Kim Ti-Sun, Holle Rolf, Hausmann Ernest, Eickholz Peter
Section of Periodontology, Department of Operative Dentistry and Periodontology, University Clinic of Dental Medicine Heidelberg, Germany.
J Periodontol. 2002 Apr;73(4):450-9. doi: 10.1902/jop.2002.73.4.450.
The aim of this 5-year follow-up case series was to clinically and radiographically evaluate the long-term results after guided tissue regeneration (GTR) therapy of infrabony defects using non-resorbable and bioabsorbable barriers.
In 12 patients with advanced chronic periodontitis 12 pairs of contralateral infrabony defects were treated. Within each patient one defect received a non-resorbable (expanded polytetrafluoroethylene [ePTFE]; control: C) and the other a bioabsorbable (polyglactin 910; test: T) barrier by random assignment. At baseline and at 6 and 60 +/- 3 months after surgery clinical parameters and standardized radiographs were obtained. Gain of bone density within infrabony defects was assessed using subtraction radiography.
Eight of 12 patients were available for the 60-month reexaminations. Six and 60 +/- 3 months after GTR therapy statistically significant (P < 0.05) vertical attachment (CAL-V) gain was observed in both groups (C6:2.6 +/- 1.4 mm; C60: 1.6 +/- 1.5 mm; T6:3.0+/- 1.7 mm; T60: 3.0 +/- 0.7mm). However at 60 months, 2 infrabony defects in the control group had lost all the attachment that had been gained 6 months after therapy and a clinically relevant but statistically in significant mean CAL-V loss of 1.0 +/- 2.1 mm was observed from 6 to 60 months. The case series failed to show statistically significant differences between test and control regarding CAL-V gain 60 months after surgery. Also subtraction analysis failed to reveal statistically significant differences regarding density gain between both groups 6 and 60 months postsurgically (C6: 26.4 +/- 54.2; C60 62.8 +/- 112.7; T6: 68.7 +/- 72.8; T60. 84.1 +/- 83.6).
CAL-V gain achieved after GTR therapy in infrabony defects using both non-resorbable and bioabsorbable barriers was quite stable after 5 years in 14 of 16 defects.
本5年随访病例系列的目的是从临床和影像学方面评估使用不可吸收和可生物吸收屏障对骨下袋缺损进行引导组织再生（GTR）治疗后的长期效果。
对12例晚期慢性牙周炎患者的12对双侧骨下袋缺损进行治疗。在每位患者中，一个缺损随机接受不可吸收屏障（膨体聚四氟乙烯[ePTFE]；对照组：C），另一个缺损接受可生物吸收屏障（聚乙醇酸910；试验组：T）。在基线以及术后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线摄影评估骨下袋缺损内的骨密度增加情况。
12例患者中有8例可进行60个月的复查。在GTR治疗后6个月和60±3个月时，两组均观察到具有统计学意义（P<0.05）的垂直附着水平（CAL-V）增加（C6：2.6±1.4mm；C60：1.6±1.5mm；T6：3.0±1.7mm；T60：3.0±0.7mm）。然而，在60个月时，对照组中有2个骨下袋缺损失去了治疗后6个月所获得的所有附着，并且从6个月到60个月观察到临床上有意义但无统计学意义的平均CAL-V丧失1.0±2.1mm。该病例系列未能显示术后60个月时试验组和对照组在CAL-V增加方面存在统计学显著差异。此外，减影分析也未显示术后6个月和60个月时两组在密度增加方面存在统计学显著差异（C6：26.4±54.2；C60：62.8±112.7；T6：68.7±72.8；T60：84.1±83.6）。
在16个缺损中的14个中，使用不可吸收和可生物吸收屏障对骨下袋缺损进行GTR治疗后5年，CAL-V增加相当稳定。
