Stoller N H, Johnson L R, Garrett S
Department of Surgical Dentistry, University of Colorado School of Dentistry, Denver 80262, USA.
J Periodontol. 2001 Feb;72(2):238-42. doi: 10.1902/jop.2001.72.2.238.
This case report describes human histologic data of periodontal regeneration following guided tissue regeneration therapy (GTR) with a bioabsorbable barrier composed of polylactic acid. The tooth that was examined was part of a previously published study of the clinical effects of GTR therapy without the use of bone or bone substitutes on Class II furcation defects. Twenty-five months following the surgical procedure, the tooth was extracted for non-periodontal reasons. During this extraction, the bone within the furcation that was treated in the study was luxated with the tooth. At the completion of the study (month 12), the furcation's vertical probing depth had decreased by 2 mm with a 2 mm gain in clinical attachment. The horizontal furcation measurement decreased by 3 mm. Following extraction, the tooth was prepared for light microscopy and sectioned in the mesial-distal plane. Reference notches were not placed in the tooth at the time of surgery as there were no plans to perform histologic analysis in the study. However, using the buccal root prominences and what we interpreted to be root planing marks on the cementum, we were able to demonstrate that complete periodontal regeneration occurred on the root surface that was exposed to the pocket environment prior to surgery. New alveolar bone, cementum, and periodontal ligament were consistently observed throughout the furcation in the areas that demonstrated clinical attachment gain and a decrease in horizontal probing depth. This case report adds to the accumulating evidence of histologic periodontal regeneration following guided tissue regeneration with bioabsorbable polylactic acid barriers.
本病例报告描述了使用由聚乳酸制成的生物可吸收屏障进行引导组织再生治疗(GTR)后牙周再生的人体组织学数据。所检查的牙齿是先前发表的一项关于GTR治疗对II类根分叉病变不使用骨或骨替代物的临床效果研究的一部分。手术25个月后,该牙齿因非牙周原因被拔除。在拔牙过程中,研究中治疗的根分叉内的骨与牙齿一起脱位。在研究结束时(第12个月),根分叉的垂直探诊深度减少了2毫米,临床附着增加了2毫米。根分叉水平测量减少了3毫米。拔牙后,将牙齿制备用于光学显微镜检查,并在近远中平面进行切片。由于研究中没有进行组织学分析的计划,手术时未在牙齿上放置参考缺口。然而,利用颊侧牙根突出以及我们认为是牙骨质上的根面平整痕迹,我们能够证明在手术前暴露于牙周袋环境的根表面发生了完全的牙周再生。在显示临床附着增加和水平探诊深度减少的区域,在整个根分叉中始终观察到新的牙槽骨、牙骨质和牙周膜。本病例报告进一步积累了使用生物可吸收聚乳酸屏障进行引导组织再生后组织学牙周再生的证据。