Anton Dr. Friedmann^1,*; Stefan Dr. Fickl²; Kai Dr. Fischer³; Werner Dr. Götz⁴; Frederic Dr. Kauffmann³

¹Periodontology, Witten/Herdecke University, Witten; ²Periodontology, Würzburg University, Würzburg; ³Periodontology, University Witten/Herdecke, Witten; ⁴Department of Orthodontics, Oral Biology Laboratory, University of Bonn, Bonn, Germany

Background: Various biomaterial combinations for augmentation of deficient alveolar ridge were extensively studied focusing on the ability to stabilize blood clot and maintain space under soft tissue to support the new bone formation. Bovine Bone Mineral (BBM) placed with a native collagen membrane (NCM), fixed by pins, is considered the golden standard. Cross-linked collagen membranes showed superior ossifying potential if applied for closure of defects augmented with various kinds of bone substitutes.

Aim/Hypothesis: The amount of newly formed mineralized tissue vs. total occupied area (ROI) vs. residual bone graft non-bone was assessed allocating 3 test groups consisting of 2 different bone substitutes applied with 2 cross-linked collagen membranes and compared to a control group treated by “golden standard”.

Material and Methods: After extraction of 4 mandibular premolars in 5 adult male beagle dogs L-shaped alveolar defects were surgically created. A total of 20 defects was allowed to heal for 6 weeks resulting in chronic type bone defects. At re-entry 4 treatment options were randomly allocated to an equal number of defects: a. BBM+NCC with a 4-pin fixation across the ridge; b. BBM+RCLC (sugar cross-linked collagen membrane); c. BBM+NCLC (native cross linked collagen membrane); d. Ca-sulfate (CS)+RCLC membrane. Membranes in b/c/d were not fixed; complete tensionless wound closure was achieved by CAF. At termination 3 months later samples were fixed with formalin, processed non-decalcified and grinded sections were stained with toluidine blue and paragon. Before sectioning blocks were mounted perpendicular to a holder for correct bucco-lingual orientation. Microscopic images obtained at standardized magnification were histomorphometrically assessed by ImageJ software (NIH); ANOVA+Post-Hoc test was applied.

Results: All sites healed uneventfully; all samples were retrieved; block separation followed at the lab before starting Technovit embedding. Two central sections per block each group were included. Two out of 5 specimen were lost due to processing error and had to be excluded from group b; Table 1 displays the histomorphometric medians and confidence intervals (CI).

New bone area was significantly greater for option b. with RCLC/BBM compared to a. with NCM/BBM, c. with NCLC/BBM, or d. with a resorbable CS/RCLC; the residual non-bone graft area was significantly less for option d. vs. a. or c.

Conclusion and Clinical implications: Histomorphometric results favor option b. as most efficient in supporting new bone formation and integrating bone substitute into newly formed bone. Option c. ranges second regarding these parameters followed by option d. that used RCLC resorbable CS. The pin fixation for option a. with the “golden standard” did not reveal additional benefit. The sugar cross-linked collagen membrane in combination with BBM provided superior outcome indicating the impact of membrane barrier on bone augmentation.

Disclosure of Interest: None Declared

Keywords: animal study, bone graft, bone regeneration

安东弗里德曼博士^1,* ; Stefan Fickl 博士² ; Kai Dr. Fischer ³ ; Werner Dr. Götz ⁴ ; 弗雷德里克考夫曼博士³

¹牙周病学，维滕/赫德克大学，维滕；²牙周病学，维尔茨堡大学，维尔茨堡；³牙周病学，威腾大学/赫德克大学，威腾；⁴德国波恩大学口腔生物学实验室正畸系

背景：广泛研究了用于增加缺陷牙槽嵴的各种生物材料组合，重点是稳定血凝块和保持软组织下空间以支持新骨形成的能力。牛骨矿物质 (BBM) 与天然胶原膜 (NCM) 一起放置，由针固定，被认为是黄金标准。如果用于修复因各种骨替代物增加的缺损，交联的胶原膜显示出优异的骨化潜力。

目的/假设：评估新形成的矿化组织的量与总占据面积 (ROI) 与残余骨移植物非骨的关系，分配 3 个测试组，这些测试组由应用了 2 个交联胶原膜的 2 种不同骨替代物组成，并与对照组采用“金标准”处理。

材料和方法：在 5 只成年雄性比格犬拔除 4 颗下颌前磨牙后，通过手术制造了 L 形牙槽缺损。总共 20 个缺损被允许愈合 6 周，导致慢性型骨缺损。在重新进入时，4 个处理选项被随机分配给相同数量的缺陷：a . BBM+NCC 用 4 针固定穿过脊；乙。BBM+RCLC（糖交联胶原膜）；丙。BBM+NCLC（天然交联胶原膜）；d. 硫酸钙 (CS) + RCLC 膜。b/c/d 中的膜没有固定；CAF 实现了完全无张力的伤口闭合。3 个月后终止时，样品用福尔马林固定，处理过的非脱钙和研磨切片用甲苯胺蓝和 Paragon 染色。在切片之前，将切片垂直安装在固定器上，以获得正确的颊舌向。在标准化放大倍数下获得的显微图像通过 ImageJ 软件 (NIH) 进行组织形态学评估；应用 ANOVA+Post-Hoc 检验。

结果：所有部位均顺利愈合；取回所有样品；在开始 Technovit 嵌入之前，在实验室进行了块分离。每组每块包括两个中心部分。5 个样本中有 2 个因处理错误而丢失，不得不从 b 组中排除；表 1 显示了组织形态测量中位数和置信区间 (CI)。

选项 b 的新骨面积明显更大。与 RCLC/BBM 相比 使用 NCM/BBM，c。与 NCLC/BBM，或 d。具有可吸收的 CS/RCLC；选项 d 的剩余非骨移植面积明显减少。与 A. 或 C.

结论和临床意义：组织形态测量结果支持选项 b。最有效地支持新骨形成和将骨替代物整合到新形成的骨中。选项 C. 范围第二个关于这些参数，然后是选项 d。使用 RCLC 可吸收 CS。选项 a 的销固定。与“黄金标准”并没有透露额外的好处。糖交联胶原膜与 BBM 结合提供了优异的结果，表明膜屏障对骨增强的影响。

利益披露：无申报

关键词: 动物研究, 骨移植, 骨再生