CAJ | 학술논문

目的研究用壳聚糖-胶原膜(chitosan-collagen membrane,CCM)引导种植体颊侧裂隙状缺损骨修复的效果.方法壳聚糖与胶原以质量比40∶1和20∶1混合,经冻干得到CCM-1和CCM-2.比格犬10只,拔除下颌右侧4颗前磨牙和第一磨牙.4个月后,每只犬下颌骨右侧各植入4枚种植体,并在其颊侧制备裂隙状骨缺损,4个骨缺损处根据覆盖膜的种类及方式的不同,采用自身对照法分为4组:CCM-1组、CCM-2组、BG组及空白对照组,每组10只犬,各组观察样本量均为10个.术后4、8、12周各处死3、3、4只实验犬,取含种植体的标本,行组织学观察和硬组织形态学测量分析.结果各实验组骨缺损区内均可见新生骨形成,随着时间延长逐渐增多、成熟.8周时,CCM-1组、CCM-2组和BG组的新生骨高度[(1.10 ±0.11) ～ (1.48 ±0.07) mm]均显著高于空白对照组[(0.74±0.12) mm](P＜0.05).12周时,CCM-1组新生骨高度[(1.91±0.25)mm]显著高于空白对照组[(1.20±0.34) mm] (P ＜0.05).各组间骨-种植体接触率、新生骨面积差异无统计学意义.结论 CCM可促进种植体颊侧裂隙状缺损内的骨组织再生并与种植体表面结合良好.
목적 연구용각취당-효원막(chitosan-collagen membrane,CCM)인도충식체협측렬극상결손골수복적효과.방법 각취당여효원이질량비40∶1화20∶1혼합,경동간득도CCM-1화CCM-2.비격견10지,발제하합우측4과전마아화제일마아.4개월후,매지견하합골우측각식입4매충식체,병재기협측제비렬극상골결손,4개골결손처근거복개막적충류급방식적불동,채용자신대조법분위4조:CCM-1조、CCM-2조、BG조급공백대조조,매조10지견,각조관찰양본량균위10개.술후4、8、12주각처사3、3、4지실험견,취함충식체적표본,행조직학관찰화경조직형태학측량분석.결과 각실험조골결손구내균가견신생골형성,수착시간연장축점증다、성숙.8주시,CCM-1조、CCM-2조화BG조적신생골고도[(1.10 ±0.11) ～ (1.48 ±0.07) mm]균현저고우공백대조조[(0.74±0.12) mm](P＜0.05).12주시,CCM-1조신생골고도[(1.91±0.25)mm]현저고우공백대조조[(1.20±0.34) mm] (P ＜0.05).각조간골-충식체접촉솔、신생골면적차이무통계학의의.결론 CCM가촉진충식체협측렬극상결손내적골조직재생병여충식체표면결합량호.
Objective To compare a developed absorbable chitosan/collagen membrane (CCM) with a standard biodegradable collagen membrane for the treatment of implant dehiscence-type defect in dog model.Methods The right four mandibular premolars and the first molar were extracted in each of 10 beagle dogs.Four months later,acute buccal dehiscence-type defects were surgically created following implant site preparation in each dog.Using self-control,defects were randomly assigned to four different groups:CCM-1 (with the ratio of chitosan and collagen of 40∶1),CCM-2 (with the ratio of chitosan and collagen of 20∶1),Bio-Gide collagen membrane (BG collagen),control.The animals were sacrificed after 4 (3 animals),8 (3 animals) and 12 (4 animals) weeks of healing interval for histological observation and histomorphometrical analysis including defect length(DL),new bone height (NBH),bone-to-implant contact (BIC) and area of new bone fill (BA).Results Newly formed bone was observed in all the groups and became mature with time.At 8 weeks,increased mean NBH and BIC values were obtained for all the groups,the mean NBH values of the CCM-1,CCM-2 and BG groups[(1.1 0 ±0.11) ～ (1.48 ±0.07) mm] were significantly higher than that of the control [(0.74 ± 0.12)mm] (P ＜ 0.05).At 12 weeks,the membranes treated groups obtained more mean NBH,BIC and BA values compared with the control.The CCM-1 groups showed the highest mean NBH value [(1.91 ± 0.25)mm],which was significantly higher than the control [(1.20 ± 0.34) mm] (P ＜ 0.05).However,no statistically significant differences in BIC and BA were found between membrane groups and control and among the membranes treated groups.Conclusions The results of this study demonstrated that the developed CCM can enhance bone regeneration and obtaine similar amounts of newly formed bone compared with defects regenerated with a standard collagen membrane.