Hideaki Hayashi

Bone Ceramic・コラーゲンゲル合材移植後の歯周組織再生に関する研究

The aim of this study is to determine the process of periodontal tissue regeneration and the metabolic activity of osteoblasts after implantation of bone ceramic and collagen gel compound materials (BC). Bone defects were artificially prepared in the alveolar septa of the bilateral upper first and second molars of Wistar rats. Subsequently, BC were implanted into the defective sites on the left side, and the gingival flaps were closed. At the defective sites on the right side, as a control, gingival flaps were closed without implantation. Rats were sacrificed 1, 3, 5, 7 or 14 weeks after implantation, and prepared tissue sections were observed both pathologically and autoradiographically using 3H-Proline. The results obtained were as follows: Pathological Findings One week after BC implantation, inflammatory cellular infiltration of the surrounding gingival connective tissue was relatively mild. Three weeks after implantation, BC were present in fibrous connective tissues, and some directly bound to the marices of regenerated bone. Observation 5 weeks after implantation revealed that BC had become embedded in the regenerated bone matrices and that there was giant cell reaction to foreign bodies at the margin of BC located in connective tissue. BC were directly bound to the regenerated bone matrices without intermediary fibrous tissues 7 and 14 weeks after implantation. Connective tissues showed high grade regeneration of collagen fiber bundles, in an arrangement that tended to be fixed in mesial and distal directions. Autoradiographic Findings There was no uptake of 3H-Proline into the regenerated bone matrices or the gingival connective tissue surrounding BC, while uptake of 3H-Proline into the entire area around the root apex and in the vicinity of the alveolar septum was observed with time (weeks) after BC implantation. These results suggest that BC provide nuclei for bone regeneration through inclusion in newly-generated periodontal bone tissue, although it is difficult to produce definite induction of bone tissue by BC alone. It is also apparent that these are useful bone implantation materials for restoration of the physiological morphology of alveolar bone in periodontal surgical treatment.

Application of local drug delivery system to periodontal therapy. 4. Comparison of the therapeutic effects of administration of a TC film or root debridement on human periodontal disease

In 8 patients with periodontal diseases under good supragingival plaque control, 22 test teeth each having a pocket not more than 4 mm deep were treated respectively with 3 consecutive administrations of tetracycline immobilized cross-linked collagen film (TC film) at intervals of 1 week, with onceroot planing and with both of these. The therapeutic effects were compared both clinically and micro biologically. The results revealed improvements in clinical symptoms such as reduction in the depth of the pocket, bleeding on pocket probing and the like for each treatment group in 6-12 weeks. The second and third groups also showed remarked gingival recession. Further more, the density of intrapocket microorganisms showed a remarked decrease up to the 8th week for each treatment group and the population of spirochetes showed a decrease up to the 6th week for the first treatment group and up to the 8th-12th week for the second and third treatment group. The results show that both local application of the TC film and root planing are effective in periodontal treatment, but not the combined treatment.