위축된 상악구치부 임플란트 식립을 위한 다양한 골재생 효과의 조직형태학적 비교연구
Comparative histomorphologic study of regenerated bone for dental implant placement in the atrophied posterior maxilla
김세정, 김성민, 김지혁, 박영욱,
소속 상세정보
김세정 ( Kim Se-Jung ) - 강릉대학교 치과대학 구강악안면외과학교실
김성민 ( Kim Soung-Min ) - 강릉대학교 치과대학 구강악안면외과학교실
김지혁 ( Kim Ji-Hyuck ) - 강릉대학교 치과대학 구강악안면외과학교실
박영욱 ( Park Young-Wook ) - 강릉대학교 치과대학 구강악안면외과학교실
KMID : 0355620070330010028
Abstract
The purpose of this study is to evaluate the regenerative capacity of reconstruction in the atrophied posterior maxilla by comparing bone graft procedures and alveolar distraction osteogenesis (ADO) techniques. We performed the autogenous iliac bone graft (AGB group, 5 specimens in 3 patients), and the combination (Mixed group, 3 specimens in 3 patients) of the autogenous and deproteinized bovine bone (Bio-Oss., Geistlich Co., Switzerland) as the ratio of 2:1 in the sinus floor elevation procedures. ADO procedures using TRACK. (KLS Martin Co., Germany) were also performed to augment vertical alveolar height in atrophied posterior maxilla (ADO group, 5 specimens in 4 patients). Newly generated bone tissues were obtained with the 2.0mm diameter trephine bur (3i Co., USA) during implant fixture installation after 5-7 months. Routine histolomorphological observation, immunodot blot assay for quantitative evaluation, and immunohistochemical staining with antibodies to MMP-1, -9, -10, TIMP-1, -2, and BMP-2, -4 were all carried out. Lamellar bone formation was well shown in all specimens and new bone formations of ADO group increased than those of other procedures. In immunohistochemical staining, the strong expression of BMP-2 was shown in all specimens, and immunodot blot assay showed that bone formation is accompanied by the good induction of factors associated with angiogenesis and appeared more increased amount of osteogenic and angiogenic factors in ADO group. ADO is the most effective technique for new bone formation compared to sinus floor elevation with autogenous or mixed bone graft in the atrophied posterior maxilla. In the quantitative immunodot blot assay, the regenerated bone after ADO showed more increased products of VEGF, BMP-2, PCNA and MMP-1 than those after the other procedures, and these findings were able to be confirmed by immunohistochemical stainings.
키워드
Alveolar distraction osteogenesis (ADO);Autogenous iliac bone graft;Deproteinized bovine bone;Sinus floor elevation;Immunodot blot assay;Immunohistochemical staining
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