Lekovic V, Camargo P M, Weinlaender M, Vasilic N, Djordjevic M, Kenney E B
School of Dentistry, University of California, Los Angeles 90095, USA.
J Periodontol. 2001 Sep;72(9):1157-63. doi: 10.1902/jop.2000.72.9.1157.
Enamel matrix derivative (EMD) and autologous fibrinogen/fibronectin system (AFFS) are agents that have been shown to be effective in periodontal regeneration. Their use in combination with graft materials, however, has not been extensively examined. The purpose of this study was to compare the clinical effectiveness of bovine porous bone mineral (BPBM) used in combination with an EMD or in combination with AFFS as regenerative treatments for periodontal intrabony defects in humans.
Twenty-three paired intrabony defects were surgically treated using a split mouth design. Defects were treated with BPBM either combined with EMD (BPBM/EMD) or with AFFS (BPBM/AFFS). The clinical parameters evaluated included changes in attachment level, probing depth, and defect fill as revealed by re-entry surgeries at 6 months.
Preoperative probing depths, attachment levels, and transoperative bone measurements were similar for the 2 treatment groups. Postsurgical measurements taken at 6 months revealed that both treatment modalities resulted in clinically and statistically significant improvements in probing depth resolution, clinical attachment gain, and defect fill as compared to baseline. Both therapy modalities improved clinical parameters as compared to baseline, but the differences found between the groups were not statistically significant.
The results of this study indicate that EMD and AFFS used in combination with BPBM have similar effects in promoting probing depth reduction, clinical attachment gain, and defect fill when employed as regenerative therapy for intraosseous lesions in humans. A study involving a larger sample size is necessary to statistically confirm the equivalence between the 2 treatment modalities.
釉基质衍生物（EMD）和自体纤维蛋白原/纤连蛋白系统（AFFS）已被证明在牙周组织再生中有效。然而，它们与移植材料联合使用的情况尚未得到广泛研究。本研究的目的是比较牛多孔骨矿物质（BPBM）与EMD联合使用或与AFFS联合使用作为人类牙周骨内缺损再生治疗的临床效果。
采用双侧对照设计对23对骨内缺损进行手术治疗。缺损分别用BPBM与EMD联合（BPBM/EMD）或与AFFS联合（BPBM/AFFS）进行治疗。评估的临床参数包括6个月时再次手术显示的附着水平、探诊深度和缺损填充情况的变化。
两个治疗组术前的探诊深度、附着水平和术中骨测量结果相似。6个月时的术后测量显示，与基线相比，两种治疗方式在探诊深度改善、临床附着获得和缺损填充方面均有临床和统计学意义上的显著改善。与基线相比，两种治疗方式均改善了临床参数，但两组之间的差异无统计学意义。
本研究结果表明，EMD和AFFS与BPBM联合使用作为人类骨内病变的再生治疗时，在促进探诊深度降低、临床附着获得和缺损填充方面具有相似的效果。需要进行一项样本量更大的研究来从统计学上确认这两种治疗方式之间的等效性。
