脱蛋白牛骨和庆大霉素作为引导组织再生术辅助材料治疗骨内缺损的随机对照临床研究

Deproteinized bovine bone and gentamicin as an adjunct to GTR in the treatment of intrabony defects: a randomized controlled clinical study.

作者信息

Stavropoulos A, Karring E S, Kostopoulos L, Karring T

机构信息

Department of Periodontology and Oral Gerodontology, Royal Dental College, University of Aarhus, Denmark.

出版信息

J Clin Periodontol. 2003 Jun;30(6):486-95. doi: 10.1034/j.1600-051x.2003.00258.x.

DOI:10.1034/j.1600-051x.2003.00258.x

PMID:12795786

Abstract

OBJECTIVES

To evaluate whether Bio-Oss used as an adjunct to guided tissue regeneration (GTR) improves the healing of 1- or 2-wall intrabony defects as compared with GTR alone, and to examine whether impregnation of Bio-Oss with gentamicin may have an added effect.

MATERIAL AND METHODS

Sixty patients, with at least one interproximal intrabony defect with probing pocket depth (PPD) > or =7 mm and radiographic evidence of an intrabony component (IC) > or =4 mm, were treated at random with either a resorbable membrane (GTR), a resorbable membrane in combination with Bio-Oss impregnated with saline (DBB-), a resorbable membrane in combination with Bio-Oss impregnated with gentamicin (DBB+), or with flap surgery (RBF).

RESULTS

All treatment modalities resulted in statistically significant clinical improvements after 1 year. Defects treated with GTR alone presented a probing attachment level (PAL) gain of 2.9 mm, a residual PPD (PPD12) of 4.9 mm, a radiographic bone level (RBL) gain of 3.1 mm, and a residual IC (IC12) of 2.7 mm. GTR combined with Bio-Oss did not improve the healing outcome (PAL gain: 2.5 mm; PPD12: 4.9 mm; RBL gain: 2.8 mm; IC12: 3.3 mm). Impregnation of the Bio-Oss with gentamicin 2% mg/ml resulted in clinical improvements (PAL gain: 3.8 mm; PPD12: 4.2 mm; RBL gain: 4.7 mm; IC12: 2.1 mm), superior to those of the other treatment modalities, but the difference was not statistically significant. Defects treated with only flap surgery showed the most inferior clinical response (PAL gain: 1.5 mm; PPD12: 5.1 mm; RBL gain: 1.2 mm; IC12: 4.2 mm) of all groups.

CONCLUSION

The results failed to demonstrate an added effect of Bio-Oss implantation in combination with GTR on the healing of deep interproximal 1- or 2-wall, or combined 1- and 2-wall intrabony defects compared with GTR alone. Local application of gentamicin, on the other hand, improved the treatment outcome but not to an extent that it was statistically significant.

摘要

目的

评估与单纯引导组织再生术（GTR）相比，使用Bio-Oss作为引导组织再生术的辅助材料是否能改善1壁或2壁骨内缺损的愈合情况，并研究庆大霉素浸渍的Bio-Oss是否具有额外效果。

材料与方法

60例患者，至少有一处邻间骨内缺损，探诊袋深度（PPD）≥7 mm且有骨内成分（IC）≥4 mm的影像学证据，随机接受以下治疗：可吸收膜（GTR）、可吸收膜联合用生理盐水浸渍的Bio-Oss（DBB-）、可吸收膜联合用庆大霉素浸渍的Bio-Oss（DBB+）或翻瓣手术（RBF）。

结果

1年后，所有治疗方式均在临床上有统计学意义的显著改善。单纯GTR治疗的缺损处探诊附着水平（PAL）增加2.9 mm，残余PPD（PPD12）为4.9 mm，影像学骨水平（RBL）增加3.1 mm，残余IC（IC12）为2.7 mm。GTR联合Bio-Oss并未改善愈合效果（PAL增加：2.5 mm；PPD12：4.9 mm；RBL增加：2.8 mm；IC12：3.3 mm）。用2%mg/ml庆大霉素浸渍Bio-Oss在临床上有改善（PAL增加：3.8 mm；PPD12：4.2 mm；RBL增加：4.7 mm；IC12：2.1 mm），优于其他治疗方式，但差异无统计学意义。仅接受翻瓣手术治疗的缺损在所有组中临床反应最差（PAL增加：1.5 mm；PPD12：5.1 mm；RBL增加：1.2 mm；IC12：4.2 mm）。