A Histo-Pathological Study of Effect on Periodontal Regeneration with Bioabsorbable Membrane on The Grade II Furcation Defects in Beagle Dogs

성견 치근이개부 병소에서 흡수성 차폐막의 치주조직재생에 미치는 영향에 대한 조직병리학적 연구

  • Kim, Jae-Kwang (Department of Periodontology, College of Dentistry, Dan-kook University) ;
  • Lim, Sung-Bin (Department of Periodontology, College of Dentistry, Dan-kook University) ;
  • Chung, Chin-Hyung (Department of Periodontology, College of Dentistry, Dan-kook University) ;
  • Lee, Chong-Heon (Department of Oral Pathology, College of Dentistry, Dan-kook University)
  • 김재광 (단국대학교 치과대학 치주과학교실) ;
  • 임성빈 (단국대학교 치과대학 치주과학교실) ;
  • 정진형 (단국대학교 치과대학 치주과학교실) ;
  • 이종헌 (단국대학교 치과대학 구강병리학교실)
  • Published : 2002.03.30

Abstract

The present study evaluated the effects of guided tissue regeneration using xenograft material(deproteinated bovine bone powder), with and without biodegradable membrane in beagle dogs. Contralateral fenestration defects (6 ${\times}$ 4mm) were created 4 mm apical to the buccal alveolar crest of maxillary premolar teeth in 5 beagle dogs. Deproteinated bovine bone powders were implanted into fenestration defect and one randomly covered biodegradable membrane (experimental group). Biodegradable membrane was used to provide GTR. Tissue blocks including defects with soft tissues which were harvested following four & eight weeks healing interval, prepared for histo-phathologic analysis. The results of this study were as follows. 1. In control group, at 4 weeks after surgery, new bony trabecular contacted with interstitial tissue and osteocytes like cell were arranged in new bony trabecule. Bony lamellation was not observed. 2. In control gruop, at 8 weeks after surgery, scar-like interstitial tissue was filled defect and bony trabecule form lamellation. New bony trabecular was contacted with interstitial tissue but defect was not filled yet. 3. In experimental group, at 4 weeks after surgery, new bony trabecular partially recovered around damaged bone. But new bony trabecular was observed as irregularity and lower density. 4. In experimental group, at 8 weeks after surgery, lamella bone trabecular developed around bone cavity and damaged tissue was replaced with dense interstitial tissue. In conclusion, new bone formation regenerated more in experimental than control groups and there was seen observe more regular bony trabecular in experimental than control groups at 4 weeks after surgery. In control group, at 8 weeks after surgery, the defects was filled with scar-like interstitial tissue but, in experimental group, the defects was connected with new bone. Therefore xenograft material had osteoconduction but could not fill the defects. We thought that the effective regeneration of periodontal tissue, could be achieved using GTR with biodegradable membrane.

