Ito K, Nanba K, Murai S
Department of Periodontology, Nihon University School of Dentistry, Tokyo, Japan.
J Periodontol. 1998 Nov;69(11):1229-37. doi: 10.1902/jop.1998.69.11.1229.
The aim of this study was to compare the effects of bioabsorbable and non-resorbable membranes on experimental guided bone augmentation in 8 Japanese white rabbits. A cutaneous flap was demarcated and raised from the forehead of each animal, the periosteum was lifted, and the calvarial bone on both sides of the midline was exposed. A titanium screw was inserted into the bone on each side of the midline and one screw was covered with a bioabsorbable (polylactic acid) membrane and the other with a non-resorbable (expanded polytetrafluoroethylene) membrane. The implanted screws and membranes were then covered with the periosteum and cutaneous flap. After healing for 6 months, the animals were euthanized and the experimental area was prepared for histological investigation. New bone had formed under both membranes with no sign of infection or membrane exposure. The amount of newly generated bone (89.0 +/- 17.3% versus 54.7 +/- 14.0%, P <0.05) and the percentage of newly generated bone height (81.5 +/- 6.3% versus 58.9 +/- 7.8%, P <0.05) in the space beneath the non-resorbable membrane was greater than that beneath the bioabsorbable membrane. However, there were no statistically significant differences between the bioabsorbable and non-resorbable membranes with respect to the percentage areas of mineralized bone (52.3 +/- 11.3% versus 47.1 +/- 6.7%, P = 0.8658) and bone marrow (47.7 +/- 11.3% versus 52.9 +/- 6.7%, P = 0.4838) and bone contact with the screw (88.3 +/- 6.9% versus 89.2 +/- 7.3%, P = 0.9999). In conclusion, at least within the limitations of this rabbit model, we suggest that non-resorbable membranes with sufficient stiffness should be used to obtain greater bone volume and height instead of bioabsorbable membranes for the GBR procedure, and that this will facilitate predictable bone augmentation in spaces beyond the bone surface. Therefore, the bioabsorbable membrane could not replace the non-resorbable membrane used in this model.
本研究的目的是比较生物可吸收膜和不可吸收膜对8只日本白兔实验性引导骨增量的影响。在每只动物的前额划定并掀起皮瓣，掀起骨膜，暴露中线两侧的颅骨。在中线两侧的骨中各植入一枚钛螺钉，一枚螺钉覆盖生物可吸收（聚乳酸）膜，另一枚覆盖不可吸收（膨体聚四氟乙烯）膜。然后将植入的螺钉和膜用骨膜和皮瓣覆盖。愈合6个月后，对动物实施安乐死，并准备对实验区域进行组织学研究。在两种膜下均有新骨形成，无感染或膜暴露迹象。不可吸收膜下方间隙中新生成骨的量（89.0±17.3%对54.7±14.0%，P<0.05）和新生成骨高度的百分比（81.5±6.3%对58.9±7.8%，P<0.05）大于生物可吸收膜下方。然而，生物可吸收膜和不可吸收膜在矿化骨面积百分比（52.3±11.3%对47.1±6.7%，P = 0.8658）、骨髓百分比（47.7±11.3%对52.9±6.7%，P = 0.4838）以及骨与螺钉的接触（88.3±6.9%对89.2±7.3%，P = 0.9999）方面无统计学显著差异。总之，至少在本兔模型的局限性范围内，我们建议在引导骨再生手术中应使用具有足够刚度的不可吸收膜以获得更大的骨体积和高度，而非生物可吸收膜，这将有助于在骨表面以外的间隙中实现可预测的骨增量。因此，生物可吸收膜不能替代本模型中使用的不可吸收膜。
