Camargo Paulo M, Lekovic Vojislav, Weinlaender Michael, Vasilic Nikola, Madzarevic Milovan, Kenney E Barrie
School of Dentistry, University of California, Los Angeles 90095, USA.
Int J Periodontics Restorative Dent. 2005 Feb;25(1):49-59.
This study compared the clinical effectiveness of a combination therapy consisting of bovine porous bone mineral (BPBM), guided tissue regeneration (GTR), and platelet-rich plasma (PRP) in the regeneration of periodontal intrabony defects in humans. Twenty-eight paired intrabony defects were surgically treated using a split-mouth design. Defects were treated with BPBM, GTR, and PRP (experimental), or with open-flap debridement (control). Clinical parameters evaluated included changes in attachment level, pocket depth, and defect fill as revealed by reentry at 6 months. Preoperative pocket depths, attachment levels, and transoperative bone measurements were similar for the two groups. Postsurgical measurements taken at 6 months revealed that both treatment modalities significantly decreased pocket depth and increased clinical attachment and defect fill compared to baseline. The differences between the experimental and control groups were 2.22+/-0.39 mm on buccal and 2.12+/-0.34 mm on lingual sites for pocket depth, 3.05+/-0.51 mm on buccal and 2.88+/-0.46 mm on lingual sites for gain in clinical attachment, and 3.46+/-0.96 mm on buccal and 3.42+/-0.02 mm on lingual sites for defect fill. These differences between groups were statistically significant in favor of the experimental defects. The combined therapy was also clinically more effective than open-flap debridement. The superiority of the experimental group could not be attributed solely to the surgical intervention and was likely a result of the BPBM/GTR/ PRP application. Combining BPBM, GTR, and PRP was an effective modality of regenerative treatment for intrabony defects in patients with advanced periodontitis.
本研究比较了由牛多孔骨矿物质(BPBM)、引导组织再生(GTR)和富血小板血浆(PRP)组成的联合疗法在人类牙周骨内缺损再生中的临床效果。采用分口设计对28对骨内缺损进行手术治疗。缺损分别采用BPBM、GTR和PRP治疗(试验组),或采用开放瓣清创术治疗(对照组)。评估的临床参数包括6个月再次手术时显示的附着水平、牙周袋深度和缺损填充情况的变化。两组术前牙周袋深度、附着水平和术中骨测量结果相似。6个月时的术后测量结果显示,与基线相比,两种治疗方式均显著降低了牙周袋深度,增加了临床附着和缺损填充。试验组和对照组在颊侧牙周袋深度的差异为2.22±0.39mm,舌侧为2.12±0.34mm;临床附着增加在颊侧为3.05±0.51mm,舌侧为2.88±0.46mm;缺损填充在颊侧为3.46±0.96mm,舌侧为3.42±0.02mm。组间差异在统计学上有利于试验组缺损。联合疗法在临床上也比开放瓣清创术更有效。试验组的优势不能仅归因于手术干预,可能是BPBM/GTR/PRP应用的结果。联合应用BPBM、GTR和PRP是晚期牙周炎患者骨内缺损再生治疗的有效方式。