The influence of root surface distance to alveolar bone and periodontal ligament on periodontal wound healing
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure. Methods: Three adult Sus scrofa domesticus specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis. Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth. Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.
Abstract
Purpose: The purpose of this animal study was to perform a 3-dimensional micro-computed tomography (micro-CT) analysis in order to investigate the influence of root surface distance to the alveolar bone and the periodontal ligament on periodontal wound healing after a guided tissue regeneration (GTR) procedure. Methods: Three adult Sus scrofa domesticus specimens were used. The study sample included 6 teeth, corresponding to 2 third mandibular incisors from each animal. After coronectomy, a circumferential bone defect was created in each tooth by means of calibrated piezoelectric inserts. The experimental defects had depths of 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm, with a constant width of 2 mm. One tooth with no defect was used as a control. The defects were covered with a bioresorbable membrane and protected with a flap. After 6 months, the animals were euthanised and tissue blocks were harvested and preserved for micro-CT analysis. Results: New alveolar bone was consistently present in all experimental defects. Signs of root resorption were observed in all samples, with the extent of resorption directly correlated to the vertical extent of the defect; the medial third of the root was the most commonly affected area. Signs of ankylosis were recorded in the defects that were 3 mm and 7 mm in depth. Density and other indicators of bone quality decreased with increasing defect depth. Conclusions: After a GTR procedure, the periodontal ligament and the alveolar bone appeared to compete in periodontal wound healing. Moreover, the observed decrease in bone quality indicators suggests that intrabony defects beyond a critical size cannot be regenerated. This finding may be relevant for the clinical application of periodontal regeneration, since it implies that GTR has a dimensional limit.
참고문헌 (40)
- Cortellini P, "Periodontal regeneration of intrabony defects: an evidence-based treatment approach", Int J Periodontics Restorative Dent, 15, pp.128~145 (1995)
- American Academy of Periodontology, "Glossary of periodontal terms" (2001), American Academy of Periodontology
- Wikesjö UM, "Periodontal wound healing and regeneration", Periodontol 2000, 19, pp.21~39 (1999)
- Sculean A, "Regeneration of periodontal tissues: combinations of barrier membranes and grafting materials-biological foundation and preclinical evidence: a systematic review", J Clin Periodontol, 35, pp.106~116 (2008)
- Trombelli L, "Which reconstructive procedures are effective for treating the periodontal intraosseous defect?", Periodontol 2000, 37, pp.88~105 (2005)
- Karring T, "Potentials for root resorption during periodontal wound healing", J Clin Periodontol, 11, pp.41~52 (1984)
- Melcher AH, "On the repair potential of periodontal tissues", J Periodontol, 47, pp.256~260 (1976)
- Magnusson I, "Root resorption following periodontal flap procedures in monkeys", J Periodontal Res, 20, pp.79~85 (1985)
- Klinge B, "Bone regeneration pattern and ankylosis in experimental furcation defects in dogs", J Clin Periodontol, 12, pp.456~464 (1985)
- Seo BM, "Investigation of multipotent postnatal stem cells from human periodontal ligament", Lancet, 364, pp.149~155 (2004)
- Nagatomo K, "Stem cell properties of human periodontal ligament cells", J Periodontal Res, 41, pp.303~310 (2006)
- Listgarten MA, "Histological study of repair following new attachment procedures in human periodontal lesions", J Periodontol, 50, pp.333~344 (1979)
- Linghorne WJ, "Studies in the regeneration and reattachment of supporting structures of the teeth; soft tissue reattachment", J Dent Res, 29, pp.419~428 (1950)
