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使用实验性生物可吸收聚二氧杂环己酮(PDS)膜引导骨内缺损的组织再生。一项为期24个月的半口研究。

Guided tissue regeneration in intrabony defects using an experimental bioresorbable polydioxanon (PDS) membrane. A 24-month split-mouth study.

作者信息

Christgau M, Bader N, Felden A, Gradl J, Wenzel A, Schmalz G

机构信息

Department of Operative Dentistry and Periodontology, University of Regensburg, Regensburg, Germany.

出版信息

J Clin Periodontol. 2002 Aug;29(8):710-23. doi: 10.1034/j.1600-051x.2002.290808.x.

Abstract

AIM

The comparison of the clinical, radiographic, and microbiological healing results in deep intrabony defects following GTR therapy with two different bioresorbable membranes in a prospective split-mouth design.

MATERIAL AND METHODS

31 pairs of contralateral intrabony defects were randomly treated with either an experimental Polydioxanon (PDS) membrane or a Polylactic acid (PLA) matrix barrier. After 6, 12 and 24 months, healing results were assessed using clinical examinations (REC, PPD, CAL, vertical relative attachment gain V-rAG), quantitative digital subtraction radiography (amount and area of bone density changes), and microbiological analysis.

RESULTS

Postoperative membrane exposures occurred in 14 PDS and 2 PLA treated sites. 6, 12 and 24 months p.o., both membranes provided a significant gain in CAL [median values: 6 months (PDS vs. PLA: 3.0 vs. 3.0 mm); 12 and 24 months (PDS vs. PLA: 4.0 vs. 4.0 mm)], which corresponded to a V-rAG of 57.1% (PDS) vs. 62.5% (PLA) after 24 months. PDS and PLA treated sites revealed significant bone density gain 6, 12 and 24 months after surgery. 38.8% (PDS) vs. 41.8% (PLA) of the initial defect areas showed bone density gain. While the gain in bone density was significantly greater in PDS than in PLA sites, neither CAL gain nor the area of bone density changes revealed significant differences. Microbiological culture revealed similar bacterial loads in PDS and PLA sites during the first 12 months.

CONCLUSION

This 24-month study indicates that the PDS and PLA membranes can provide similar favorable regeneration results in deep intrabony periodontal defects, although considerably more postoperative membrane exposures have to be expected in PDS treated sites.

摘要

目的

采用前瞻性双侧对照设计,比较两种不同生物可吸收膜引导组织再生(GTR)治疗后深部骨内缺损的临床、影像学及微生物学愈合结果。

材料与方法

31对双侧骨内缺损随机采用实验性聚二氧六环酮(PDS)膜或聚乳酸(PLA)基质屏障进行治疗。在6、12和24个月后,通过临床检查(REC、PPD、CAL、垂直相对附着获得量V-rAG)、定量数字减影放射摄影(骨密度变化的量和面积)及微生物学分析评估愈合结果。

结果

术后14个接受PDS治疗的部位和2个接受PLA治疗的部位出现膜暴露。术后6、12和24个月,两种膜均使临床附着水平(CAL)显著增加[中位数:6个月(PDS与PLA:3.0对3.0mm);12和24个月(PDS与PLA:4.0对4.0mm)],24个月后对应的垂直相对附着获得量(V-rAG)为PDS组57.1%,PLA组62.5%。PDS和PLA治疗部位在术后6、12和24个月骨密度均显著增加。初始缺损面积的38.8%(PDS)对41.8%(PLA)显示骨密度增加。虽然PDS治疗部位的骨密度增加显著大于PLA治疗部位,但CAL增加量和骨密度变化面积均未显示出显著差异。微生物培养显示,在最初12个月内,PDS和PLA治疗部位的细菌载量相似。

结论

这项为期24个月的研究表明,PDS和PLA膜在深部骨内牙周缺损中可提供相似良好的再生结果,尽管预计PDS治疗部位术后膜暴露会更多。

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