A Proposal of Pseudo-periosteum Classification After GBR by Means of Titanium-Reinforced d-PTFE Membranes or Titanium Meshes Plus Cross-Linked Collagen Membranes
A Proposal of Pseudo-periosteum Classification After GBR by Means of Titanium-Reinforced d-PTFE Membranes or Titanium Meshes Plus Cross-Linked Collagen Membranes
复制标题
DOI：
10.11607/prd.3598
复制
发表时间：
2019-07-01
影响因子：
1.6
通讯作者：
Corinaldesi, Giuseppe
中科院分区：
文献类型：
--
作者：
Cucchi, Alessandro;Sartori, Maria;Corinaldesi, Giuseppe
使用不同的设备进行引导骨再生（GBR）后，可以在新形成的骨骼上方观察到一层称为假骨膜的结缔组织。本研究的目的是评估临床和组织学特征，并建议采用不可吸收膜或钛 (Ti) 网加可吸收膜进行 GBR 后结缔组织的分类。将 40 例下颌后牙部分缺牙患者随机分为两组：其中 20 例患者采用钛增强致密聚四氟乙烯 (d-PTFE) 膜（A 组）治疗，另 20 例患者采用钛网和交联胶原膜治疗（B 组）。 9个月后和重新开放手术期间，记录骨密度和假骨膜类型。假性骨膜分为1型（无组织或组织<1mm）； 2 型（1 至 2 毫米之间的常规组织）； 3 型（不规则组织或组织 > 2 毫米）。进行组织学分析以确定假骨膜的特征。在 40 名患者中，有 36 名患者（A 组 n = 19；B 组 n = 17）的 99 个种植体在 GBR 后根据研究方案进行了分析。 A 组的垂直骨增量为 4.2 +/- 1.0 mm，B 组的垂直骨增益为 4.1 +/- 1.0 mm。A 组的骨密度高于 B 组，且 1 型骨膜数量较多（两者 P = 0.01）。本研究的初步结果表明，d-PTFE 膜和 Ti-mesh 加胶原膜都是下颌骨增骨的两种有效选择。然而，不可吸收的膜可实现更高的骨密度和新形成的骨上方更薄的假骨膜层。
After guided bone regeneration (GBR) with different devices, a layer of connective tissue called pseudo-periosteum can be observed above the newly formed bone. The aim of this study is to evaluate the clinical and histologic features and to suggest a classification of this connective tissue after GBR with nonresorbable membranes or titanium (Ti)-mesh plus resorbable membranes. Forty patients with partial edentulism in the posterior mandible were randomized into two groups: 20 patients were treated by means of Ti-reinforced dense polytetrafluoroethylene (d-PTFE) membrane (group A), while the other 20 patients were treated with Ti-mesh and a cross-linked collagen membrane (group B). After 9 months and during re-opening surgery, bone density and pseudo-periosteum type were recorded. Pseudo-periosteum was classified into Type 1 (no tissue or tissue < 1 mm); Type 2 (regular tissue between 1 and 2 mm); and Type 3 (irregular tissue or tissue > 2 mm). Histologic analyses were performed to identify the features of pseudo-periosteum. Out of 40 patients, 36 (n = 19 in Group A; n = 17 in Group B) with 99 implants were analyzed after GBR and according to the study protocol. The vertical bone gain was 4.2 +/- 1.0 mm in Group A and 4.1 +/- 1.0 mm in Group B. Group A had a higher bone density and greater amounts of type 1 periosteum than Group B (P = .01 for both). The preliminary results of this study show that both d-PTFE membranes and Ti-mesh plus collagen membranes are two valid options for bone augmentation in the mandible. However, nonresorbable membranes achieve higher bone density and a thinner pseudo-periosteum layer above the newly formed bone.