Keywords

References

  1. Samuel EL: Methods for Evaluation of Regenerative Procedures. J Periodontol 1992; 63: 1085-1092 https://doi.org/10.1902/jop.1992.63.12s.1085
  2. Wikesjo UME, Nilveus RE, Selvig KA: Significance of Early Healing Events on Periodontal Repair: A Review. J Periodontol 1992; 63: 158-165 https://doi.org/10.1902/jop.1992.63.3.158
  3. Caton J, Nyman S, Zander H: Histometric evaluation of periodontal surgery. II. Connective tissue attachment levels after four regenerative procedures. J Clin Periodontol 1980: 7:224-231 https://doi.org/10.1111/j.1600-051X.1980.tb01965.x
  4. Melcher AH: On the Repair Potential of Periodontal Tissues. J Periodontol 1976; 47: 256-260 https://doi.org/10.1902/jop.1976.47.5.256
  5. Nyman S, Lindhe J, Karring T, and Rylander M : New attachment following surgical treatement of human periodontal disease. J. Clin. Periodontol. 9:290, 1982 https://doi.org/10.1111/j.1600-051X.1982.tb02095.x
  6. Nyman S, Karring L, Lindhe J, and Planten S : Healing following implantation of periodontitis afected roots in to gingival connective tissue. J. Clin. Periodontol. 7:394, 1980 https://doi.org/10.1111/j.1600-051X.1980.tb02012.x
  7. Nyman S, Gottlow J, Karring L, and Lindhe J : The regenerative potential of the periodontal ligament. J. Clin. Periodontol. 9:257, 1982 https://doi.org/10.1111/j.1600-051X.1982.tb02065.x
  8. Ellegaard B, Karring T, Loe H: New Periodontal Attachment Procedure Based on Retardation of Epithelial Migration. J Clin Periodontol 1974; 1: 75-88 https://doi.org/10.1111/j.1600-051X.1974.tb01242.x
  9. Bussehop J, De boever J: Clinical and Histological Characteristics of Lyophilized Allogenic Dura Mater in Periodontal Bony Defects in Humans. J Clin Periodontol 1983; 10: 399-407 https://doi.org/10.1111/j.1600-051X.1983.tb01289.x
  10. Tal H, Stahl SS: Elimination of Epithelium from Healing Postsurgical Periodontal Wounds by Ultralow Temperature: Initial Observations. J Periodontol 1985; 56: 488-491 https://doi.org/10.1902/jop.1985.56.8.488
  11. Gottlow J, Nyman S, Lindhe J, Karring T: New Attachment Formation in the Human Periodontium by Guided Tissue Regeneration. J Clin Periodontol 1986; 13: 604-616 https://doi.org/10.1111/j.1600-051X.1986.tb00854.x
  12. Wikesjo UME, Sigurdsson TJ: Guided Bone Regeneration: Is it a reproducible technique? J Parodontol Implantol Orale 1994; 13: 243-257
  13. Mariano Sanz, Ion Zabalegui, Alfonso Vila, Alberto Sicilia: Guided tissue regeneration in human class II furcations and interproximal infrabony defects after using a bioabsorbable membrane barrier. The International Jonual of Periodontics & Restorative Dentistry
  14. Nyman S, Gottlow J, Lindhe J, Karring T, Wennstrom J: New Attachment Following Guided Tissue Regeneration. J Periodont Res 1987; 22: 252-254 https://doi.org/10.1111/j.1600-0765.1987.tb01581.x
  15. Becker W, Becker BE, Prichard J, Caffesse RG, Rosenberg E, GianGrasso J: Root Isolation for New Attachment Procedures: A Surgical and Suturing Method. Three Case Reports. J Periodontol 1987; 58: 819-823 https://doi.org/10.1902/jop.1987.58.12.819
  16. Becker W, Becker BE, Berg L, Prichard J, Caffesse RG, Rosenberg E: New Attachment after Treatment with Root Isolation Procedures: Report of Treated Class III and Class II Furcations and Vertical Osseous Defects. Int J Periodont Rest Dent 1988; 8: 9-23
  17. Pontoriero R, Lindhe J, Nyman S, Karring T, Rosenberg E, Sanavi F: Guided Tissue Regeneration in Degree II Furcation involved Mandibular Molars. A clinical Study. J Clin Periodontol 1998; 15: 247-254 https://doi.org/10.1111/j.1600-051X.1988.tb01578.x
  18. Caffesse RG, Smith BA, Duff B, Morrison EC, Merrill D, Becker W: Class II Furcations Treated by Guided Tissue Regeneration in Humans: Case Reports. J Periodontol 1990; 60: 510-514
  19. Peter Eickolz and Ernest Hausmann: Evidence for healing of class II and III furcations after GTR therapy: Digital subtraction and clinical measurements. J. Periodontol 1997; 68:636-644 https://doi.org/10.1902/jop.1997.68.7.636
  20. Selvig K, Kersten B, Chamberlain A: A Regenerative surgery of infrabony periodontal defects using e-PTEF barrier membranes. Scanning electron microscopic evaluation of retrieved membranes vs clinical healing. J Periodontol 1996: 63:974-978 https://doi.org/10.1902/jop.1992.63.12.974
