JP2001511677A - Bone graft - Google Patents

Abstract

  (57) [Summary] The present invention relates to implants for guided or controlled bone tissue regeneration. The implant is essentially a three-dimensional material that can attach bone cells to it or can be modified to attach them to it, allowing the cells to grow in more than one layer. It consists of a three-dimensional material in a possible form. According to the invention, the material consists essentially of a biocompatible fiber material.

Description

DETAILED DESCRIPTION OF THE INVENTION Bone Graft The present invention relates to a graft for guided or controlled bone regeneration. Guided tissue regeneration is a known technique for making new periodontal attachments to actual teeth. This technique is based on the assumption that only some of the jaw cell types have a positive effect on the formation of supporting tissue, while others have a negative effect. The latter, ie, epithelium, connective tissue and bone cells, should not reach the teeth, whereas the former should allow almost free access to the teeth from the periodontal ligament. A "cell-tight" filter or membrane placed near the teeth is used to keep unwanted cells apart. The soft film is applied to or adheres to the teeth. A commonly used membrane consists of expanded PTFE and is sold under the trade name GORE periodontal membrane [Gottlow et al. Clin. Pe riodontology 1984; 9: 494-503, Pontoriero R. J. et al. Clin. Periodontology 1988; 15: 247-254, Pontrylo R. J. et al. Clin. Periodontology 1989; 16: 170-174; Et al., 1986; 13: 604-616, Becker W. et al. Et al., Int. G. Periodont. Rest. Dent. 1988; 3: 2-16]. This technique, when modified, is said to be useful in connection with fixtures. A flat membrane is applied over the fixture, below the flap [Dahlin et al., Int. J. Oral Maxillofac. Implants 1989; 4 (1): 19-25, Becker W. Et al., Int. J. Periodont. Rest. Dent. 1990; 10: 93-102]. However, it has been found that this technique does not provide satisfactory regeneration of bone tissue. As described in the patent publication PCT / SE91 / 00216, a soft cell-tight membrane allows the fixture to continuously regenerate bone tissue, ie from the surrounding bone level (up). It has been found to be inappropriate for coronal regeneration. Instead, jaw cells, previously thought to be disadvantageous for bone tissue regeneration, have in fact proved to be very advantageous in this way. Therefore, bone cells from the periosteum and epiphysis should be able to reach the surgical area around the fixture. This accessibility can be caused by the rigidity and holes of the device according to this patent publication. This technology is described in The International Journal of Oral and Maxillofacial Implants (1995), Vol. S.1 It is also described in the literature by Jovanovic et al. According to this document, coronary bone formation is exemplified by membrane implantation treatment in a dog model. Bone formation has been obtained by using a reinforced e-PTFE membrane using titanium. These membranes retained their original morphology during the study, providing more room for clot stabilization and resulting in more bone than with standard membranes. It has now been found that replacing the net used in the literature by Jovanovic et al. With a fibrous material, preferably in the form of wool, provides a sufficiently stiff and space-giving ability. WO 9007308 describes a barrier which may be in the form of a fibrous material. This barrier is intended for the regeneration of bone-supporting tissue, and predictable healing, including firstly periodontal ligament tissue, secondly surrounding alveolar bone tissue, thirdly gingival connective tissue and epithelial regeneration It is said to give results. For example, it is essential to use a barrier in combination with a separating means including a ridge. It is further recommended that the barrier be made of a biodegradable material. In contrast to this known material, which gives special healing results of different cells, the fibrous material according to the invention mainly or essentially induces or regulates the regeneration or growth of only bone cells in the surgical intervention area It is intended to be used as a transplant tissue for the purpose. According to the patent WO 90007308, the kind of separating means required is unnecessary. Furthermore, according to the invention, the induced growth or regeneration of bone cells is determined by the shape and material of the implant and depends on the injury to be treated. In practice, the shape of the implant is determined by the person performing the surgery. The novel implant according to the present invention consists essentially of a porous, biocompatible, non-biodegradable (non-biodegradable) material that forms a three-dimensional space, the material comprising bone cells. It can be attached to it or modified so that the cells attach to it, in a form that allows the cells to grow three-dimensionally. It is essential that this material be fibrous, preferably in the form of wool. Particularly preferred forms are wool, thread or pad, which can be easily made by the surgeon to the desired shape. The novel material according to the invention should be strong enough to withstand the pressure prevailing in the region of the body into which it is inserted and have a suitable porosity. The actual diameter of the fiber will vary depending on the body part and the required strength. Usually this diameter is smaller than 1 mm, preferably smaller than 0.5 mm, most preferably 0. Less than 1 mm. Regarding porosity, it is clear that the higher the porosity, the more bone cells will form in the space of the implant. However, too high a porosity reduces the ability of the implant to withstand the pressure exerted by adjacent tissue. On the other hand, if a drilling operation has to be performed in the newly formed bone, for example to fix a screw, the porosity should not be too low. Thus, the optimal porosity depends on where the fiber material is used and can be easily determined by one skilled in the art. The novel biocompatible implant preferably comprises titanium or titanium-coated fibers. Preferably, the fibers are in the form of titanium wool. Another type of material is a ceramic material. In addition, the novel materials can be provided in the form of threads or pads, which are optionally at least partially provided by a film or membrane of polylactic acid, for example, to avoid inadvertent penetration of fibers through the mucous membrane. May be coated. Compared to the devices known from PCT / SE91 / 00216 and the above-mentioned document by Jabanovic et al., The device according to the invention offers several advantages. That is, the new device can be obtained in almost any form and can be more or less tailored to the intended use. The new material provides an increased surface for rapid bone regeneration, thereby increasing bone cell proliferation, as newly formed bone cells have been shown to have a tendency to bulge on surfaces. Another advantage is that the equipment can be made without the need for expensive manufacturing equipment. Another advantage relates to the ability to bind bone morphological proteins (BMPs) to the fibers according to the invention. The novel device is also useful in areas other than dental prostheses where there is a problem replacing skeletal parts that have lost their original configuration. After a traffic accident, crushed or depressed skeletal parts of the face must be repaired, and bone regeneration treatment requires surgical removal of skeletal parts that need to be replaced from time to time. The method using the transplanted tissue is described below. The area where the implant is to be implanted is first exposed by lifting one or two separate mucoperiosteal flaps. Drill fine holes (0.5-1 mm in diameter) in the bone tissue and drill holes in the dense bone wall to facilitate bleeding into the injured area. This technician improves the bone regeneration process in the area to be regenerated. The surgeon examines the area and selects the appropriate implant size. Thereafter, the implant is trimmed to conform to the defect morphology. If necessary, the implant is fixed to the bone. For example, this can be done differently with small screws. Trim the soft tissue and place it over the implant so that it is completely covered by the valve. The valve is sutured and the area is left to treat. During the treatment phase, the area should be protected against external forces. This means that if the implant is used in the mouth, it is better not to have removable dentures during the treatment phase.

