Eickholz P, Kim T S, Holle R, Hausmann E
Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University Heidelberg, Germany.
J Periodontol. 2001 Jan;72(1):35-42. doi: 10.1902/jop.2001.72.1.35.
The aim of this 5-year follow-up study was to clinically and radiographically evaluate the long-term results after guided tissue regeneration (GTR) therapy of Class II furcation defects using non-resorbable and bioabsorbable barriers.
Nine pairs of contralateral Class II furcation defects were treated in 9 patients with advanced periodontitis. Within each patient, one defect received a non-resorbable (expanded polytetrafluoroethylene [ePTFE]; control, C) barrier and the other a bioabsorbable (polyglactin 910; test, T) barrier by random assignment. At baseline, 6, and 60 +/- 3 months after surgery, clinical parameters and standardized radiographs were obtained. Gain of bone density within furcation areas was assessed using subtraction radiography.
Six and 60 months after GTR therapy, statistically significant (P <0.05) horizontal attachment (CAL-H) gain was observed in both groups (C6: 1.7 +/- 0.8 mm; C60: 1.6 +/- 1.2 mm; T6: 2.0 +/- 0.7 mm; T60: 2.2 +/- 0.9 mm). However, 1 furcation assessed as Class I six months after GTR therapy with a bioabsorbable barrier had progressed to Class III after 5 years, and in another patient, 5 years after placement of an ePTFE barrier, 1 furcation had lost all the CAL-H gain that had been observed at 6 months. Subtraction analysis revealed similar area gain in both groups 6 and 60 months postsurgically (C6: 0.3 +/- 0.5; C60 1.0 +/- 1.7; T6: 0.4 +/- 0.4; T60: 1.1 +/- 1.7).
CAL-H gain achieved after GTR therapy in Class II furcations was stable after 5 years in 16 of 18 defects. The study failed to show a statistically significant difference in stability of CAL-H gain between control and test groups 5 years after GTR therapy.
这项为期5年的随访研究旨在从临床和影像学方面评估使用不可吸收屏障和可生物吸收屏障对II度根分叉病变进行引导组织再生(GTR)治疗后的长期效果。
对9例晚期牙周炎患者的9对双侧II度根分叉病变进行治疗。在每位患者中,通过随机分配,一个病变接受不可吸收(膨体聚四氟乙烯[ePTFE];对照组,C)屏障,另一个病变接受可生物吸收(聚乙醇酸910;试验组,T)屏障。在基线、术后6个月和60±3个月时,获取临床参数和标准化X线片。使用减影X线摄影评估根分叉区域内的骨密度增加情况。
GTR治疗后6个月和60个月时,两组均观察到具有统计学意义(P<0.05)的水平附着丧失(CAL-H)改善(C6:1.7±0.8mm;C60:1.6±1.2mm;T6:2.0±0.7mm;T60:2.2±0.9mm)。然而,1例在使用可生物吸收屏障进行GTR治疗6个月后评估为I度的根分叉在5年后进展为III度,在另1例患者中,在放置ePTFE屏障5年后,1个根分叉丧失了在6个月时观察到的所有CAL-H改善。减影分析显示术后6个月和60个月时两组的面积增加相似(C6:0.3±0.5;C60 1.0±1.7;T6:0.4±0.4;T60:1.1±1.7)。
II度根分叉病变在GTR治疗后实现的CAL-H改善在18个病变中的16个在5年后是稳定的。该研究未能显示GTR治疗5年后对照组和试验组在CAL-H改善稳定性方面存在统计学意义上的显著差异。