  21. Mombelli A, Lang N, Nyman S. Isolation of periodontal species after guided tissue regeneration. J Periodontol 1993; 64(suppl):1171-1175 https://doi.org/10.1902/jop.1993.64.11s.1171
  22. Tonetti M, Pini-Prato G, Cortellini P: Periodontal regeneration of human infrabony defects. IV. Determinants of the healing response. j Periodontol 1993; 64: 1171-1175 https://doi.org/10.1902/jop.1993.64.11s.1171
  23. Cortellini P, Pini Prato G, Tonetti MS: Interproximal Free Gingival Grafts After Membrane Removal in Guided Tissue Regeneration Treatment of Infrabony Defects. A Randomized Controlled Clinical Trial. J Periodontol 1995; 66: 488-493 https://doi.org/10.1902/jop.1995.66.6.488
  24. Cortellini P, Pini Prato G, Tonetti MS: Periodontal Regeneration of Human Intrabony Defects with Bioresorbable Membranes. A Controlled Clinical Trial. J Periodontol 1996; 67: 217-223 https://doi.org/10.1902/jop.1996.67.3.217
  25. R Weltman, PM Terjo, E Morrison and R Caffesse: Assement of guide tissue regeneration procedure in infrabony defects with bioabsorbable and non-resorbable barriers. J Periodontol June 1997; 68: 582-591 https://doi.org/10.1902/jop.1997.68.6.582
  26. Haney JM, Nilveus RE, McMillan PJ, Wikesjo UME: Periodontal Repair in Dogs: e-PTFE Barrier Membranes Support Wound Stabilization and Enhance Bone Regeneration. J Periodontol 1993; 64: 883-890 https://doi.org/10.1902/jop.1993.64.9.883
  27. Dahlin C, Lindhe A, Gottlow J, Nyman S: Healing of Bone Defects by Guided Tissue Regeneration. Plast Reconstr Surg 1989; 81: 672-676
  28. Dahlin C, Sennerby L, Lekholm U, Lindhe A, Nyman S: Generation of New Bone around Titanium implants using a Membrane Technique: An Experimental Study in Rabbits. Int J Oral Maxillofac Implants 1989; 4: 19-25
  29. Melcher AH, Dreyer CJ: Protection of the Blood Clot in Healing Circumscribed Bone Defects. J Bone Joint Surg 1962; 44B: 424-430
  30. Murray G, Holden R, Roachlau W: Experimental and Clinical Study of New Growth of Bone in a Cavity. Am J Surg 1957; 93: 385-387 https://doi.org/10.1016/0002-9610(57)90827-9
  31. Seibert J, Nyman S: Localized ridge augmentation in dogs: A Pilot Study Using Membranes and Hydroxyapatite. J Periodontol 1990; 61: 157-165 https://doi.org/10.1902/jop.1990.61.3.157
  32. Scoop, I.W, Kassouny, D.Y. and Morgan, F.H. : Bovine bone (Boplant) J. Periodontol.1966 37(5):400-7 https://doi.org/10.1902/jop.1966.37.5.400
  33. Scoop, I.W, Morgan, F.H, Dooner, J.J.,Fredrics, H.J. and Heyman, R.A.: Bovine bone(Boplant) implants for infrabony lesion(Clinicaltrials in humans) periodontics,1966 4:169
  34. Stephen T. Sonis, Ray C. Williams, Marjorie K. Jeffcoat : Healing of spontareous periodontal defects in dogs treated with xenogenic demineralized bone, J. periodontol 1985 8:470-479
  35. Anderegg CR, Marin SJ, Gray JL, Mellonig JT, Gher ME: Clinical Evaluation of the Use of Decalcified Freeze-Dried Bone Allograft With Guided Tissue Regeneration in the Treatment of Molar Furcation Invasions. J Periodontol 1991; 62: 264-268 https://doi.org/10.1902/jop.1991.62.4.264
  36. Arrocha. R.,Wittwer, J. and Gargiulo, A. : Tissue response to heterogeneous bone inplantation in dog J. Periodontol 1968.39(3):162-6 https://doi.org/10.1902/jop.1968.39.3.162
  37. Melcher, A.H. : The use of heterogeneous anorganic bone in periodontal bone grafting : A preliminary report.I. Dent Assoc. South Afr, 1958 13:80
  38. Melcher, A.H. : The use of heterogeneous anorganic bone as an implant material in or procedure oral surg.,1962 15:996
  39. Scoop, I.W, Kassouny, D.Y. and Morgan, F.H. : Bovine bone (Boplant) J. Periodontol.1966 37(5):400-7 https://doi.org/10.1902/jop.1966.37.5.400
  40. Scoop, I.W, Morgan, F.H, Dooner, J.J.,Fredrics, H.J. and Heyman, R.A.: Bovine bone(Boplant) implants for infrabony lesion(Clinicaltrials in humans) periodontics,1966 4:169
  41. Stephen T. Sonis, Ray C. Williams, Marjorie K. Jeffcoat : Healing of spontareous periodontal defects in dogs treated with xenogenic demineralized bone, J. periodontol 1985 8:470-479
  42. Anderegg CR, Marin SJ, Gray JL, Mellonig JT, Gher ME: Clinical Evaluation of the Use of Decalcified Freeze-Dried Bone Allograft With Guided Tissue Regeneration in the Treatment of Molar Furcation Invasions. J Periodontol 1991; 62: 264-268 https://doi.org/10.1902/jop.1991.62.4.264
