Collagen absorbable hemostat와 Porous replamineform hydroxyapatite가 성견 치주조직의 치유에 미치는 영향에 대한 연구

Abstract

[한글]

본 연구의 목적은 만성 치주염을 야기시킨 성견에서 porous replamineform hydroxyapatite를 치조골 결손부에 이식하고 collagen absorbable hemostat를 함께 사용한 경우 치주조직의 재생과 치유에 미치는 영향을 알아보기 위함이다.

5마리의 성견 소구치와 대구치에 교정용 탄성사를 결찰하여 만성치주염을 야기시킨 후 치은 박리 수술만 시행한 군을 대조군으로, 치은 박리 수술시 collagen membrane을 사용한 군을 실험 1군으로, 치은 박리 수술시 collagen membrane과 porous replamineform hyd

roxyapatite를 함께 사용한 군을 실험 2군으로 나누고, 술 후 1일, 1주, 3주, , 12주, 26주의 치유 결과를 조직학적으로 관찰하여 다음과 같은 결과를 얻었다.

1. collagen absorbable hemostat는 1일부터 흡수되기 시작하여 1주에는 실험 1, 2군에서 대부분 흡수되었으며 3주에는 약간의 잔여 물질을 보였다.

2. 접합상피의 치근단 이동은 대조군에서는 1주부터 시작되어 12주에는 notch의 치근단 부위까지 관찰되었으며, 실험 1, 2군에서는 1주부터 시작되어 7주에서는 notch의 상방에서 관찰되어 억제되는 양상을 보였다.

3. 상피층 하부 결합조직 내 염증세포 침윤 상태는 대조군과 실험 1, 2군 모두 1주에 심하게 나타났으나, 3주부터는 대조군과 실험군 공히 감소하는 양상을 보였다.

4. 신생백악질의 형성은 대조군에서는 전 실험기간동안 관찰되지 않았고, 실험 1, 2군에서는 3주부터 notch 주위에서 관찰되어 12주에는 notch의 상방까지 형성되는 소견을 보였다.

5. notch주위의 신생골의 형성은 대조군에서는 전 실험기간 동안 관찰되지 않았고 실험 1군에서는 26주에서 신생골의 형성을 보였으며, 실험 2군에서는 3주에서 신생골이 관찰되기 시작하여 26주까지 이식재 사이로 신생골의 형성이 증가하였다.

6. 대조군에서는 결합조직 섬유와 치근과의 무착이 관찰되지 않았으며, 실험 1, 2군에서는 결합조직섬유가 3주부터 평행하게 배열되기 시작하여 12주에는 기능적인 배열로 연결되었다.

[영문]

The purpose of this study was to evaluate the effects of collagen absorbable hemo stat and porous replamineform hydroxyapatite in treatment of periodontitis of dogs.

Experimental periodontitis was induced by the ligation of orthodontic elastic threads in the premolars and 1st molar of 5 adult dogs for 10 weeks.

After 10 weeks, regenerative procedures were performed in experimental areas divided into 3groups.

The three groups were as follows :

1) flap operation(control group)

2) flap operation with collagen absorbable hemostat(experimental group Ⅰ)

3) flap operation with collagen absorbable hemostat and porous repamineform hydroxyapatite(experimental group Ⅱ)

At the 1st day, 1, 3, 12 and 26th week, dogs were serially sacrificed and specimens were prepared with hematoxylin-eosin stain for the light microscopic evaluation.

The results were as follows :

1. The resorption of collagen absorbable hemostat started from the 1st day. At the 3rd week, it remained a little in experimental groups.

2. In control group, epithelial migration was started at the 1st week, at the 12th week was observed at the apical portion of the notch. In the experimental groups, the migration was started at the 1st week but the junctional epithelium did net reach to the notch at any time.

3. In the aspects of the inflammatory cell infiltration, it was observed severe aggregation at the1st week, but it was reduced from the 3rd week slightly in all groups.

4. The new cementum formation was net seen in the control group. In experimental groups, the thin layer of new cementum was seen at the 3rd week on the apical portion of the notch, and new cementum was observed at the level to the coronal portion of the notch at the 12th week.

7. The new bone formation was net observed in the control group. In the experimental group 1, new bone formation was seen at the 26th week But in experimental group Ⅱ , it was formed from the 3rd week around the implanted material near the alveol

ar bone and increased with time.

6. In the control group, the new connection of collagen fiber and the root surface was not seen. In the experimental groups, collagen fiber was parallely arranged from the 3rd week and functional arrangement was seen at the 12th week.