Kim Ti-Sun, Knittel Markus, Dörfer Christof, Steinbrenner Harald, Holle Rolf, Eickholz Peter
Section of Periodontology, Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-Universität Heidelberg, Germany.
Int J Periodontics Restorative Dent. 2003 Oct;23(5):481-9.
The aim of the present study was to compare the efficacy of guided tissue regeneration (GTR) using two different biodegradable barriers (polylactide acetyltributyl citrate; polydioxanon) in three- and two-walled infrabony defects. The polydioxanon barrier is an experimental GTR membrane that consists of a continuous occlusive barrier with a layer of slings on the side that is meant to face the mucoperiosteal flap. Fifteen patients provided 15 pairs of similar contralateral periodontal defects: 12 predominantly two-walled and 18 predominantly three-walled infrabony defects. Each defect was randomly assigned to treatment with polylactide acetyltributyl citrate (control) or polydioxanon (test) devices. At baseline, 6, 12, 18, and 24 months after surgery, clinical measurements were performed and standardized radiographs obtained (not at 18 months). Both treatments revealed a significant Gingival Index reduction, probing depth reduction, and vertical probing attachment level gain 24 months after surgery. Both treatments showed slight resorption of the crestal alveolar ridge after 24 months, which failed to reach statistical significance. A statistically significant bone gain within the infrabony pockets was measured for both treatment options 24 months postsurgical. Regarding Gingival Index and probing depth reduction as well as vertical probing attachment level and bone gain, there were neither statistically significant nor clinically relevant differences between test and control barriers. The use of both biodegradable barriers in GTR therapy may be recommended.
本研究的目的是比较在三壁和两壁骨下袋缺损中使用两种不同的可生物降解屏障(聚丙交酯乙酰柠檬酸三丁酯;聚二氧六环酮)进行引导组织再生(GTR)的疗效。聚二氧六环酮屏障是一种实验性GTR膜,由连续的封闭屏障组成,在面向粘骨膜瓣的一侧有一层吊带。15名患者提供了15对相似的对侧牙周缺损:12个主要为两壁骨下袋缺损,18个主要为三壁骨下袋缺损。每个缺损被随机分配接受聚丙交酯乙酰柠檬酸三丁酯(对照)或聚二氧六环酮(试验)装置治疗。在基线、术后6个月、12个月、18个月和24个月时进行临床测量并获取标准化X线片(18个月时未获取)。两种治疗在术后24个月时均显示牙龈指数显著降低、探诊深度降低以及垂直探诊附着水平增加。两种治疗在24个月后均显示牙槽嵴顶有轻微吸收,但未达到统计学显著性。两种治疗方案在术后24个月时均测量到骨下袋内有统计学显著性的骨增量。关于牙龈指数、探诊深度降低以及垂直探诊附着水平和骨增量,试验组和对照组屏障之间既无统计学显著性差异,也无临床相关性差异。可以推荐在GTR治疗中使用这两种可生物降解屏障。