Blumenthal Neil M, Alves Mario E A F, Al-Huwais Salah, Hofbauer Ann Marie, Koperski Rebecca D
Department of Periodontics, University of Illinois at Chicago, College of Dentistry, Chicago, IL 60612, USA.
J Periodontol. 2003 Jan;74(1):10-24. doi: 10.1902/jop.2003.74.1.10.
In an effort to regenerate periodontal intrabony defects, the healing potential of the defect should determine what therapeutic modalities and materials are employed. The purpose of this study was to compare regenerative outcomes in baboon intrabony defects that were contained versus non-contained, using various regenerative therapies.
Nine adult baboons (Papio anubis) in good health were treated. Eighty-six interproximal, intrabony defects were surgically created: 43 contained by 3 walls of bone; 43 non-contained with a missing buccal wall. Chronicity and plaque accumulation were encouraged with wire ligature placement for 8 weeks. After ligature removal, scaling, and a 2- to 4-week healing period, the defects were treated with the following therapies: collagen membrane (GTR), human demineralized freeze-dried bone (DFDB) grafting (BG), combined therapy (GTR + BG) and a DFDB-glycoprotein sponge matrix (MAT). Clinical healing responses were evaluated in 58 sites by changes in soft tissue (recession, probing, clinical attachment) and hard tissue (resorption, defect fill) parameters 6 months post-treatment. Histologic evaluation (defect regeneration, connective tissue attachment, epithelial migration) was done on 26 sites.
For contained defects, no real significant clinical (ANOVA) or histologic differences existed among treatments. However, for non-contained defects, combined therapy (GTR + BG) demonstrated clinically significant (P < or = 0.05, ANOVA) and histologically superior healing results over the other therapies tested.
These results confirm a defect morphology directed rationale for periodontal intrabony therapy.
为了使牙周骨内缺损再生，缺损的愈合潜力应决定采用何种治疗方式和材料。本研究的目的是使用各种再生疗法，比较狒狒骨内缺损在有骨壁包绕与无骨壁包绕情况下的再生效果。
对9只健康成年狒狒（埃及狒狒）进行治疗。通过手术制造了86个邻间骨内缺损：43个有三面骨壁包绕；43个无骨壁包绕，颊侧骨壁缺失。通过放置钢丝结扎8周来促进慢性炎症和菌斑堆积。去除结扎丝、进行洁治并经过2至4周的愈合期后，对缺损采用以下疗法进行治疗：胶原膜（引导组织再生术）、人脱矿冻干骨（DFDB）移植（骨移植）、联合疗法（引导组织再生术 + 骨移植）和DFDB - 糖蛋白海绵基质（基质）。在治疗后6个月，通过软组织（退缩、探诊、临床附着）和硬组织（吸收、缺损填充）参数的变化，对58个部位的临床愈合反应进行评估。对26个部位进行了组织学评估（缺损再生、结缔组织附着、上皮迁移）。
对于有骨壁包绕的缺损，各治疗组之间在临床（方差分析）或组织学上均无显著差异。然而，对于无骨壁包绕的缺损，联合疗法（引导组织再生术 + 骨移植）在临床上显示出显著（P≤0.05，方差分析）且在组织学上优于其他测试疗法的愈合效果。
这些结果证实了牙周骨内治疗基于缺损形态的治疗原理。
