Aloe vera와 냉동 건조골 이식이 성견 수평 치조골 결손부 치유에 미치는 영향

Abstract

[한글]

질환이나 외상으로 치주조직의 부착이 파괴된 후 부착조직의 재생은 치과에서 중요한 문제이며, 상실된 치주조직의 재생과 기능회복을 위하여 다양한 골이식재가 사용되어졌다. 이중 동종골 이식은 치조골의 적절한 형태형성 및 뛰어난 골유도 능력이 있다고 알려졌

기 때문에 광범위하게 연구되어져 왔고, 치조골 결손부위에 널리 이용되어져 왔다. 또 Aloe vera는 조직의 치유에 도움을 주고, 동통의 완화에 도움이 된다고 보고된바 있다. 수술방법에 있어, 수평치조골 결손의 경우 치주조직의 복원을 위해 치아를 완전히 조직으로

매복시킴으로써 많은 양의 치주조직 재생을 관찰한 바 있다.

이에 본 연구는 성견에서 수평치조골 결손이 있는 경우 치주수술과 함께 Aloe vera와 탈회 냉동 건조골을 이식하고, 조직으로 완전히 매복시킨 후 치조골, 백악질, 치주인대, 결합조직의 재생과 치유에 미치는 영향을 평가하기 위하여 실시하였다. 이를 위해 성견의

소구치 부위에 치근 이개부위가 노출되도록 백악-법랑경계에서 치조골 변연부까지 5mm가되도록 치조골을 제거한 후, 치근 표면 활택을 시행하고, 좌측부위에 치주수술을 시행한 후 조직을 치관부위 방향으로 위치하여 매몰시켜 봉합하여 준 것을 대조군으로, Aloe ver

a를 사용한 것을 실험 1군, 우측부위에 Aloe vera와 DFDB이식을 같이 사용한 것을 실험 2군으로 하여, 술후 8주 후에 치유결과를 조직학적으로 비교 관찰하여 다음과 같은 결과를 얻었다.

1. 치조골 형성의 양은 대조군에서 0.76±0.72mm, 실험 1군에서 0.41±0.46mm, 실험 2군에서 1.93±0.54mm로 나타났으며, 각 군간엔 유의성 있는 차이가 있었다. (P<0.01).

2. 백악질 형성의 양은 대조군에서 1.60±0.65mm, 실험 1군에서 1.36±0.62mm, 실험 2군에서 1.96±7.54mm로 나타났으며, 각 군간에 유의성 있는 차이가 없었다.

3. 결합조직 유착의 양은 대조군에서 0.58± 0.57mm, 실험 1군에서 0.51±0.43mm, 실험 2군에서 0.64±0.47mm로 나타났으며, 각 군간에 유의성 있는 차이가 없었다.

4. 결합조직의 치유는 대조군에서 1.43±0.52mm, 실험 1군에서 1.46±0.84mm, 실험 2군에서 0.08±0.59mm로 나타났으며, 각 군간에 유의성 있는 차이가 있었고(P<0.05),결합조직의 주행방향은 대조군에서는 주로 치근와 평행하게 나타났으며, 실험 1군에서는 평행하거나, 불규칙한 형태이고, 실험 2군은 불규칙하거나, 수직으로 형성되어 있었다.

5. 치은퇴축의 양은 대조군에서 2.82±0.66mm, 실험 1군에서 3.13±0.58mm, 실험 2군에서 2.40±0.68mm로 나타났으며. 각 군간의 유의성 있는 차이가 없었다.

6. 치근의 흡수는 실험 1군에서 대조군이나 실험 2군보다 더 많이 관찰되었다.

The Effect of Aloe vera and a Decalcified freeze-dried bone allograft on the

Healing of the Horizontal alveolar defects in Dogs

Seong Ho Choi, D.D.S., M.S.D.

Department of Dental Science Graduate School, Yonsei University

(Directed by Professor Chong Kwan Kim, D.D.S., M.S.D, Ph.D.)

Regeneration of periodontal tissue after a loss of attachment due to disease or

trauma repesents an important issue in dentistry, and various bone graft materials

have been used to regenerated lost periodontal tissue and restore proper suctions.

Among those, allografts have been extensively researched and widely used

clinically, since they are known to possess an excellent osteoinduction capability

and result in proper topography of alveolar bone. Aloe versa has also been shown to

aid tissue healing and reduce pain.

Regeneration of periodontal tissue in supraalveolar defects may be technically

difficult. However, a large amount of regeneration has been observed by complete

tissue coverage of involved teeth.

