Schulz A, Hilgers R D, Niedermeier W
Department of Prosthetic Dentistry, School of Dental Medicine, University of Cologne, ZMK-Klinik, Kerpener Strasse 32, 50931 Cologne, Germany.
Clin Oral Investig. 2000 Jun;4(2):98-105. doi: 10.1007/s007840050123.
The purpose of this study was to evaluate the effect of splinting teeth on the results of periodontal reconstructive surgery using a specific carbonate bone replacement graft (BRG) material. Forty-five patients were randomly treated with a periodontal surgery approach. Natural coral calcium BRG was utilised in 33 patients. This 33-patient group was divided into three equal groups. In the presplint group, teeth were splinted to at least two rigid teeth before surgery, in the postsplint group, teeth were splinted at suture removal, and in the nonsplint group, the treated teeth were not splinted at all. In 12 patients, teeth were treated with surgical debridement (DEBR) alone and not splinted. Periodontal probing depth (PPD), clinical probing attachment level (CPAL), and tooth mobility were measured using desmodontometry (DDM) and periotest (PTV) with reproducible methods before surgery and at various periods up to 1 year afterwards. A decrease in PPD (5.4 mm, SD 1.4 mm) and tooth mobility (DDM-horizontal 257 microns, SD 60 microns) and a gain of CPAL (5.1 mm, SD 1.4 mm) were seen following the use of BRG in presplint teeth. In the same group, PPD and tooth mobility were significantly reduced compared to nonsplint teeth. DEBR alone showed reductions in tooth mobility and PPD and a significantly smaller gain in CPAL than in presplint teeth treated with BRG. The less favourable improvement in periodontal function of postsplint or nonsplint teeth seemed to be due to the loss of BRG material caused by tooth mobility. These results indicate that an undisturbed wound healing process using BRG together with tooth stability is beneficial to overall clinical success.
本研究的目的是评估使用特定的碳酸盐骨替代移植物（BRG）材料对牙齿进行夹板固定对牙周重建手术结果的影响。45例患者接受了随机的牙周手术治疗。33例患者使用天然珊瑚钙BRG。这33例患者被分为三个相等的组。在术前夹板固定组中，手术前将牙齿夹板固定到至少两颗坚固的牙齿上；在术后夹板固定组中，在拆线时进行牙齿夹板固定；在非夹板固定组中，治疗的牙齿根本不进行夹板固定。12例患者仅接受手术清创（DEBR）治疗且未进行夹板固定。在手术前以及术后长达1年的不同时期，使用可重复的方法通过牙动度测量法（DDM）和牙周探针（PTV）测量牙周探诊深度（PPD）、临床探诊附着水平（CPAL）和牙齿松动度。在术前夹板固定的牙齿中使用BRG后，PPD（5.4毫米，标准差1.4毫米）和牙齿松动度（DDM-水平方向257微米，标准差60微米）降低，CPAL增加（5.1毫米，标准差1.4毫米）。在同一组中，与未夹板固定的牙齿相比，PPD和牙齿松动度显著降低。单独的DEBR显示牙齿松动度和PPD降低，并且与使用BRG治疗的术前夹板固定牙齿相比，CPAL的增加明显较小。术后夹板固定或未夹板固定牙齿的牙周功能改善较差似乎是由于牙齿松动导致BRG材料丢失所致。这些结果表明，使用BRG并保持牙齿稳定的不受干扰的伤口愈合过程有利于整体临床成功。
