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Abstracts


本研究之目的在評估三種牙周再生膜片材料之臨床使用特性,應用在體外培養的human gingival fibroblast細胞與gingival epithelial cells以電子顯微鏡觀察其結構變化與通透性並藉此探討其組織再生模式及評估各種膜片在臨床應用之適用性。另外並應用12隻年齡爲12個月的雄性小獵犬,分爲4組(分別於7天、14天、28天、3個月犧牲)作爲動物活體評估模式,在實驗犬之左、右下顎第一、二小白齒及大白齒的頰側區製造骨缺損後,分別植入組織導引再生膜片,取下缺損區骨頭,以光學顯微鏡觀察量利其牙堊質再生高度與齒槽骨再生高度之變化,結果顯示,雖然可吸收式膜片(膠原蛋白膜片、PLA-PGA膜片)有早期裂解吸收的現象,但是經由實驗的觀察證明其吸收速度相當緩慢,其效果依然存在與組織保持良好的位置,術後第3個月時,牙堊質再生高度分別可達2.6mm以及2.47mm,優於e-PTFE膜片(2.31mm);在新生骨之生成方面,膜片植入後三個月後,可發現齒槽骨再生高度平均分別可達1.01mm, 1.05mm,也優於e-PTFE膜片(0.74mm)。綜合以上觀察,可吸收式膜片(膠原蛋白膜片、PLA-PGA膜片)在防止上皮細胞向牙根尖部生長,及促使牙周結締組織生長於牙根表面上,比不可吸收式膜片不僅有更佳之功能還有避免二次手術的便利性,但其仍需進一步的人體臨床實驗已確認其療效。

Parallel abstracts


This study was to examine the historical changes of implanted three commercial GTR (Guided Tissue Regeneration) membranes for confirming the clinical feasibility in vitro and vivo. Among the resorbable GTR membranes, the collagen membrane is collagen base, and the PLA-PGA membrane is synthesized membrane, while the e-PTFE (Expanded polytetrafluoroethylene) is synthesized but nonresorbable. The membrane material was placed on the bottom of the hole of prepared culture well, then 2 culture wells were assembled to a study device by silicone sealing. And all of devices were placed in 24 wells culture plate. After 24 hours incubation, flowcytometric analysis was performed to measure the numbers of cells in the collection. Membranes were observed at SEM on both up-side and downside. Then Beagle dogs were used as animal model. Buccal mucoperiosteal flaps were reflected in the bilateral mandibular premolar and molar areas. Buccal alveolar bone was reduced on 1st and 2nd premolar and molar to a level 5 mm apical to the cemento-enemel junction (CEJ). Root surface was denuded of periodontal ligament and cementum, and notches were placed at the bone level of each root. The tested GTR barriers were implanted in critical bone defect areas. Flaps were coronally positioned and sutured. Two beagle dogs were sacrificed each time as the designed time period after surgery. Histological and histometirc evaluation at 7 days, 14 days, 28 days, 3 months were performed postoperatively to determine the healing response of each treatment modality. Both the cementum height and bone height were measured as the index of tissue occlusion effect. Like all resorbable GTR membrane, the collagen membrane and the PLA-PGA membrane were observed membrane resorption and cells infiltration in the fibril network after 24 hours incubation. But the collagen membrane and the PLA-PGA membrane enhanced the cementum regeneration of 2.6mm and 2.47mm averagely after 3months implantation. On the contrast, cementum height of 2.31 mm was observed in e-PTFE group. The collagen membrane and the PLA-PGA membrane seemed to be efficient in treatment of Guided Tissue Regeneration.

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