Elharar F, Rodriguez H J, Benqué E P, Caffesse R G
Department of Oral Biology, Faculty of Odontology, Paul Sabatier University, Toulouse, France.
J Periodontol. 1998 Nov;69(11):1218-28. doi: 10.1902/jop.1998.69.11.1218.
The purpose of the present study was to evaluate the healing events and compare the effects of guided tissue regeneration (GTR) using 3 different membranes: a weakly cross-linked bioabsorbable bovine collagen membrane; a strongly cross-linked bioabsorbable bovine collagen membrane; and a non-resorbable ePTFE membrane. Twenty adult female beagle dogs with naturally occurring periodontitis were subjected to periodontal probing and scaling. In both right and left mandibular quadrants, mucoperiosteal flaps were raised, and after debridement, the roots of experimental premolar teeth received apical reference notches. The following treatments were randomly assigned: 1) gingival flap curettage (GFC) + ePTFE membrane, control membrane; 2) GFC + slightly cross-linked collagen membrane, 1st test membrane; and 3) GFC + strongly cross-linked collagen membrane, 2nd test membrane. The flaps were sutured in such a manner that the membranes were completely covered. All dogs received a soft diet for a 2-week period and an oral hygiene program until time of sacrifice. The animals were randomly scheduled for sacrifice at 2, 4, 12, and 24 weeks. The ePTFE membranes still in place were removed at 6 weeks. The jaws were dissected and specimens prepared for descriptive histology and histomorphometry. The early resorption of the 1st test membrane was achieved at 4 weeks, and the 2nd test membrane at 12 weeks, both with normal inflammatory reaction. Measurements of epithelium, connective tissue attachment, new bone, and neocementum were compared within an animal (paired t test). Analyses were performed on data at 4, 12, and 24 weeks post-healing; little differences were found between these periods. Limited connective tissue repair was favored by the placement of all the membranes (about 20%), with no statistically significant difference. These findings indicate that bioabsorbable collagen membranes with different cross-linking and ePTFE barriers promote similar new attachment in GTR procedures on naturally occurring periodontal defects in dogs.
本研究的目的是评估愈合情况，并比较使用3种不同膜进行引导组织再生（GTR）的效果：一种弱交联生物可吸收牛胶原膜；一种强交联生物可吸收牛胶原膜；以及一种不可吸收的ePTFE膜。20只患有自然发生牙周炎的成年雌性比格犬接受了牙周探诊和刮治。在左右下颌象限，掀起黏骨膜瓣，清创后，实验前磨牙的牙根制作根尖参考切口。随机分配以下治疗方法：1）牙龈瓣刮治术（GFC）+ePTFE膜，对照膜；2）GFC+轻度交联胶原膜，第一种测试膜；3）GFC+强交联胶原膜，第二种测试膜。以完全覆盖膜的方式缝合瓣。所有犬在2周内给予软食，并进行口腔卫生护理直至处死。动物被随机安排在2、4、12和24周处死。6周时取出仍在位的ePTFE膜。解剖颌骨并制备标本用于描述性组织学和组织形态计量学。第一种测试膜在4周时实现早期吸收，第二种测试膜在12周时实现早期吸收，两者均伴有正常炎症反应。在动物体内比较上皮、结缔组织附着、新骨和新牙骨质的测量值（配对t检验）。对愈合后4、12和24周的数据进行分析；这些时期之间几乎没有差异。所有膜的放置都有利于有限的结缔组织修复（约20%），无统计学显著差异。这些发现表明，具有不同交联度的生物可吸收胶原膜和ePTFE屏障在犬自然发生的牙周缺损的GTR手术中促进了相似的新附着形成。
