Oxidized Cellulose Membrane과 Collagen Absorbable Hemostat가 성견 치주조직 치유에 미치는 영향에 대한 연구

Abstract

[한글]

저자는 6마리 잡종 성견을 대상으로 하여 하악 소구치, 대구치 부위의 치조골을 외과적으로 제거하고 6주간 tin - foil을 삽입시켜 자연치유를 방해하고 치태침착을 증가시켜 치조골 결손을 동반한 만성 파괴성치주염을 야기시킨 후에, 치은 박리 소파수술시 치조골 위로 아무 재료도 넣지 않은 군(대조군), oxidized cellulose membrane(Surgical**R)을 넣은 군(실험 I 군), collagen absorbable hemostat(Instat**R)를 넣은군(실험 Ⅱ군)의 3군으로 나누어 시간 경과에 따라 1주, 2주, 3주, 4주, 8주, 16주후에 실험동물들을 회생

시켜 조직학적으로 비교, 관찰하여 다음과 같은 결론을 얻었다.

1. Oxidized cellulose membrane은 1주부터 부분적으로 흡수되기 시작하여, 4주에서 8주 사이에 완전히 흡수되었고, Collagen absorbable hemostat는 4주까지는 유지되다가 4주에서 8주 사이에 완전히 흡수되었다.

2. 상피층 하부 결합조직 내 염증세포 침윤상태는 대조군과 실험 Ⅰ, Ⅱ군에서 뚜렷한 차이없이 대조군에서는 염증세포 침윤상태가 3주부터 감소되어 8주부터 미약해지는 반면, 실험 Ⅰ, Ⅱ군에서는 2주부터 감소되어 8주부터 미약해졌다.

3. 접합상피의 치근단이동은 대조군에서는 진행되어 긴 절합상피로 치유되는 반면, 실험 Ⅰ, Ⅱ군에서는 억제되어 신생부착으로 치유되었다. 접합상피의 길이와 신생부착의 길이는 대조군과 실험 Ⅰ, Ⅱ군에서는 통계학적인 유의차가 있었고(P<0.05), 실험 Ⅰ 군과

Ⅱ군 사이에는 통계학적인 유의차는 없었으나, 실험 Ⅱ군에서 접합상피의 치근단이동 억제효과가 더 좋은 경향을 보였다.

4. 신생 백악질은 대조군에서는 형성되지 않았던 반면, 실험 Ⅰ, Ⅱ군에서는 신생 백악질이 형성되어, 신생 백악질의 길이가 통계학적인 유의차를 보였고(P<0.05), 실험 Ⅰ 군과 Ⅱ군 사이에는 통계학적인 유의차가 없었다.

5. 신생골은 대조군에서는 형성되지 않았던 반면, 실험 Ⅰ, Ⅱ군에서는 신생골의 형성이 보였다.

6. 교원질섬유의 배열은 대조군에서는 불규칙하다가 4주부터 평행하게 되는 반면, 실험 Ⅰ, Ⅱ군에서는 3주부터 평행하게 배열되기 시작해서 8주부터는 신생골로부터 신생 백악질로 기능적인 배열을 하였다.

[영문]

The aim of this study was to evaluate the effects of the resorbable membrane such as oxidized cellulose membrane, collagen absorbable hemostat in the treatment of periodontitis of dogs.

Experimental periodontitis were created in the manibular, and 1st, 2nd, 3rd, 4th premolar, and 1st molar of 6 adult dogs.

Bone was surgically removed from the dogs in the buccal and lingual aspects and tinfoil was inserted into that portion to make a chronic inf1ammatory status.

After 6 weeks, the tinfoil was removed, and regenerative procedures were performed in experimental areas divided into 3 groups.

The three groups were as follows ;

1) flap operation(control group)

2) flap operation with oxidized cellulose membrane(experimental group I)

3) flap operation with collagen absorbable hemostat(exmperimental group Ⅱ)

Thereafter, dogs were serially sacrificed on the 1, 2, 3, 4, 8, and 16th week and the specimens were prepared and stained with hematoxylin - eoain stain for the light microscopic evaluation.

The results of this study were as follows ;

1. Oxidized cellulose membrane was partially resorbed from the 1st week, and completely resorbed between the 4th and the 8th week, and while collagen absorbable hemostat was maintained until the 4th week, and completely resorbed between the 4th and the attn week.

2. In the aspects of the inflammatory cell infilltration, slight decrease was observed from the 3rd week and a few aggregation on the 8th week in the control group. But in the experimental group I and Ⅱ, decrease was observed from the 2nd

week and a few aggregation on the 8th week without distinct difference.

3. In the control group, periodontal tissue was healed with long junctional epithelium because of apical migration of epithelium, but in the experimental group I and Ⅱ, periodontal tissue was healed with new attachment because of the prevention of migration of epithelium. The legth of junctional epithelium and new attachment was statistically significant between control and experimental group I and Ⅱ(P<0.05), but was not between experimental group I and Ⅱ.

4. In the control group, new cementum was not formed, while in the experimental group l and Ⅱ, new cementum was formed. the length of new cementum was statistically significant between control and experimental group Ⅰ and Ⅱ(P<0.05), but was not between experimental group Ⅰ and Ⅱ.

5. In the control group, new bone formation was not seen, while in the experimental group Ⅰ and Ⅱ, new bone formation was seen.

6. In the control group, collagen fiber was parallely arranged from the 4th week, while in the experimental group Ⅰ and Ⅱ, it was the 3rd week, functional arrangement was seen at the 8th week.