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使用生物可吸收胶原膜的根分叉治疗:一项临床试验。

Furcation therapy with bioabsorbable collagen membrane: a clinical trial.

作者信息

Pruthi Vijay K, Gelskey Shirley C, Mirbod Sayed M

机构信息

Department of Dental Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

J Can Dent Assoc. 2002 Nov;68(10):610-5.

Abstract

This study compared the effectiveness of 2 barrier membranes, expanded polytetrafluoroethylene (e-PTFE) and collagen, in treating Class II furcation defects of mandibular molars in humans. Seventeen nonsmoking subjects with no history of systemic disease each presenting with Class II furcation defects in 2 mandibular molars were selected and underwent initial therapy. At the time of the surgery and at 8-month follow-up, soft-tissue measurements consisting of the gingival index, vertical and horizontal probing depth, recession and clinical attachment level were obtained at the midfurcation level. At the time of membrane placement and at 12-month re-entry, horizontal midfurcation probing depth and hard-tissue measurement of vertical fill (from the crown to the depth of the pocket) were also obtained. According to the surgical protocol, both membranes were completely covered with a coronally positioned flap, and in all cases healing was uneventful. Data were analyzed first by comparing baseline measurements (at surgery) with measurements at 8-month follow-up and 12-month re-entry for both e-PTFE and collagen membranes according to repeated-measures analysis of variance. The changes from surgery to follow-up and re-entry were then compared between the 2 treatment modalities with paired Wilcoxon rank-sum tests. No statistically significant differences were found between e-PTFE and collagen membranes with respect to gingival index, reduction in probing depth, gain in clinical attachment or filling of the horizontal defect. However, the improvement in vertical fill at 12-month re-entry was more substantial for the teeth treated with collagen membrane than those treated with e-PTFE (p < 0.05). Within the limits of this study, it appears that collagen is a beneficial material for regenerative therapy of Class II furcation defects in humans, yielding results that are similar to or better than (vertical fill) those for e-PTFE membrane.

摘要

本研究比较了两种屏障膜,即膨体聚四氟乙烯(e-PTFE)和胶原,在治疗人类下颌磨牙Ⅱ度根分叉病变中的有效性。选取了17名无全身疾病史的非吸烟受试者,每人下颌的两颗磨牙均患有Ⅱ度根分叉病变,并接受了初始治疗。在手术时以及8个月随访时,于根分叉中部水平获取软组织测量数据,包括牙龈指数、垂直和水平探诊深度、牙龈退缩及临床附着水平。在放置膜时以及12个月再次手术时,还获取了根分叉中部水平的水平探诊深度以及垂直填充(从牙冠到袋底深度)的硬组织测量数据。根据手术方案,两种膜均完全被冠向复位瓣覆盖,所有病例愈合均顺利。首先根据重复测量方差分析,比较e-PTFE膜和胶原膜在基线测量值(手术时)与8个月随访及12个月再次手术时测量值之间的差异,对数据进行分析。然后使用配对Wilcoxon秩和检验比较两种治疗方式从手术到随访及再次手术时的变化。在牙龈指数、探诊深度减少、临床附着增加或水平缺损填充方面,e-PTFE膜和胶原膜之间未发现统计学上的显著差异。然而,在12个月再次手术时,用胶原膜治疗的牙齿垂直填充改善程度比用e-PTFE膜治疗的牙齿更显著(p < 0.05)。在本研究的范围内,似乎胶原是人类Ⅱ度根分叉病变再生治疗的有益材料,其产生的结果与e-PTFE膜相似或更好(垂直填充方面)。

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