Browse > Article

Exophytic bone formation using porous titanium membrane combined with pins in rabbit calvarium.  

Kim, Young (Department of Periodontology, School of Dentistry, Kyung Hee University)
Kwon, Young-Hyuk (Department of Periodontology, School of Dentistry, Kyung Hee University)
Park, Joon-Bong (Department of Periodontology, School of Dentistry, Kyung Hee University)
Herr, Yeek (Department of Periodontology, School of Dentistry, Kyung Hee University)
Chung, Jong-Hyuk (Department of Periodontology, School of Dentistry, Kyung Hee University)
Publication Information
Journal of Periodontal and Implant Science / v.36, no.2, 2006 , pp. 273-288 More about this Journal
Abstract
The purpose of this study was to evaluate exophytically vertical bone formation in rabbit calvaria by the concept of guided bone regeneration with a custom-made porous titanium membrane combined with bone graft materials. For this purpose, a total of 12 rabbits were used, and decorticated calvaria were created with round carbide bur to promote bleeding and blood clot formation in the wound area. Porous titanium membranes (0.5 mm in pore diameter, 10 mm in one side, 2 mm in inner height) were placed on the decorticated calvaria, fixed with metal pins and covered with full-thickness flap. Experimental group I was treated as titanium membrane only. Experimental group II, III, IV was treated as titanium membrane with BBM, titanium membrane with DFDB and titanium membrane with FDB. The animals were sacrificed at 8 and 12 weeks after surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. 1. Porous titanium membrane was biocompatable and capable of maintaining the regeneration space. 2. At 8 and 12 weeks, all groups demonstrated exophytic bone formation and there was a statistical significant difference among different groups only at 12 weeks. 3. The DFDB group revealed the most new bone formation compared to other groups (p<0.05). 4. At 12 weeks, DFDB and FDB groups showed the most significant resorption of graft materials (p<0.05). 5. The BBM was not resorbed at all until 12 weeks. 6. The fixation metal pin revealed excellent effect in peripheral sealing. On the basis of these findings, we conclude that a porous titanium membrane may be used as an augmentation membrane for guided bone regeneration, and DFDB as an effective bone forming graft material. The fixation of the membrane with pin will be helpful in GBR technique. However, further study is required to examine their efficacy in the intraoral experiments.
Keywords
Porous titanium membrane; Guided bone regeneration; Exophytic bone formation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Keller EE, Tolman DE, Eckert S. Surgical-Prosthodontic reconstruction of advanced maxillary bone compromise with autogenous onlay block bone grafts and osseointegrated endosseous implants: A 12-year study of 32 consecutive patients. Int J Oral Maxillofac Impl 1999;14:197-209
2 Chin M. The role of distraction osteogenesis in oral and maxillofacial surgery. J Oral Maxillofac Surg 1998;56:805-806
3 Donos N, Kostopoulos L, Karring T. Augmentation of the rat jaw with autogeneic cortico-cancellous bone grafts and guided tissue regeneration. Clin Oral Impl Res 2002;13:192-202   DOI   ScienceOn
4 Hass R, Haiolvogl D, Dortbudal O, Mailath G. Freeze-dried bone for maxillary sinus augmentation in sheep. Part II: biomechanical findings. Clin Oral Impl Res 2002;13:581-586   DOI   ScienceOn
5 이근혁, 권영혁, 박준봉, 허익. 골유도재생술시 그물형 티타늄막의 천공수가 골형성에 미치는 영향. 대한치주과학회지 2004;34:411-424
