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Polyglactin 910 mesh를 replamineform hydroxyapatite 및 calcium carbonate와 함께 사용시 성견치주조직의 치유에 미치는 영향

Issue Date
1992
Description
치의학과/박사
Abstract
[한글] 치주질환에 의해 파괴된 치주조직의 재생을 위해 조직유도재생술이 사용되고 있다. 이러한 치료들은 실제로 많은 양의 신부착을 형성하였으나 상실된 치조골의 재생에는 효과적이지 못하였으므로 조직유도재생술에 치조골 재생을 위한 부가적 술식이 필요하게 되었 다. 따라서 본 연구는 흡수성막인 polyglactin 910 mesh만 사용하는 경우와 polyglactin 910 mesh와 골대체 물질인 porous replamineform hydroxyapatite 및 porous resorbable calcium carbonate를 함께 사용한 경우 치주조직의 재생과 치유에 미치는 영향을 비교하여 보고자 하였다. 이를 위해 성견 하악소구치에 교정용 탄성사를 결찰하여 만성치주염을 유발시킨 후 치은박리소파술을 시행하고 polyglactin 910 mesh만 덮은 경우를 대조군으로, 수술 후 polyglactin 910 mesh와 porous replamineform hydroxyapatite를 이식한 경우를 실험 Ⅰ군으 로, 수술 후 polyglactin 910 mesh와 porous resorbable calcium carbonate를 이식한 경우를 실험 Ⅱ군으로 나누어 각각 1, 3, 6, 12, 26, 32, 56주후에 치결과를 조직학적으로 비교 관찰하여 다음과 같은 결론를 얻었다. 1. 접합상피의 근단이동은 대조군과 실험 Ⅰ, Ⅱ군에서 실험 전 기간동안 억제되었다. 2. 결합조직내의 염증세포 침윤은 대조군과 실험 Ⅰ, Ⅱ군에서 1주에 가장 심하게 나타났으며 3주부터 감소하기 시작하여 6주 이후에는 급격히 감소하였다. 3. Polyglactin 910 mesh는 3주부터 흡수되기 시작하여 12주 이후에는 완전히 흡수되어 관찰되지 않았다. 4. 신생백악질 형성은 대조군과 실험 Ⅰ, Ⅱ군에서 6주부터 관찰되기 시작하였다. 5. 치근면에 대한 결합조직섬유의 배열은 대조군과 실험 Ⅰ, Ⅱ군에서 6주까지 불규칙한 양상을 보이나 12주부터 기능적 배열을 하였다. 6. 신생골 형성은 대조군과 실험 Ⅰ, Ⅱ군에서 3주에 notch기저부에서 시작되었으나, notch상방으로의 성장은 대조군의 경우 32주부터, 실험 Ⅰ군의 경우 12주부터, 실험 Ⅱ군의 경우 6주부터 시작되었다. 7. 이식재와 신생골의 유착은 실험 Ⅰ군의 경우 56주에 실험 Ⅱ군의 경우 26주부터 대부분 이루어졌다. 8. 이식재와 신생골과의 접합부위는 시간이 경과함에 따라 실험 Ⅰ군은 변화가 없었으나 실험 Ⅱ군은 불규칙하게 흡수되는 양상을 보였다.
[영문] The guided tissue regeneration is being used for regeneration of periodontal tissue destructed by periodontal disease. This treatment has resulted in the formation of substantial amounts of new attachment, but they do not encourage regeneration of lost alveolar bone. Therefore, an additional approach to guided tissue regeneration should be aimed at encouraging new bone regeneration. The purpose of this study was to evaluate the effect of resorbable polyglaction 910 mesh combined with porous replamineform hydroxyapatite and porous resorbable calcium carbonate on the regeneration and healing of periodontal tissue as compared to barrier technique alone. For this study, after inducing chronic periodontal inflammation by ligation orthodontic elastic threads around mandibular premolars in adult dogs, the flap operation was performed. And then, three groups were divided as follows. 1. In case only polyglactin 910 mesh was covered after flap operation(control group). 2. In case polyglactin 910 mesh and porous replamineform hydroxyapatite were used after flap operation(experimental group Ⅰ). 3. In case polyglactin 910 mesh and porous resorbable calcium carbonate were used after flap operation(experimental group Ⅱ). After 1, 3, 6, 12, 26, 32 and 56 week, the healing effect for each case were observed and compared histologically and the following results were obtained 1. The apical migration of the junctional epithelium was minimal in the control group and experimental group Ⅰ, Ⅱ during the whole period of experiment. 2. The inflammatory cell infiltration in the connective tissue was heady at the 1st week in the control group and experimental group Ⅰ and Ⅱ, began decreased from the 3rd week and decreased rapidly from the 6th week. 3. Polyglactin 910 mesh began to be absorbed from the 3rd week, completely absorbed at the 12th week and was not observed thereafter. 4. The new cementum formation began to be observed from the 6th week in the control group and experimental group Ⅰ, Ⅱ. 5. The arrangement of connective tissue fibers to the root surface was irregular until the 6th week but was functional the after 12th week in the control group and experimental group Ⅰ, Ⅱ. 6. The new bone formation began form the 3rd week at the notch base in the control group and experimental group Ⅰ, Ⅱ. But the bone growth above the notch began from the 32nd week in the control group, from the 12th week in the experimental group Ⅰ and from the 6th week in the experimental group Ⅱ. 7. The ankylosis of the implanted material and new bone was mostly formed at the 56th week in the experimental group Ⅰ, and observed from the 26th week in the experimental group Ⅱ. 8. The surface of implanted material was even in the experimental group Ⅰ, but was resorbed irregularly in the experimental group Ⅱ with the lapse of time.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/115759
Appears in Collections:
2. 학위논문 > 2. College of Dentistry (치과대학) > 박사
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