In this study, supraalveolar defects in adult dogs were treated with periodontal

surgery, decalcified freer-dried bone allograft and Aloe vera, complete tissue

coverage was attained, and effects on repair and regeneration of alveolar bone,

cementum and periodontal ligament were studied. Exposure of premolar furcation of

adult dogs was attained by removing marginal alveolar bone down to 5mm from CEJ,

and root surfaces were planed with curettes. On the left side, defects were treated

without any allograft(Control Group) , or with Aloe vera alone(Experimental Group

Ⅰ). On the right side, a combination of DFDB and Aloe vera was used(Experimental

Group Ⅱ). In all groups, flaps were coronally positioned and sutured, completely

submerging the treated defects. Healing progresses were histologically observed

after eight weeks and the results were as follows :

1. The amount of alveolar bane formation was : 0.767±0.72mm in the control

group, 0.41± 0.46mm in experimental group Ⅰ, and 1.93± 0.54mm in experimental

group Ⅱ, with significant differences between various groups.(P<0.01)

2. The amount of cementum formation was : 1.60± 0.65mm in the control group,

1.36± 0.62mm in experimental group Ⅰ, and 1.96± 0.54mm in experimental group Ⅱ,

with no significant differences between various groups.

3. Connective tissue adhesion was: 0.58± 0.57mm in the control group, 0.51±

0.43mm in experimental group Ⅰ, and 0.64± 0.47mm in experimental group Ⅱ, with

no significant differences between various groups.

4. Connective tissue healing was ; 1.43± 0.52mm in the control group, 1.46±

0.84mm in experimental group Ⅰ, and 0.68± 0.59mm in experimental group Ⅱ, with

significant differences between various groups.(P<0.05) Orientation of connective

tissue fibers in relation to root surfaces was : mostly parallel in the control

group, parallel or irregular in group Ⅰ, and irregular or vertical in group Ⅱ.

5. Gingival recession was : 2.82± 0.66mm in the control group, 3.13±0.55mm in

experimental group Ⅰ, and 2.40± 0.68mm in experimental group Ⅱ, with no

significant differences between various groups.

6. Root resorption was observed larger in experimental group Ⅱ than in other two

groups.

[영문]

Regeneration of periodontal tissue after a loss of attachment due to disease or trauma repesents an important issue in dentistry, and various bone graft materials have been used to regenerated lost periodontal tissue and restore proper suctions.

Among those, allografts have been extensively researched and widely used clinically, since they are known to possess an excellent osteoinduction capability and result in proper topography of alveolar bone. Aloe versa has also been shown to

aid tissue healing and reduce pain.

Regeneration of periodontal tissue in supraalveolar defects may be technically difficult. However, a large amount of regeneration has been observed by complete tissue coverage of involved teeth.

In this study, supraalveolar defects in adult dogs were treated with periodontal surgery, decalcified freer-dried bone allograft and Aloe vera, complete tissue coverage was attained, and effects on repair and regeneration of alveolar bone, cementum and periodontal ligament were studied. Exposure of premolar furcation of adult dogs was attained by removing marginal alveolar bone down to 5mm from CEJ, and root surfaces were planed with curettes. On the left side, defects were treated without any allograft(Control Group) , or with Aloe vera alone(Experimental Group Ⅰ). On the right side, a combination of DFDB and Aloe vera was used(Experimental Group Ⅱ). In all groups, flaps were coronally positioned and sutured, completely submerging the treated defects. Healing progresses were histologically observed

after eight weeks and the results were as follows :

1. The amount of alveolar bane formation was : 0.767±0.72mm in the control group, 0.41± 0.46mm in experimental group Ⅰ, and 1.93± 0.54mm in experimental group Ⅱ, with significant differences between various groups.(P<0.01)

2. The amount of cementum formation was : 1.60± 0.65mm in the control group, 1.36± 0.62mm in experimental group Ⅰ, and 1.96± 0.54mm in experimental group Ⅱ, with no significant differences between various groups.

3. Connective tissue adhesion was: 0.58± 0.57mm in the control group, 0.51± 0.43mm in experimental group Ⅰ, and 0.64± 0.47mm in experimental group Ⅱ, with no significant differences between various groups.

4. Connective tissue healing was ; 1.43± 0.52mm in the control group, 1.46± 0.84mm in experimental group Ⅰ, and 0.68± 0.59mm in experimental group Ⅱ, with significant differences between various groups.(P<0.05) Orientation of connective tissue fibers in relation to root surfaces was : mostly parallel in the control

group, parallel or irregular in group Ⅰ, and irregular or vertical in group Ⅱ.

5. Gingival recession was : 2.82± 0.66mm in the control group, 3.13±0.55mm in experimental group Ⅰ, and 2.40± 0.68mm in experimental group Ⅱ, with no significant differences between various groups.

6. Root resorption was observed larger in experimental group Ⅱ than in other two groups.