1994 Fiscal Year Final Research Report Summary
Functional Jowbone Reconstruction Using Biodegradable Materials
| Project/Area Number |
04404079
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
外科・放射線系歯学
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| Research Institution | KANAGAWA DENTAL COLLAGE |
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Principal Investigator |
SHIMURA Kaizo Kanagawa Dental College, Dental Medicine, Professor, 歯学部, 教授 (20084725)
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| Co-Investigator(Kenkyū-buntansha) |
KUZUHARA Takeshi Kanagawa Dental Collage, Dental Medicine, Assistant, 歯学部, 助手 (40234439)
KOBAYASHI Masaru Kanagawa Dental Collage, Dental Medicine, Instructor, 歯学部, 講師 (00162024)
KINOSHITA Yukihiko Kanagawa Dental Collage, Dental Medicine, Assistant Prof., 歯学部, 助教授 (70084770)
IKADA Yoshito Kyoto University, Research Center for Biomedical Engineering, Professor, 生体医療工学センター, 教授 (00025909)
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| Project Period (FY) |
1992 – 1994
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| Keywords | biomaterials / poly (L-lactide) / jowbone reconstruction / particulate cancellous bone and mallow / bone grafts / dental implants / alveolar ridge augmentation |
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| Research Abstract |
The purpose of this study is to present a new procedure for functional reconstruction of jowbone that involves the use of a newly developed poly (L-lactide) (PLLA) mesh tray and autogenous particulate cancellous boneand marrow (PCBM) grafts. PLLA monofilaments, mesh sheets and mesh cylinders filled with fresh PCBM were implanted subcutaneously into the back of 22 adult dogs and evaluated with regard to the degradation rate of the monofilaments, the tssue reaction to the mesh sheets, and the bone formation of PCBM within the mesh cylinders. After mandiblectomy, reconstruction using PLLA mesh tray and PCBM grafts and/or endosseous implants were performed in 13 adult dogs. PLLA mesh tray was fixed to the mandibular bone as 1) the concave surface of the chute was fitted to the inferior border of the mandible (U-fixation) (4 dogs), 2) the concave surface of the chute was fitted to the superior border of the mandible (inverted U-fixation) (4 dogs), or 3) a thinner type of PLLA mesh tray whic
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h had the connectors for implants was fixed as inverted U-fixation and endosseous implants were conneced to the tray (5 dogs). Follow-up periods ranged from 1 month to 1 year. The mechanical strength of PLLA monofilaments did not change for 2 months after implantation, and 80% of its initial strength was retained after 3 months. The inflammatory response to PLLA mesh sheets was slight within 2 months after implantation. Histiocytes and multinucleate giant cells appeared on the surface of filaments of the PLLA mesh sheets after 3 months and gradually increased in number as the filaments were degraded. However, almost no cellular infiltration was seen in the tissue around the PLLA mesh sheets. The bone formation within PLLA mesh cylinders reached its peak 1 month after implantation and the cylinders were nearly filled with newly formed bone. All of 4 U-fixation showed good clinical healing, and the continuity of mandible was regained within 2 months postoperatively. The boundaries between the newly formed bone and the residual bone were radiographically unclear 6 months after surgery. The alveolar ridges, however, were poorly shaped. Three of 4 inverted U-fixation showed good bony regeneration with a well-shaped alveolar ride. However, there were partial exposures of the PLLA mesh tray ; without graft resorption in one of the above 3 and with graft resorption in the remaining one. All of 5 inverted U-fixation using the thinner type of PLLA mesh tray showed good bony regeneration with a well-shaped alveolar ride, and there was not any tray exposure or infection. Two months postoperatively, all of the endosseous implants were stable. These results suggest that a combination of the PLLA mesh tray and PCBM grafts is a useful technique for jowbone reconstruction and oral rehabilitation. Less
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