传统治疗和再生治疗5年后牙周缺损愈合的证据：数字减影和骨水平测量

Evidence for healing of periodontal defects 5 years after conventional and regenerative therapy: digital subtraction and bone level measurements.

作者信息

Eickholz Peter, Hausmann Ernest

机构信息

Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.

出版信息

J Clin Periodontol. 2002 Oct;29(10):922-8. doi: 10.1034/j.1600-051x.2002.291007.x.

DOI:10.1034/j.1600-051x.2002.291007.x

PMID:12445224

Abstract

OBJECTIVE

The aim of the present study was to compare radiographic assessment of bony fill by digital subtraction analyses (DSA) after periodontal surgery of infrabony and furcation defects with bone level measurements.

METHODS

For 19 patients with 19 infrabony lesions and 20 degree II furcation defects, five defects were treated conventionally and 34 defects were treated by regenerative periodontal surgery. At baseline and 60 +/- 3 months after surgery, clinical measurements (GI, PPD, PAL-V, PAL-H, PlI) and standardized radiographs were obtained. Furthermore, intrasurgically after reflection of a mucoperiosteal flap and 60 months after surgery after local anesthesia without flap reflection, the distance from the cementoenamel junction (CEJ) to bottom of the bony defect (BD) was measured vertically (PBL-V) and, in furcation defects, horizontally (PBL-H). Pre- and postsurgical radiographs were analyzed by digital subtraction. Bone level gain and DSA results were compared by simple regression analysis.

RESULTS

Surgical treatment revealed significant PPD reduction (- 3.45 +/- 1.56 mm; P < 0.001), PAL-V gain (2.84 +/- 1.36 mm; P < 0.001), and PBL-V gain (1.68 +/- 1.20 mm; P < 0.001) in infrabony defects, as well as PPD reduction (- 1.68 +/- 1.73 mm; P = 0.001) and PAL-H gain [1.43 +/- 1.70 mm (P = 0.001)] in furcation defects after 5 years. A correlation could be found in furcation defects between PBL-H gain and DSA (R2 = 0.34, P = 0.003), whereas the study failed to demonstrate a consistent correlation between PBL-V and DSA in infrabony defects (R2 = 0.12, P = 0.149).

CONCLUSIONS

DSA correlates significantly with PBL-H measurements in furcation defects. Thus, either method is a sufficient tool to evaluate bony fill within furcation defects. On the other hand, DSA did not correlate significantly with PBL-V measurements in infrabony defects. This discrepant contribution of DSA in the evaluation of these two types of defects may be explained by the fact that DSA primarily evaluates change in a buccolingual direction.

摘要

目的

本研究旨在通过数字减影分析（DSA）对骨下袋和根分叉病变牙周手术后骨填充的影像学评估与骨水平测量进行比较。

方法

对19例患有19处骨下袋病变和20处II度根分叉病变的患者，5处病变采用传统治疗，34处病变采用牙周再生手术治疗。在基线和术后60±3个月时，进行临床测量（牙龈指数、探诊深度、垂直探诊附着水平、水平探诊附着水平、菌斑指数）并获取标准化X线片。此外，在翻瓣术后手术中以及术后60个月在局部麻醉下不翻瓣时，垂直测量从牙骨质釉质界（CEJ）到骨缺损底部（BD）的距离（垂直骨袋深度），在根分叉病变中水平测量（水平骨袋深度）。术前和术后的X线片通过数字减影进行分析。通过简单回归分析比较骨水平增益和DSA结果。

结果

手术治疗显示骨下袋病变的探诊深度显著降低（-3.45±1.56mm；P<0.001），垂直探诊附着水平增加（2.84±1.36mm；P<0.001），垂直骨袋深度增加（1.68±1.20mm；P<0.001），以及根分叉病变在5年后探诊深度降低（-1.68±1.73mm；P = 0.001）和水平探诊附着水平增加[1.43±1.70mm（P = 0.001）]。在根分叉病变中可以发现水平骨袋深度增加与DSA之间存在相关性（R2 = 0.34，P = 0.003），而该研究未能证明骨下袋病变中垂直骨袋深度与DSA之间存在一致的相关性（R2 = 0.12，P = 0.149）。