Histopathological evaluation of bone regeneration using human resorbable demineralized membrane

Abstract

Background/Aim. Filling a bone defect with bone substitution materials is a therapy of choice, but the infiltration of connective tissue from the mucoperiostal flap may compromise a healing of bone substitutions with bony wall defects. Application of membrane as a barrier is indicated as a solution to this problem. The aim of this study was to show a pathohistological view of bone regeneration and the significance of human resorbable demineralized membrane (HRDM), 200 μ thick in bone regeneration regarding mandibular defects in an experiment on dogs. Methods. The experiment was performed on six dogs. Bone defects were created in all six dogs on the right side of the mandible after the elevation of the mucoperiostal flap. One defect was filled with human deproteinised bone (HDB), and in between HDB and soft tissue RHDM of 200 μ thick was placed. In the second defect, used as a control one, only HDB without RHDM was placed. Two dogs were sacrificed two months after the surgery, another two dogs four months after the surgery and the last two dogs six months after the surgery. After that, samples of bone tissue were taken for histopathological analysis. Results. In all the six dogs with defects treated with HDB and RHDM the level of bone regeneration was much higher in comparison with the control defects without RHDM. Conclusion. Membrane, as a cover of bony defect, is useful and benefits bone regeneration. Bony defects covered with RHDM show better bony healing despite the fact that bone regeneration was not fully complete for as long as six months after the RHDM implantation.

Uvod/Cilj. Popunjavanje koštanih defekata zamenicima kosti je terapija izbora, ali prorastanje vezivnog tkiva iz mukoperiostalnog režnja može kompromitovati sam proces zarastanja zamenika kosti sa zidovima koštanih defekata. U cilju rešavanja ovog problema indikovana je primena membrane kao barijere. Cilj ove studije bio je da se prikaže patohistološki izgled koštane regeneracije i značaj resorptivne demineralizovane membrane humanog porekla (RHDM), debljine 200 mikrona, u regeneraciji kosti kod mandibularnih defekata u eksperimentu rađenom na psima. Metode. Eksperiment je vršen na šest pasa kojima je sa desne strane donje vilice, po podizanju mukoperiostalnog režnja, pravljen koštani defekt. U jedan defekt stavljana je humana deproteinizovana kost (HDK), a između nje i mekotkivnog dela stavljana je RHDM debljine 200 mikrona. U drugi defekt, koji je služio kao kontrola, stavljena je samo HDK, bez RHDM. Dva psa žrtvovana su dva meseca nakon hirurške intervencije, dva posle četiri meseca, a preostala dva šest meseci nakon hirurške intervencije. Nakon žrtvovanja uzimani su isečci za patohistološku analizu. Rezultati. Kod svih šest pasa kod kojih je u koštani defekt ugrađena HDK i RHDM stepen koštane regeneracije bio je daleko veći u odnosu na kontrolne defekte bez RHDM. Zaključak. Membrana, kao pokrivač koštanog defekta, podesna je i poboljšava koštanu regeneraciju. Koštani defekti prekriveni RHDM pokazali su značajno bolje koštano zarastanje, mada koštana regeneracija nije bila potpuna ni šest meseci nakon njene ugradnje.