The effects of noncrystalline calcium phosphate glass on the healing of 1-wall intrabony defects in beagle dogs

Abstract

[한글]

치주치료의 궁극적 목표는 치주질환을 정지시키는 것뿐만 아니라 파괴된 치주조직을 재생시켜 정상적으로 기능하게 하는 것이다. 치주조직의 재생은 신생골 형성과 함께 치근면에 새로운 백악질이 형성되고 여기에 치주인대의 기능적인 삽입이 이루어 지는 것이 필요하다.

이번 실험의 목적은 외과적으로 형성된 성견의 1면 골내낭에 새롭게 제조된, Ca

P 비율이 0.6인 비결정성 calcium phosphate를 적용하였을 때 치주조직의 재생에 미치는 영향을 평가하는 것이다.

6마리 성견의 양측 하악 제2소구치의 원심면, 제4소구치의 근심면에 외과적으로 1면 골내낭을 형성하여 치은박리소파술을 시행한 부위를 대조군으로, calcium phosphate만을 이식한 부위를 실험 1군, calcium phosphate와 GTR을 동반한 부위를 실험 2군으로 설정하고 실험하여 술 후 8주에 치유결과를 조직학적으로 관찰하여 다음과 같은 결론을 얻었다.

1. 접합상피의 치근단 이동은 대조군에서 결손부 깊이의 30.90 ± 9.92%, 실험 1군에서 결손부 깊이의 24.08 ± 9.12%, 실험 2군에서 결손부 깊이의 38.68 ± 12.22%로 나타났으며 대조군과 실험 1,2군간에 통계적 유의차는 없었다.

2. 결합조직 유착은 대조군에서 결손부 깊이의 36.38 ± 9.03%, 실험 1군에서 결손부 깊이의 26.96 ± 4.24%, 실험 2군에서 결손부 깊이의 27.87 ± 9.70%로 나타났으며 대조군과 실험 1, 2군간에 통계적 유의차는 없었다.

3. 신생백악질 형성은 대조군에서 결손부 깊이의 32.92 ± 10.51%, 실험 1군에서 결손부 깊이의 49.16 ± 12.70%, 실험 2군에서 결손부 깊이의 39.62 ± 12.14%로 나타났으며 대조군과 실험 1군간에 통계적 유의차가 있었다.

4. 신생골 형성은 대조군에서 결손부 깊이의 27.24 ± 7.49%, 실험 1군에서 결손부 깊이의 43.51 ± 13.34%, 실험 2군에서 결손부 깊이의 36.47 ± 15.11%로 나타났으며 대조군과 실험 1, 2군간에 통계적 유의차는 없었다.

이상의 결과에서 볼 때, calcium phosphate glasses는 신생골 형성에는 통계적으로 유의차는 없었지만 상당히 증가된 양상을 보였고 신생백악질 형성에는 크게 기여함을 알수 있었다.

[영문]

Background: The ultimate goal of periodontal therapy is the regeneration of periodontal tissue that has been lost due to destructive periodontal disease. This requires new bone formation and new cementum formation accompanied by newly inserted fibers at a tooth site previously exposed to oral environment. The purpose of this study is to evaluate the effect of noncrystalline calcium phosphate glasses and combined therapy with calcium phosphate glass and GTR on the regeneration of periodontal tissue in beagle dog.

Materials and Methods: Eighteen (18) intrabony defects (4×4㎜ 1-wall intrabony defects) were surgically created in the mandibular second and fourth premolars of 6 beagle dogs. The control group carried out a conventional flap operation. Experimental group 1 was treated with calcium phosphate glasses only and experimental group 2 was treated with calcium phosphate glasses and GTR. The subjects were sacrificed 8 weeks after the operation and a histological examination was done.

Results:

1. The defect height was 4.82 ± 0.45 ㎜ in the control group, 4.61 ± 0.71 ㎜ in experimental group 1, and 4.92 ± 0.62 ㎜ in experimental group 2. There was no statistically significant difference in defect height among the groups.

2. The junctional epithelium migration was 30.90 ± 9.92% of the defect height in the control group, 24.08 ± 9.12% in experimental group 1, and 38.68 ± 12.22% in experimental group 2. There was no statistically significant difference in junctional epithelium migration among the groups.

3. The connective tissue adhesion was 36.38 ± 9.03% of the defect height in the control group, 26.96 ± 4.24% in experimental group 1, and 27.87 ± 9.70% in experimental group 2. There was no statistically significant difference in connective tissue adhesion among the groups.

4. New cementum regeneration was 32.92 ± 10.51% of the defect height in the control group, 49.16 ± 12.70% in experimental group 1, and 39.62 ± 12.14% in experimental group 2. There was a statistically significant difference in new cementum regeneration between the control group and experimental group 1.

5. New bone regeneration was 27.24 ± 7.49% of the defect height in the control group, 43.51 ± 13.34% in experimental group 1, and 36.47 ± 15.11% in experimental group 2. There was no statistically significant difference in new bone regeneration among the groups.

Conclusion: The calcium phosphate glasses used in this study restrained the migration of junctional epithelium and increased the formation of new cementum and relatively new bone.