Sallum Enilson A, Pimentel Suzana P, Saldanha Juliana B, Nogueira-Filho Getúlio R, Casati Marcio Z, Nociti Francisco H Júnior, Sallum Antonio Wilson
Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, São Paulo, Brazil.
J Periodontol. 2004 Oct;75(10):1357-63. doi: 10.1902/jop.2004.75.10.1357.
The goal of this investigation was to histologically and histometrically evaluate the healing process of dehiscence-type defects treated by enamel matrix derivative (EMD) and/or guided tissue regeneration (GTR).
Seven mongrel dogs were used. Buccal osseous dehiscences were surgically created on the mesial roots of the mandibular third and fourth premolars. The defects were exposed to plaque accumulation for 3 months. After this period, the defects were randomly assigned to one of the treatments: open flap debridement (OFD), enamel matrix derivative (EMD), GTR with bioabsorbable membrane (GTR), and the combination of both procedures (EMD + GTR). After 4 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included gingival recession, epithelial length, connective tissue adaptation, new cementum, and new bone.
A superior length of new cementum was observed in the sites treated by EMD (3.7 mm) and EMD + GTR (3.8 mm) in comparison with OFD (2.4 mm) (P < 0.05). No statistically significant differences were found in the remaining histometric parameters.
Within the limits of this study, it can be concluded that EMD alone or in combination with GTR barriers may effectively promote new cementum formation. The combination of both therapies may not provide additional benefits.
本研究的目的是从组织学和组织计量学角度评估釉基质衍生物(EMD)和/或引导组织再生(GTR)治疗裂开型缺损的愈合过程。
使用7只杂种犬。在下颌第三和第四前磨牙的近中根上手术制造颊侧骨缺损。使缺损暴露于菌斑积聚3个月。在此期间后,将缺损随机分配至以下治疗之一:开放瓣清创术(OFD)、釉基质衍生物(EMD)、使用可生物吸收膜的引导组织再生术(GTR)以及两种方法联合使用(EMD + GTR)。愈合4个月后,处死犬只并处理组织块。评估的组织计量学参数包括牙龈退缩、上皮长度、结缔组织适应性、新牙骨质和新骨。
与OFD组(2.4 mm)相比,在接受EMD治疗的部位(3.7 mm)和EMD + GTR治疗的部位(3.8 mm)观察到新牙骨质长度更长(P < 0.05)。在其余组织计量学参数方面未发现统计学上的显著差异。
在本研究的范围内,可以得出结论,单独使用EMD或与GTR屏障联合使用可有效促进新牙骨质形成。两种治疗方法联合使用可能不会带来额外益处。