Porous resorbable calcium carbonate가 성견 치조골 결손부 치유에 미치는 영향

Abstract

[한글]

본 연구의 목적은 porous resorbable calcium carbonate의 이식이 치주조직의 치유에 미치는 영향을 알아보기 위하여 성견에서 실험적으로 형성된 치조골 결손부에 porous resorbable calciumnrbonate 이식 후 다공성 replamineform hydroxyapatite 이식과 통상의 치주 수술을 비교하는데 있다.

성견의 상악 소구치와 하악 소구치, 대구치의 근심면에 외과적으로 2면 골내낭을 형성하고 8주간 tin - foil을 삽입하여 만성치주염을 야기시킨 후, 치은박리소파술만을 시행한 경우(대조군),다공성 replamineform hydroxyapatite를 이식시킨 경우(실험대조군), po

rous resorbable calciumcarbonate를 이식한 경우(실험군)의 3군으로 나누어 각 1, 2, 3, 4, 8, 16주의 치유결과를 조직학적으로 비교 관찰하여 다음과 같은 결론을 얻었다.

1. 결합조직내의 염증세포 침윤상태는 대조군과 실험군에서 뚜렷한 차이 없이 대조군에서는 4주부터 감소되는 양상이 관찰되었으며 실험군과 실험 대조군에서는 2주부터 감소하여 미약한 염증상태를 보였다.

2. 상피의 치근단 이동이 대조군에서는 notch주위로 일어났으나 1주를 제외한 실험 대조군과 실험군에서는 대조군에 비하여 실험기간동안 접함 상피의 치근단이동이 미약하였다.

3. 신생 백악질의 형성은 실험대조군에서는 2주부터 형성되기 시작하여 16주에도 notch 부위까지 형성되었으나 실험군에서는 2주부터 미약하게 형성되기 시작하여 8주에는 치조정 상부까지 형성되었다.

4. 실험 대조군에서 16주에 신생 백악질에 결합조직 섬유가 수직배열의 부착상태를 보였으나 실험군에서는 8주부터 수직배열의 부착상태를 보였다.

5. 신생골의 형성은 대조군에서는 미약하였으며 실험 대조군에서는 4주 후에 골내낭 기저부에서부터 신생골 형성이 시작되어 증가하는 양상을 보였으나 재료 주위는 결합조직 섬유에 의하여 둘러싸여져 있었고 실험군에서는 재료주위로 2주부터 골양조직이 형성되어 4주부터 16주까지 시간경과에 따라 신생골 형성이 증가되는 양상을 보였다.

6. 실험 대조군의 재료는 실험기간동안 흡수되지 않았으나 실험군의 재료는 4주부터 흡수가 시작되어 8주, 16주에도 계속적인 흡수상이 관찰되었다.

[영문]

The purpose of this study was to evaluate the effect of porous resorbable calcium carbonate on healing responses of alveolar bone defects in dogs.

Periodontal 2-wall intrabony defects were created surgically with a surgical bur and a chisel on mesial surfaces of the maxillary 2nd and 3rd premolars, and the mandibular 2nd, 3rd, 4th premolars and 1st molars.

Tin foils were placed to maintain a chronic inflammatory state.

All defects were reopened 8 weeks later and the foils were removed and the notches were made on the root at the base of each defect to serve as reference points and regeneration procedures were performed in experimental areas. Three different groups were designated according to treatment.

The 3 groups were as follows :

1) flap operation only (control group)

2) flap operation with porous replamineform hydroxyapatite implant(experimental-control group)

3) flap operation with porous resorbable calcium carbonate implant(experimental group)

At 1, 2, 3, 4, 8, and 16 weeks, dogs were serially sacrificed and specimens were prepared with hematoxylin-eosin stain for light microscopic evaluation.

The results were as follows :

1. According to the inflammatory cell infiltration, a few aggregations were seen by the 4th week in the control group while in the experimental-control and experimental group a few aggregations were observed at the 2nd week.

2. Epithelial migration to the reference notch was observed in the control group. In the experimental-control group, a migration was seen only at the 1st week and in the experimental group the junctional epithelium did not reach to the notch at any time.

3. New cementum formation on the root was seen at the 2nd week in the experimental and experimental-control group. New cementum was limited to the notch in the experimental-control group at the 16th week but this extended to the alveolar crest level at the 8th week in the experimental group.

4. In the experimental-control group, connective tissue fibers started to show perpendicular arrangement to the root at the 16th week while a full functional arrangement of the fibers was seen at the 8th week in the experimental group.

5. The new bone formation was minimal in the control group. In the experimental-control group, new bone formation from the apical portion of the defects was seen at the 4th week and inclosed gradually with time. Implant particles were surrounded with fibrous tissues.

In the experimental group, osteoid tissue was formed around the implant particles at the 2nd week, and the new bone formation was increased with time.

6. The implant material o( the experimental-control group was not resorbed during the experimental periods. In the experimental group, resoiption of the implant material started from the 4th week and continued to the 8th and 16th weeks.