- Karring T, "Development of the biological concept of guided tissue regeneration-animal and human studies", Periodontol 2000, 1, pp.26~35 (1993)
- Karring T, "Regenerative therapy: furcation defects", Periodontol 2000, 19, pp.115~137 (1999)
- Polimeni G, "Regenerative potential and healing dynamics of the periodontium: a critical-size supra-alveolar periodontal defect study", J Clin Periodontol, 36, pp.258~264 (2009)
- Graziani F, "Periodontal wound healing following GTR therapy of dehiscence-type defects in the monkey: short-, medium- and long-term healing", J Clin Periodontol, 32, pp.905~914 (2005)
- Laurell L, "The structure of periodontal tissues formed following guided tissue regeneration therapy of intra-bony defects in the monkey", J Clin Periodontol, 33, pp.596~603 (2006)
- Samuel JL, "Periodontal disease in feral pigs (Sus scrofa) from Queensland, Australia", J Wildl Dis, 24, pp.201~206 (1988)
- Štembírek J, "The pig as an experimental model for clinical craniofacial research", Lab Anim, 46, pp.269~279 (2012)
- Hildebrand T, "Quantification of bone microarchitecture with the structure model index", Comput Methods Biomech Biomed Engin, 1, pp.15~23 (1997)
- "The principles of humane experimental technique" (2015)[URL]
- Pandis N, "Sample calculation for split-mouth designs", Am J Orthod Dentofacial Orthop, 141, pp.818~819 (2012)
- Becker W, "Periodontal regeneration: a contemporary re-evaluation", Periodontol 2000, 19, pp.104~114 (1999)
- Karring T, "Healing following implantation of periodontitis affected roots into bone tissue", J Clin Periodontol, 7, pp.96~105 (1980)
- Nyman S, "Healing following implantation of periodontitis-affected roots into gingival connective tissue", J Clin Periodontol, 7, pp.394~401 (1980)
- Gottlow J, "Healing following citric acid conditioning of roots implanted into bone and gingival connective tissue", J Periodontal Res, 19, pp.214~220 (1984)
- Crigger M, "Repair following treatment of circumferential periodontal defects in dogs with collagen and expanded polytetrafluoroethylene barrier membranes", J Periodontol, 67, pp.403~413 (1996)
- Klinge B, "Effect of flap placement and defect size on healing of experimental furcation defects", J Periodontal Res, 16, pp.236~248 (1981)
- Karring T, "New attachment formation on teeth with a reduced but healthy periodontal ligament", J Clin Periodontol, 12, pp.51~60 (1985)
- Andreasen JO, "The effect of splinting upon periodontal healing after replantation of permanent incisors in monkeys", Acta Odontol Scand, 33, pp.313~323 (1975)
- Nasjleti CE, "The effects of different splinting times on replantation of teeth in monkeys", Oral Surg Oral Med Oral Pathol, 53, pp.557~566 (1982)
- Kristerson L, "The effect of splinting upon periodontal and pulpal healing after autotransplantation of mature and immature permanent incisors in monkeys", Int J Oral Surg, 12, pp.239~249 (1983)
- Bauss O, "Autotransplantation of immature third molars: influence of different splinting methods and fixation periods", Dent Traumatol, 18, pp.322~328 (2002)
- Gandolfi MG, "3D micro-CT analysis of the interface voids associated with Thermafil root fillings used with AH Plus or a flowable MTA sealer", Int Endod J, 46, pp.253~263 (2013)
- Park CH, "Three-dimensional micro-computed tomographic imaging of alveolar bone in experimental bone loss or repair", J Periodontol, 78, pp.273~281 (2007)
- de Paula Reis MV, "Histologic and micro-computed tomographic analyses of replanted teeth stored in different kind of media", J Endod, 40, pp.665~669 (2014)
- Martini L, "Long-term results following cranial hydroxyapatite prosthesis implantation in a large skull defect model", Plast Reconstr Surg, 129, pp.625e~635e (2012)
- Vercellotti T, "Osseous response following resective therapy with piezosurgery", Int J Periodontics Restorative Dent, 25, pp.543~549 (2005)
- 도민재, "Development of animal experimental periodontitis models", Journal of Periodontal & Implant Science, 43(4), pp.147~152 (2013), 대한치주과학회