6 Cuching M. Autogenous red marrow grafts: Potential for induction osteogenesis. J Periodontol 1969;40:492-497   DOI
7 Mellonig JT, Triplet J. Guided tissue regeneration and endosseous dental implants. Int J Perio Rest Dent 1993;13:109-119
8 Urist MR, Dowell TA. Inductive substratum for osteogenesis in pellets of particulate bone matrix. Clin Orthop 1970;61:61-78
9 Hockers T, Abensur D, Valentini D. The combined use of bioresorbable membranes and xenografts or autografts in the treatment of bone defects around implants. A study in beagle dogs. Clin Oral Impl Res 1999;9:487-498
10 Lundgren D, Lundgren AK, Sennerby L, Nyman S. Augmentation of intramembraneous bone beyond the skeletal envelope using an occlusive titanium barrier. An experimental study in the rabbit. Clin Oral Impl Res 1995;6:67-72   DOI   ScienceOn
11 Schenk RK, Hardwick WR, Dahlin C. Healing pattern of bone regeneration in membrane protected defects. A histologic study in the canine mandible. Int J Oral Maxillofac Impl 1994;9:13-29
12 Zellin G, Linde A. Effects of different osteopromotive membrane porosities on experimental bone neogenesis in rats. Biomaterials 1996;17:695-702   DOI   ScienceOn
13 Kostopoulos L, Karring T, Augmentation of the rat mandible using guided tissue regeneration. Clin Oral Impl Res 1994;5:75-82   DOI   ScienceOn
14 Becker W, Dahlin C, Becker BE, Lekholm U, Van Steenberghe, Higuchi K, Kultje. The use of e-PTFE barrier membranes for bone promotion around titanium implants placed into extraction sockets: A prospective multicenter study. Int J Oral Maxillfac Impl 1994;9:31-40
15 Simion M, Dahlin C, Trisi P, Piattelli A. Qualitative and quantitative comparative study on different filling materials used in bone tissue regeneration. A controlled clinical study. Int J Perio Rest Dent 1994;14:195-215
16 Berglundh T & Lindhe J. Healing around implants placed in bone defects treated with Bio-Oss. An experimental study in the dog. Clin Oral Impl Res 1997;8:117-124   DOI   ScienceOn
17 McAllister B, Margolin M, Cogan A, Buck D, Hollinger J, Lynch S. Eighteen month radiographic and histologic evaluation of sinus grafting with anorganic bovine bone in the chimpanzee. Int J Oral Maxillofac Impl 1999;14:361-368
18 Donos N, Kostopoulos L, Karring T. Alveolar ridge augmentation by combining autogenous mandibular bone graft and nonresorbable membranes. An experimental study in the rat. Clin Oral Impl Res 2002;13:185-191   DOI   ScienceOn
19 Artzi Z, Dayan D, Alpern Y, Nemcovsky CE. Vertical ridge augmentation using xenogenic material supported by a conFigureured titanium mesh: Clinicohistopathologic and histochemical study. Int J Oral Maxillofac Impl 2003;18:440-446
20 Chin M, Toth BA. Distraction osteogenesis in maxillofacial surgery using internal devices: Review of five cases. J Oral Maxillofac Surg 1996;54:45-53   DOI   ScienceOn
21 Donos N, Kostopoulos L, Karring T. Augmentation of the mandible with GTR and onlay cortical bone grafting. An experimental study in the rat. Clin Oral Impl Res 2002;13:175-184   DOI   ScienceOn
22 Norton MR, Odell EW, Thompson ID, Cook RJ. Efficacy of bovine bone mineral for alveolar augmentation: a human histologic study. Clin Oral Impl Res 2003;14:775-783   DOI   ScienceOn
23 Gangloff RK, Cole M, Whitlow W, Boyne PJ. Titanium mesh and particulate cancellous bone and marrow grafts to augment the maxillary alveolar ridge. Int J Oral Maxillofac Surg 1986;15:263-268   DOI   ScienceOn
