目的:本研究旨在评估在实验性裂开缺损中使用骨替代物移植物进行引导骨再生(GBR)的膜使用。
方法:取9只犬上颌第二切牙(I2)。六周后,插入植入物,并在颊侧产生实验性开裂缺损(5×3mm)。用去蛋白的牛骨矿物质移植缺损和周围的骨。一侧(测试)覆盖有可再吸收的胶原膜,而对侧(对照)则没有。6周后,进行组织形态计量学分析以评估:(a)首次骨与植入物接触(FBIC),(b)距植入物肩部1mm增量的颊骨厚度,(c)再生面积(RA),(d)新骨的面积和百分比(B),骨替代物(BS)和矿化组织(MT)。
结果:测试部位和对照部位的组织学外观相似。在中央和侧面部分,fBIC组间没有差异,颊骨厚度,RA,BS,B,%B,MT和%MT。在中央部分,膜使用有利于更多的%BS和%MT(p=0.052)。有更多的B,与中央部分相比,横向的B和MT占%。
结论:膜使用倾向于保留更多的骨替代物,但对新骨向内生长没有影响。与中央切片相比,外侧切片显示出更多的骨向内生长和矿化组织,确认新骨向内生长主要来自缺损的侧壁。
结论:阐明GBR手术中骨再生动力学的临床前研究与临床实践有关。
OBJECTIVE: This study aimed to assess membrane use with a bone substitute graft for guided bone regeneration (GBR) in experimental dehiscence defects.
METHODS: Maxillary second incisors (I2) in 9 dogs were extracted. Six weeks later, implants were inserted and experimental dehiscence defects (5 × 3 mm) created on the buccal aspect. The defects and surrounding bone were grafted with deproteinized bovine bone mineral. One side (test) was covered with a resorbable collagen membrane whereas the contralateral side (control) was not. After 6 weeks, histomorphometrical analysis was performed to evaluate: (a) first bone-to-implant contact (fBIC), (b) buccal bone thickness at 1 mm increments from implant shoulder, (c) regenerated area (RA), (d) area and percentages of new bone (B), bone substitute (BS) and mineralized tissue (MT).
RESULTS: The histological appearance was similar between test and control sites. At central and lateral sections, there were no differences between groups for fBIC, buccal bone thickness, RA, BS, B, %B, MT and %MT. At central sections, membrane use favoured more %BS and %MT (p = 0.052). There was significantly more B, %B and MT at lateral compared to central sections.
CONCLUSIONS: Membrane use tended to retain more bone substitute, but had no effect on new bone ingrowth. Lateral sections showed significantly more bone ingrowth and mineralized tissue compared to central sections, confirming that new bone ingrowth takes place mainly from the lateral walls of the defect.
CONCLUSIONS: Preclinical research to clarify the dynamics of bone regeneration in GBR procedures is relevant in clinical practice.