臺灣博碩士論文加值系統

基於幾丁聚醣具有抗菌、縮短傷口癒合時間、及增加骨生成速率之特點，本研究之目的在以動物試驗評估本實驗室發展的可注射式聚乳酸/幾丁聚醣/非晶型磷酸鈣(PLA/chitosan/ACP)引導組織再生阻隔材對牙周治療的效果。在兩組動物試驗中，第一組用4隻米格魯犬，從牙釉牙堊質聯合(CEJ)處往下製造5 mm齒槽骨上牙周組織缺損(supra-alveolar periodontal defects)，將可注射式之PLA/chitosan/ACP、PLA/doxycycline、PLA或Atrisorb®填入缺損區域中固化後縫合，另以不填入材料當控制組，8週後評估其對齒槽骨和牙堊質再生之影響。另ㄧ組則以2隻米格魯在齒槽脊中製造出4 x 5 mm的兩面骨缺損(two-wall intrabony defects)，以去礦化冷凍乾燥同類骨移植體(demineralized freeze-dried bone allograft, DFDBA)為支架，將可注射式之PLA/chitosan、PLA/doxycycline、Atrisorb®阻隔材填入缺損區域，另以不填入任何材料和只填入DFDBA為控制組，分別在4週跟12週評估結合DFDBA為支架之可注射式再生阻隔材對牙周再生的影響。結果顯示不加DFDBA的測試發現齒槽骨和牙堊質的再生有限；添加DFDBA手術後12週則全部都有齒槽骨再生現象。綜合以上觀察，可注射式聚乳酸/聚丁聚醣/非晶型磷酸鈣再生阻隔材在配合DFDBA的應用下，可阻擋牙齦上皮細胞向牙根尖生長，並可觀察到齒槽骨之再生，具有良好之組織再生效果。

The goal of the study is to evaluate the effects and limitation of injectable PLA/chitosan/ACP GTR barrier in animal study. This study is further divided into two parts: In the first part of the study, 5-mm supra-alveolar periodontal defects were surgically created in 4 beagle dogs. Defects were treated with PLA/chitosan/ACP, PLA/doxycycline, PLA or Atrisorb®, the last group was treated with flap suture only as control. Alveolar bone and cementum regeneration were evaluated after 8 weeks. In the second part, 4x5 mm 2-wall intrabony defects were surgically created in 2 beagle dogs. The defects were treated with PLA/chitosan, PLA/doxycycline, Atrisorb®, while DFDBA was filling into defects as scaffold, be treated with flap suture only and DFDBA only as control. The effect of periodontal regeneration to GTR combined with DFDBA scaffold was evaluated after 4 and 12 weeks. Increasing height of alveolar bone regeneration was found in all groups in the second study. The above results confirmed the efficacy of PLA/chitosan barrier in preventing the apical migration of epithelial cell and inducing new bone formation. Therefore, its application in guided tissue regeneration with DFDBA is feasible.

中文摘要 II
Abstract IV
目錄 VI
表目錄 VIII
圖目錄 IX
第1章 緒論 1
1-1研究動機 1
1-2研究目的 2
1-3研究假設 4
第2章 文獻回顧 5
2-1引導牙周組織再生術 5
2-2影響引導組織再生手術臨床結果的因子 7
2-3幾丁聚醣 10
2-4非晶型磷酸鈣 12
2-5動物實驗模型 13
2-5-1 常見臨床檢測牙周組織再生效果方式 13
2-5-2 各類牙周組織缺損設計分類比較 14
第3章 研究方法與材料 19
3-1 實驗材料 19
3-2實驗設計 19
3-3實驗方法和步驟 21
第4章結果 25
4-1臨床觀察 25
4-2 組織切片觀察 27
4-3數值統計 29
第5章 討論 31
5-1置放DFDBA對引導組織再生的效用 31
5-2有無使用再生阻隔材對人工骨缺損區的影響 33
5-3各種不同流動性再生膜的效益 34
5-4可注射式的PLA再生膜在引導組織手術的應用 36
第6章 結論 37
參考文獻 38

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