Paolantonio Michele
University G. D'Annunzio, Chieti School of Dentistry, Department of Periodontology, Italy.
J Periodontol. 2002 Feb;73(2):158-66. doi: 10.1902/jop.2002.73.2.158.
Combined periodontal regenerative technique (CPRT) is a surgical procedure that combines the use of barrier membranes with a filling material in the treatment of periodontal defects. The effectiveness of CPRT has been evaluated in many studies in comparison to GTR with membranes alone, but conflicting results have been obtained by different clinicians, particularly in the treatment of intrabony defects. The aim of the present study was to compare CPRT to GTR with collagen membranes in the treatment of human intrabony defects characterized by a relevant 1-wall component.
Thirty-four (34) healthy, non-smoking patients affected by moderate to severe chronic periodontitis participated in this study. Each patient had good oral hygiene and at least 1 radiographically detectable intrabony defect > or = 4 mm, with a 1-wall component of at least 50% of the defect, involving 2 tooth surfaces or more with a probing depth (PD) > or = 6 mm. Seventeen (17) subjects were randomly assigned to the test group and underwent CPRT by anorganic bovine bone and a collagen membrane, and 17 randomly assigned to the control group who received GTR with a collagen membrane alone. Pre- and post-therapy clinical parameters (probing depth [PD]; clinical attachment level [CAL]; gingival recession [GR]) and intrasurgical parameters (depth of intraosseous component [IOC]; level of the alveolar crest [ACL]) were compared between test and control groups 1 year after treatment. Vertical bone gain (VBG) from the base of the defect to the cemento-enamel junction was also evaluated in both groups.
At the 1-year examination, clinical and intrasurgical parameters showed statistically significant changes within each experimental group from baseline. A statistically greater CAL gain was reported in the test group (P<0.05), whereas the control group exhibited more GR and alveolar crest resorption at a statistically significant level (P<0.01). VBG was significantly greater (P<0.01) at test sites (5.23 +/- 1.30 mm) compared to controls (3.82 +/- 1.28 mm).
The results suggest that the use of CPRT may be preferred when bioabsorbable membranes are used to treat intrabony defects characterized by unfavorable architecture.
联合牙周再生技术（CPRT）是一种在牙周缺损治疗中联合使用屏障膜和填充材料的外科手术。与仅使用膜的引导组织再生术（GTR）相比，许多研究已对CPRT的有效性进行了评估，但不同临床医生得到了相互矛盾的结果，尤其是在骨内缺损的治疗中。本研究的目的是比较CPRT与使用胶原膜的GTR在治疗以相关单壁成分为特征的人类骨内缺损中的效果。
34名患有中度至重度慢性牙周炎的健康、不吸烟患者参与了本研究。每位患者口腔卫生良好，至少有1个在X线片上可检测到的骨内缺损≥4mm，单壁成分占缺损的至少50%，累及2个或更多牙面，探诊深度（PD）≥6mm。17名受试者被随机分配到试验组，接受用无机牛骨和胶原膜进行的CPRT，17名随机分配到对照组，仅接受使用胶原膜的GTR。在治疗1年后，比较试验组和对照组的治疗前和治疗后临床参数（探诊深度[PD]；临床附着水平[CAL]；牙龈退缩[GR]）和手术中参数（骨内成分深度[IOC]；牙槽嵴水平[ACL]）。还评估了两组从缺损底部到牙骨质-釉质界的垂直骨增量（VBG）。
在1年检查时，每个试验组的临床和手术中参数与基线相比均有统计学上的显著变化。试验组报告的CAL增加在统计学上更显著（P<0.05），而对照组在统计学显著水平上表现出更多的GR和牙槽嵴吸收（P<0.01）。与对照组（3.82±1.28mm）相比，试验部位的VBG显著更大（P<0.01）（5.23±1.30mm）。
结果表明，当使用生物可吸收膜治疗以结构不利为特征的骨内缺损时，CPRT可能是更优选择。
