Yukna Raymonda, Salinas Thomas J, Carr Ronald F
Department of Periodontics, Louisiana State University, School of Dentistry, New Orleans 70119-2799, USA.
Int J Periodontics Restorative Dent. 2002 Apr;22(2):146-55.
ABM/P-15 is a combination of a natural anorganic bovine-derived hydroxyapatite matrix (ABM) and a synthetic cell-binding peptide (P- 15; PepGen P- 15) that has shown the capacity to encourage substantial clinical fill of periodontal infrabony defects. Human histology following its use has not been evaluated on pathologic root surfaces. A maxillary lateral incisor with advanced adult periodontitis that was treatment planned for extraction was treated with sulcular incisions, full-thickness flap reflection, debridement of granulomatous tissue from the defect, placement of a notch in the root at the apical extent of calculus, mechanical root planing, brief cleansing with citric acid, grafting with ABM/P-15, wound closure with sutures, and placement of a periodontal dressing. Biweekly to monthly recalls were made until removal of a small block section biopsy at about 6 months. Histologic evaluation of the region coronal to the apical edge of the calculus notch showed evidence of regeneration (new cementum, bone, and periodontal ligament). Graft particles were still present at 6 months, but no evidence of root resorption, ankylosis, or untoward inflammation was seen. This case report fulfills the proof of principle that use of ABM/P-15 can result in periodontal regeneration on previously diseased root surfaces in humans.
ABM/P - 15是一种天然无机牛源性羟基磷灰石基质(ABM)与合成细胞结合肽(P - 15;PepGen P - 15)的组合,已显示出能够促进牙周骨下袋缺损大量临床填充的能力。其使用后的人体组织学情况尚未在病理性牙根表面进行评估。对一颗计划拔除的患有晚期成人牙周炎的上颌侧切牙进行治疗,包括龈沟切口、全厚瓣翻瓣、清除缺损处的肉芽组织、在牙石根尖范围的牙根处刻痕、机械性牙根平整、用柠檬酸短暂冲洗、用ABM/P - 15移植、缝合伤口闭合以及放置牙周敷料。每两周至每月进行复查,直至约6个月时切除小块组织活检。对牙石刻痕根尖边缘上方区域的组织学评估显示有再生迹象(新牙骨质、骨和牙周膜)。6个月时移植颗粒仍存在,但未见牙根吸收、牙根粘连或不良炎症的迹象。本病例报告证实了使用ABM/P - 15可在人类先前患病的牙根表面实现牙周再生这一原理。