24 Stavropoulos A, Kostopoulos L, Mardas N, Karring T. Deproteinized bovine bone used as an adjunct to guided bone augmentation: An experimental study in the rat. Clin Impl Dent and related Res 2001;3:156-165   DOI   ScienceOn
25 Nyman S, Lang NP, Buser D, Bragger U. Bone regeneration adjacent to titanium dental implants using guided tissue regeneration: a report of two cases. Int J Oral Maxillofac Impl 1990;5:9-14
26 Sottosanti JS, Bierly JA. The storage of marrow and its relation to periodontal grafting procedures. J Periodontol 1975;46:162-170   DOI
27 Proussaefs P, Lozada J, Kleinman A, Rohrer MD, McMillan PJ. The use of titanium mesh in conjuncion with autogenous bone graft and inorganic bone mineral(bio-Oss) for localized alveolar ridge augmentation: a human study. Int J Perio Rest Dent 2003;23:185-195
28 Slotte C, Lundgren D, Burgos PM. Placement of autogenic bone chips or bovine bone mineral in guided bone augmentation: A rabbit skull study. Int J Oral Maxillofac Impl 2003;18:795-806
29 Hammerle CH, Olah AJ, Schmid JI. The biological effect of natural bone mineral on bone neoformation on the rabbit skull. Clin Oral Impl Res 1997;8:198-207   DOI   ScienceOn
30 von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Perio Rest Dent 1998;18:117-127
31 Jovanovic SA, Nevins M. Bone formation utilizing titanium- reinforced barrier membranes. Int J Perio Rest Dent 1995;15:57-69
32 Seibert J, Nyman S. Localized ridge augmentation in dogs: A pilot study using membranes and hydroxyapatite. J Periodontol 1990;61:157 -165   DOI
33 Cortellini P. Localized ridge augmentation using guided tissue regeneration in humans. Clin Oral Impl Res 1993;4:203-209   DOI
34 von Steenberghe D, Johansson C, Quirynen M, Molly L, Albrektsson T, Naert I. Bone augmentation by means of a stiff occlusive titanium barrier. A study in rabbits and humans. Clin Oral Impl Res 2003;14: 63-71   DOI   ScienceOn
35 von Arx T, Cochran DL, Hermann JS, Schenk RK, Buser D. Lateral ridge augmentation using different bone fillers and barrier membrane application. A histologic and histomorphometric pilot study in the mandible. Clin Oral Impl Res 2001;12:260-269   DOI
36 von Arx T, Hardt N, Wallkamm B. Die Time Technik. Lokale Osteoplastik mit dem Micro-Titan-Mesh zur Alveolarkamm-Augmentation. Schweiz Monatsschr Zahnmed 1995;105:651-659
37 Buser D, Dula K, Belser U, Hirt HP, Berthold H. Localized ridge augmentation using guided bone regeneration. I. Surgical procedure in the maxilla. Int J Perio Rest Dent 1993;13:29-45
38 Jovanovic SA, Spiekemann H, Richter EJ. Bone regeneration around titanium implants in dehised defect sites. A clinical study. Int J Oral Maxillofac Impl 1992;7:233-245
39 Rompen EH, Biewer R, Banheusden A, Zaheki S, Nusgens B. The influence of cortical peripheral blood on the kinetics of guided bone regeneration. Clin Oral Impl Res 1999;10:85-94   DOI   ScienceOn
40 Buser D, Bragger D, Lang NP, Nyman S. Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Impl Res 1990;1:22-32   DOI   ScienceOn
41 von Arx T, Hardt N, Wallkamm B. The TIME technique: a new method for localized alveolar ridge augmentation prior to placement of dental implants. Int J Oral Maxillofac Impl 1996;11:387-394
42 Lindhe A. Creation of new bone by an osteopromotive membrane technique. An experimental study in rats. J Oral Maxillofac Surg 1993;51:892-897   DOI   ScienceOn
43 Piattelli A, Scarano M, Piattelli M. Comparison of bone regeneration with the use of mineralized and demineralized freeze-dried bone allografts: a histologic and histochemical study in man. Biomaterials 1996;17:1127-1131   DOI   ScienceOn