  43. Caffesse RG, Dominguez LE, Nasjleti CE, Castelli WA, Morrison EC, Smith BA: Furcation Defects in Dogs Treated by Guided Tissue Regeneration. J Periodontol 1990; 61: 45-50 https://doi.org/10.1902/jop.1990.61.1.45
  44. Mellado JR, Salkin LM, Freedman AL, Stein MD: A Comparative Study of e-PTFE Periodontal Membranes With and Without Decalcified Freeze-Dried Bone Allografts for the Regeneration of Interproximal Intraosseous Defects. J Periodontol 1995; 66: 751-755 https://doi.org/10.1902/jop.1995.66.9.751
  45. Pitaru S, Tal H, Soldinger M, Azar-Avidan O, Noff M: Collagen Membrane Prevent the Apical Migration of Epithelium During Periodontal Wound Healing. J Periodont Res 1987; 22: 331-333 https://doi.org/10.1111/j.1600-0765.1987.tb01594.x
  46. Black BC, Gher ME, Sandifer JB, Fucini SE, Rechardson AC: Comparative Study of Collagen and e-PTFE Membranes in the Treatment of Human Class II Furcation Defects. J Periodontol 1994; 65: 598-604 https://doi.org/10.1902/jop.1994.65.6.598
  47. Magnusson I, Batich C, Collins BR: New Attachment Formation Following Controlled Tissue Regeneration Using Biodegradable Membranes. J Periodontol 1988; 59: 1-7 https://doi.org/10.1902/jop.1988.59.1.1
  48. Fleisher N, Waal HD, Bloom A: Regeneration of Lost Attachment Apparatus in the Dog Using Vicryl Absorbable Mesh(Polyglactic 910). Int J Periodont Rest Dent 1988; 8: 45-55.
  49. Laurell I, Falk H, Fornell J, Johard G, Gottlow J: Clinical Use of Bioresorbable Matrix Barrier in Guided Tissue Regeneration Therapy: Case Series. J Periodontol 1994; 65: 967-975 https://doi.org/10.1902/jop.1994.65.10.967
  50. Caton J, Greenstein G, Zappa U: Synthetic Bioabsorbable Barrier for Regeneration in Human Periodontal Defects. J Periodontol 1994; 65: 1037-1045 https://doi.org/10.1902/jop.1994.65.11.1037
  51. Caffesse RG, Nasjleti CE, Morrison EC, Sanchez R: Guided Tissue Regeneration: Comparison of Bioabsorbable and Nonbioabsorbable Membranes. Histologic and Histometric Study in Dogs. J Periodontol 1994; 65: 583-591 https://doi.org/10.1902/jop.1994.65.6.583
  52. 김태훈, 허원실, 이승희: 심한 정출과 치주-치근단 병소를 동반한 복합병소에서 국산 흡수성 골유도 재생 차폐막을 이용한 조직 유도 재생술의 응용. 대한치과의사협회지 1998; 36: 497-502
  53. Jan Gottlow, Lars Laurell, Dan Lundgren et al: Periodontal tissue response to a new bioresorbable guided tissue regeneration device : A longitudinal study in monkeys. Int J Periodont Rest Dent 1994; 14:437-449)
  54. Lundgren D, Slotte C: Reconstruction of Anatomically Complicated Periodontal Defects Using a Bioresorbable GTR Barrier Supported by Bone Mineral. A 6-Month Follow-Up Study of 6 Cases. J Clin Periodontol 1999; 26: 56-62 https://doi.org/10.1034/j.1600-051X.1999.260110.x
  55. Hurzeler MB, Kohal RJ, Naghshbandi J, Mota LF, Conradt J, Hutmacher D, Caffesse RG: Evaluation of a New Bioresorbable Barrier to Facilitate Guided Bone Regeneration Around Exposed Implant Threads. Int J Oral Maxillofac Surg 1998; 27: 315-320 https://doi.org/10.1016/S0901-5027(05)80623-X
  56. D. De Leonardis, A.K. Garg, V. Pedrazzoli, and G.E. Pecora: Clinical evaluation of the treatment of classⅡ furcation involvements with bioabsorbable barriers alone or associated with demineralized freeze-deried bone allograft. J Periodontol 1999; 70: 8-12 https://doi.org/10.1902/jop.1999.70.1.8
  57. Bowers GM, Chadorff B, Carnevale R, Mellonig JT, Corio R, Emerson J, Stevens J, Romberg E: Histologic Evaluation of New Attachment Apparatus Formation in Humans. Part I. J Periodontol 1989; 60: 664-674 https://doi.org/10.1902/jop.1989.60.12.664
  58. Bowers GM, Chadorff B, Carnevale R, Mellonig JT, Corio R, Emerson J, Stevens J, Romberg E: Histologic Evaluation of New Attachment Apparatus Formation in Humans. Part II. J Periodontol 1989; 60: 675-682 https://doi.org/10.1902/jop.1989.60.12.675
  59. Caffesse RG, Nasjleti CE, Plotzke AE, Anderson GB, Morrison EC: Guided Tissue Regeneration and Bone Grafts in the Treatment of Furcation Defects. J Periodontol 1993; 64: 1145-1153 https://doi.org/10.1902/jop.1993.64.11s.1145
  60. Wallace SC, Gellin RG, Miller MC, Mishkin DJ: Guided Tissue Regeneration With and Without Decalcified Freeze-Dried Bone in Mandibular Class II Furcation Invasions. J Periodontol 1994; 65: 244-254 https://doi.org/10.1902/jop.1994.65.3.244