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引导组织再生术治疗Ⅱ度根分叉病变的临床及影像学评估:一项随机临床试验

Clinical and radiographic evaluation of guided tissue regeneration in the treatment of class II furcation defects. A randomized clinical trial.

作者信息

Cury Patricia R, Jeffcoat Marjorie K, Sallum Antônio W, Cafesse Raul, Nociti Júnior Francisco H, Sallum Enilson A

机构信息

Dept. of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, University of Campinas, Piracicaba, SP, Brazil.

出版信息

Am J Dent. 2003 Sep;16 Spec No:13A-16A.

Abstract

PURPOSE

To evaluate the treatment outcomes after guided tissue regeneration (GTR) with a bioabsorbable membrane in Class II furcation defects in mandibular molars. The open flap debridement (OFD) was used as the control.

METHODS

Nine patients, with two comparable Class II furcation defects were included in the study. After initial preparation, the defects were randomly assigned in each patient to either GTR-group or OFD-group. Clinical parameters and standardized radiographs were obtained at baseline and 6 months after the surgeries. The radiographs were analyzed by subtraction radiography.

RESULTS

Comparing baseline to 6-month results, both groups showed statistically significant probing depth reduction (PD), horizontal clinical attachment level (CAL-h) gain, and increase in gingival recession (GR). The vertical clinical attachment level (CAL-v) gain was statistically significant only for the OFD-group. Comparing the two treatments, no statistically significant differences were found in PD reduction (GTR: 1.67 mm; OFD: 2.51 mm, P = 0.26), CAL-v gain (GTR: 0.62 mm; OFD: 1.16 mm, P= 0.37), and GR increase (GTR: 1.04 mm; OFD: 1.24 mm, P = 0.31). GTR provided complete closure of the furcation defect in two sites and superior horizontal clinical attachment level gain (GTR: 2.27 mm; OFD: 1.01 mm, P = 0.05). Subtraction radiography showed significant difference in bone height change between GTR-group and OFD-group (-0.14 mm and 0.86 mm, respectively; P = 0.028) at 6 months.

摘要

目的

评估在下颌磨牙Ⅱ度根分叉病变中使用可吸收生物膜引导组织再生(GTR)后的治疗效果。采用开放性龈下刮治术(OFD)作为对照。

方法

本研究纳入9例患者,每例患者均有两个可比较的Ⅱ度根分叉病变。在初始准备后,将每个患者的病变随机分为GTR组或OFD组。在基线和手术后6个月获取临床参数和标准化X线片。通过减影X线摄影分析X线片。

结果

比较基线和6个月的结果,两组的探诊深度(PD)均有统计学意义的降低、水平临床附着水平(CAL-h)增加以及牙龈退缩(GR)增加。垂直临床附着水平(CAL-v)增加仅在OFD组有统计学意义。比较两种治疗方法,在PD降低(GTR:1.67mm;OFD:2.51mm,P = 0.26)、CAL-v增加(GTR:0.62mm;OFD:1.16mm,P = 0.37)和GR增加(GTR:1.04mm;OFD:1.24mm,P = 0.31)方面未发现统计学意义上的显著差异。GTR在两个部位实现了根分叉病变的完全封闭,并在水平临床附着水平增加方面更优(GTR:2.27mm;OFD:1.01mm,P = 0.05)。减影X线摄影显示,6个月时GTR组和OFD组之间的骨高度变化存在显著差异(分别为-0.14mm和0.86mm;P = 0.028)。

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