Claims (1)

[Claims]   1. Porous biocompatible materials forming a three-dimensional space that is essentially non-biodegradable Is a new implant that consists essentially of In a form that can be denatured so that the cells can adhere to it, Moreover, bone cells can be grown mainly three-dimensionally, essentially from fiber material. The above transplant.   2. The fiber material of claim 1, wherein the fiber material consists essentially of titanium or titanium-coated fibers. Transplant tissue.   3. 2. The method of claim 1, wherein the bioresorbable membrane is at least partially covered by the bioresorbable membrane. Transplant tissue.   4. 4. A titanium wool thread or pad in the form of one of claims 1-3. 3. The transplanted tissue according to 1.   5. The transplant according to any one of claims 1 to 4, further comprising a bone morphological factor.   6. This is a method of using a transplant that can mainly grow bone cells three-dimensionally. Thus, the implant is a porous biomaterial that forms a three-dimensional space that is essentially non-biodegradable. Consists essentially of a biocompatible material, and the implant attaches the bone cells to it Morphology or morphology in which those cells can be denatured to allow them to attach to them The use as described above, wherein the method consists essentially of a fibrous material.   7. Growing bone tissue in a method for providing selective regeneration or growth of bone tissue A defined place for surgery is provided by surgical intervention; three that are essentially non-biodegradable An implant consisting essentially of a porous biocompatible material that forms a three-dimensional space In a form that allows bone cells to attach to it, or so that the cells can attach to it. The implant, which has a morphologically compatible form and consists essentially of a fibrous material, is selected The soft tissue is trimmed, and then the soft tissue is sutured. Thereafter, the soft tissue is placed over the implant in a manner that completely covers the implant. The above method, characterized in that: