흡수성막으로 골결손수 차폐시 골형성 양상에 관한 조직학적 고찰

Histologic study of the bone formation in bony defects, using absorbable membranes

The formation of mature, fibrous tissue in surgical or congenital bony defects during healing process can produce undesirable results. The biologic principle of GTR (guided tissue regeneration) has been developed, and bone regeneration as well as bone neogenesis was allowed by nonabsorbale e-PTFE (Gore-Tex, expanded-polytetrafluoroethylene) membranes. However, for certain cases, absorbable membranes are preferred and have more advantages. This study was aimed to observe the stability of the membrane and the tissue reaction by using absorbable membranes (Vicryl mesh, Resolut) and to compare the bone formation of absorbable membranes with that of biologically inert nonabsorbable membrane. The bone formation was observed by light microscope(LM) at the circular defect (9mm in diameter) of the rabbit s skull. Three types of membrane were used, that is, nonabsorbable membrane as a control and two absorbable membranes as test groups. Each rabbit ws sacrificed at 2, 4 and 6 weeks respectively. The results were as follows. 1. There was no significant difference in the bone formation between nonabsorbable membrane and absorbable ones. 2. The mild inflammation was observed at 2 weeks posteratively in the specimen of Resolut which was stiffer than Vicryl. 3. At the specimens of 2 and 4 weeks, the osteogenic activity in the bony defects of the test group was found to be somewhat more advanced than that of the control group. 4. The collapse of the Vicryl mesh into the defect area was remarkably observed, but little collapse tendency in the Resolut and Gore-Tex. In conclusion, the absorbable membranes might be more advantageous in the clinical use, because the osteogenic activity of the absorbable membranes were as effective as that of nonabsorbable membrane.