Collagen absorbable hemostat와 Porous resorbable calcium carbonate가 성견 치조골 결손부 치유에 미치는 영향에 대한 연구

Abstract

[한글]본 연구의 목적은 collagen absorbable hemostat와 porous resorbable calcium carbonate의 이식이 성견 치조골 결손부 치유에 미치는 영향을 알아보는데 있다. 6마리 성견의 소구치 및 대구치 부위에 치태 침착을 시키기위해 10주간 탄성사를 결찰하여 만성 치주염을 야기시킨 후에 치은 박리 소파술만 시행한 것을 대조군, 치은 박리 소파술시 collagen absorbable hemostat를 사용한 군을 실험 1군, 치은 박리 소파술시 collagen absorbable hemostat와 porous resorbable calcium carbonate를 함께 사용한 군을 실험 2군으로 나누고 1일, 1주, 3주, 6주, 12주, 26주 후에 실험동물들을 희생시켜 조직학적으로 비교, 관찰하여 다음과 같은 결과를 얻었다.

1. collagen absorbable hemostat는 1일부터 흡수되기 시작하여 1주에는 잔여물질이 보였고 3주에는 관찰되지 않았다.

2. 상피층 하부 결합조직내 염증 세포 침윤상태는 대조군과 실험 1, 2군에서 뚜렷한 차이없이 3주부터 감소되어 26주까지 감소되는 양상을 보였다.

3. 접합상피의 치근단 이동은 대조군에서는 1주부터 시작되어 6주에 notch의 치근단 부위까지 관찰되었으며 26주에도 유사한 양상을 보였다. 실험 1군에서는 1주부터 시작되어 12주와 26주에 notch의 치관부까지 관찰되었고, 실험 2군에서는 전 실험기간 동안 미약하였다.

4. 신생 백악질의 형성은 대조군에서는 전 실험 기간동안 관찰되지 않았고 실험 1군에서는 6주부터 부분적으로 notch 치근단 부위에 관찰되었으며 실험 2군에서는 3주에 notch 부위에 시작되어 26주에는notch 치관부 부위까지 형성되는 소견을 보였다.

5. 신생골의 형성은 대조군과 실험 1군에서는 미약하였고 실험 2군에서는 3주에 이식재 주위로 치조골과 접한 부위에 국한되어 관찰되었으며 26주까지 부분적으로 증가되는 양상을 보였다.

[영문]This study was conducted to evaluate the healing potential of collagen absorbable hemostat and porous resorbable calcium carbonate in 6 dogs. Chronic periodontitis was induced by ligating elastic threads around premolars and molars for 10 weeks. Three different groups were randomly assigned as fellows. The group in which only flap operation was performed was used as control. The group in which flap operation using collagen absorbable hemostat was performed was used as experimental 1. The

group in which flap operation using both collagen absorbable hemostat and porous resorbable calcium carbonate was performed was used as experimental 2. At the time of surgery a reference notch was made at the level of remaining alveolar bone crest. Plaque control with 0.12% chlorhexidine digluconate was carried out 3 times a week during the healing period. Animals were sacrificed at 1 day, 1, 3, 6, 12, 26 weeks after flap operation. Routine histological preparations were made and the following results were obtained.

1. Collagen absorbable hemostat was found to have atarted to be absorbed at 1 day. It remained as small remnant at 1 week. It was hardly observed at 3 weeks.

2. There was no significant difference in inflammatory cell infiltration underneath epithelium among 3 groups. Inflammatory cell infiltration reduced with the lapse of time after 3 weeks to 26 weeks.

3. Apical migration of junctional epithelium was observed at 1 week and progressed dowm to the apical portion of the notch at 6 weeks in contro group. It was shown at the coronal portion of the notch at 12 weeks in experimental 1 group. In contrast, it was negligible in experimental 2 group.

4. New cementum formation was not observed in the control group through the whole period of this studs. It was locally found at the apical portion of the notch in experimental 1 group at 6 weeks and thereafter.

It was observed at the notch at 3 weeks and up to the coronal portion of the notch at 26 weeks in experimental 2 group.

5. At 3 weeks new bone was obsevred in the area where porous resorbable calcium carbonate had been placed adjacent to the remaining alveolar bone and its formation seemed to increase locally up to 26 weeks.

There was no conclusive evidence to show active resorbable of porous resorbable calcium carbonate particles through the whole period of this study.