is an increase in bone to metal contact with time and following fixture loading and that this may also occur with bone regenerated under Gore-Tex membranes.
很少有研究探讨引导组织再生技术形成的骨组织的长期转归。本研究的目的是评估种植体周围伴有骨裂开缺损处的骨填充情况，并研究其对负荷的反应。10例患者采用2枚Brånemark式种植体支持覆盖义齿。为进行本研究，在下颌最前部植入第3枚直径7 mm×3.75 mm的种植体，其颊侧有4至5 mm的骨裂开缺损（3至4个螺纹暴露），用Gore-Tex膜覆盖并埋于黏膜下。5个月后暴露种植体（二期手术），连接球形基台并通过覆盖义齿加载1年。加载1年后，9枚种植体功能良好，其中6枚用环钻取出用于组织学检查，并与我们之前报道的研究中取出的6枚未加载种植体进行比较。在颊侧和舌侧表面的3个最根尖和3个最冠方的螺纹处测量填充螺纹轮廓的骨面积（BA%）和骨与金属接触面积（BMC%）。在根尖区域，加载种植体的BMC%显著更高（P < 0.01）（颊侧：加载组为51%，未加载组为25%；舌侧：加载组为49%，未加载组为24%）。再生部位的差异接近显著水平（加载组为22%，未加载组为6%），但冠方舌侧区域无差异（加载组为28%，未加载组为20%）。BA%无差异。本研究证实，随着时间推移和种植体加载，骨与金属的接触增加，在Gore-Tex膜下再生的骨组织也可能出现这种情况。
