【超微显微镜观察游离胶原膜植入后牙周组织再生】。

M Ooba
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引用次数: 0

摘要

本研究的目的是澄清实验性皮瓣手术后牙周组织伤口愈合过程,当应用交联间胶原膜(AM)引导组织再生(GTR)技术时。在大鼠上颌第一磨牙的腭龈上制作粘骨膜瓣。通过刮除牙髓以暴露牙本质表面。实验组在解剖部位植入AM,对照组不植入AM。实验组在种植后1、3、5、7、14、21天及2、3个月采用电镜观察观察AM的吸收过程及暴露根面创面愈合过程。对照组在皮瓣术后2、3个月从精细结构水平观察牙周组织的伤口愈合情况。结果如下:在AM的吸收过程中,植入部位出现了大量中性粒细胞的早期侵袭。在最初几天中性粒细胞被吸引并粘附在AM纤维上。AM在1 ~ 3天被中性粒细胞分解成细纤维结构。第3 ~ 7天植入部位出现大量巨噬细胞,第5天中性粒细胞减少。植入物迅速被巨噬细胞吞噬,有时形成巨细胞。观察到成纤维细胞向牙龈周围结缔组织浸润,并形成微丝。植入材料在14天后完全溶解。光镜下观察,实验组上皮向下生长明显受到抑制,牙龈结缔组织纤维束明显垂直于根面排列,21天后新生牙骨质组织沉积到根面。电镜观察,愈合初期牙本质表面出现牙本质颗粒层(d.g.l)。对照组2 ~ 3个月后,高密度纤维层向根表面增加。结缔组织纤维束平行于根表面。以上结果表明,采用间胶原膜的GTR技术可作为促进牙周手术后牙周组织再生的有效方法。
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[Electron microscopic observation for periodontal tissue regeneration after implantation of atelocollagen membrane].

The purpose of the present study was to clarify wound healing process of periodontal tissue following experimental flap surgery, when applied the guided tissue regeneration (GTR) technique using a cross-linked atelocollagen membrane (AM). Mucoperiosteal flaps were made on the palatal gingiva of maxillary first molars of rats. The cementum was removed by curettage in order to expose the dentin surface. An AM was implanted into the site of dissection in the experimental group, while the control group received no implantation. The resorption processes of AM and wound healing processes of exposed root surface in the experimental group were examined by electron microscopic observation, 1, 3, 5, 7, 14 and 21 days, and 2, 3 months after the implantation. While the wound healing processes of periodontal tissue in the control group were examined at the fine structural level, 2 and 3 months after the flap surgery. The results were as follows. At the resorption processes of AM, the early invasion of a large number of neutrophils appeared in the site of of implantation. Neutrophils were attracted to and adhered to the AM fibers over the first few days after. AM was resolved to fine fibrous structure by the neutrophils between 1 and 3 days. A large number of macrophages appeared in the implanted site between 3 and 7 days, and neutrophils subsided after 5 days. The implanted material was rapidly resolved be macrophages with active phagocytosis, sometimes forming giant cells. Fibroblasts were invading to peripheral gingival connective tissue and were development of microfilament were observed. The implanted materials were completely resolved after 14 days. In light microscopical findings, of the experimental group, epithelial downgrowth was markedly inhibited, fibrous bundles of the gingival connective tissue were clearly arranged vertical to the root surface and new cementum tissue deposited to the root surface after 21 days. At electron microscopic observation in early stage of healing, dens granular layer (d. g. l.) was presented to the dentin surface. After 2 or 3 months of the control group, high density fibrous layer increased to the root surface. Connective tissue fiber bundles were paralleled to the root surface. The above results indicate that the GTR technique using an atelocollagen membrane may provide an effective method to promote periodontal tissue regeneration after periodontal surgery.

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