44 최성재, 권영혁, 박준봉. 탈회동결건조골과 합성골이식재가 치조골 결손부 재생과정에 미치는 영향. 대한치주과학회지 1994;24:671-684
45 Schmid J, Hammerle CH, Olah AJ, Lang NP. Membrane permeability is unnecessary for guided regeneraion of new bone. An experimental study in the rabbit. Clin Oral Impl Res 1994;5:125-130   DOI   ScienceOn
46 Boyne PJ, Cole MD, Stringer D, Shafqat JP. A technique for osseous restoration of deficient edentulous maxillary ridges. J Oral Maxillofac Surg 1985;43:87-91   DOI   ScienceOn
47 Schimid J, Wallkmm B, Hammerle CHF, Gogolwski S, Lang NP. The significance of angiogenesis in guided bone regeneration. A case report of a rabbit experiment. Clin Oral Impl Res 1997;8:244-288   DOI   ScienceOn
48 Donos N, Lang NP, Karoussis IK, Bosshardt D, Tonetti M, Kostopoulos L. Effect of GBR in combination with deproteinized bovine bone mineral and or enamel matrix proteins on the healing of critical size defects. Clin Oral Impl Res 2004;15:101-111   DOI   ScienceOn
49 Malchiodi L, Scarano A, Quaranta M, Piattelli A. Rigid fixation by means of titanium mesh in edentulous ridge in the maxilla. Int J Oral Maxillofac Impl 1998;13:701-705
50 Assenza B, Piattelli M, Scarano A, Lezzi G, Petrone G, Piattelli A. Localized ridge augmentation using titanium micromesh. J Oral Implantol 2001;27:287-292   DOI   ScienceOn
51 Schmid J. Supraplant a novel implant system based on the principle of guided bone regeneration. Clin Oral Impl Res 1991;2:199-202   DOI   ScienceOn
52 Urist MR. Dowel TA, Hay PH, Strates BS. Inductive substrates for bone formation. Clin Orthop 1968;59:59-96
53 Nevins M, Mellonig JT, Clem DSC III, Reiser GM, Buser DA. Implants in regenerated bone: long term surivial. Int J Perio Rest Dent 1998;18:35-45
54 Lee YM, Nam SH, Kim TI, Lee SJ, Ku Y, Rhyu IC, Chung CP. Enhanced bone augmentation by controlled release of recombinant human bone morphogenetic protein-2 from bioresorbable membranes. J Periodontol 2003;74:865-872   DOI   ScienceOn
55 Dahlin C, Andersson L, Lindhe A. Bone augmentation at fenestrated implants by an osteopromotive membrane technique. A controlled clinical study. Clin Oral Impl Res 1991:2:159-165   DOI   ScienceOn
56 Nevins M, Mellonig JT. Enhancement of the damaged edentulous ridge to receive dental implants: a combination of allograft and the GORE-TEX membrane. Int J Perio Rest Dent 1992;12:97 -111
57 Scantlebury TV. A decade of technology development for guided tissue regeneration. J Periodontol 1993;64:1129-1137   DOI
58 Slott C, Lundgren D. Augmentation of calvarial tissue using nonpermeable silicone domes and bovine bone mineral. An experimental study in the rat. Clin Oral Impl Res 1999;10:468-476   DOI   ScienceOn
59 Urist MR. Bone formation by autoinduction. Science 1965:150:893-899   DOI   ScienceOn
60 Misch CE, Kietsh F. Endosteal implants and iliac crest grafts to restore severely resorbed totally edentulous maxillae: A retrospective study. J Oral Implant 1994;20:100-110
61 Hammerle CH, Chiantella G, Karring T, Lang NP. The effect of a deproteinized bovine bone mineral on bone regeneration around titanium dental implants. Clin Oral Impl Res 1998;9:151-162   DOI   ScienceOn
62 Young C, Sandstedt P, Skoglund A. A comparative study of anorganic xenogenic bone and autogenous bone implants for bone regeneration in rabbits. Int J Oral Maxillofac Impl 1999;14:72-76
63 Feuille F, Knapp CI, Brunsuold MA, Mellonig JT. Clinical and histologic evaluation of bone replacement grafts in the treatment of localized alveolar ridge defects. Int J Perio Rest Dent 2003;23: 29-35