Harrel Stephen K, Wilson Thomas G, Nunn Martha E
Private practice and Baylor College of Dentistry, Dallas, TX 75229, USA.
J Periodontol. 2005 Mar;76(3):380-4. doi: 10.1902/jop.2005.76.3.380.
Minimally invasive surgery (MIS) is a surgical technique using very small incisions, indicated for performing regenerative therapy in periodontal defects. Enamel matrix proteins (EMP) have been shown to enhance periodontal regeneration. This study was undertaken to determine the effect of using EMP in combination with an MIS approach.
Patients from two private periodontal practices with chronic periodontitis who, following non-surgical therapy, had one or more sites with probing depths (PD) of > or =6 mm were included in the study. An MIS approach was utilized for surgical access. Following surgical debridement, EMP was placed into the bony defect. The surgical sites were reevaluated after at least 11 months.
Surgical treatment was performed at 160 sites in 16 patients. No significant differences were noted in the results between the two offices and the data were combined. Mean PD reduction (P = 0.002) and attachment level improvements (P = 0.012) were significantly greater than 3 mm with mean post-surgical PD of 3.17 mm and attachment levels of 4.05 mm, based on subject means. Mean change in recession following surgery was negligible (0.01 mm). All sites were considered to be clinically successful.
The combination of MIS and EMP yields significant reductions in probing depths and improvements in attachment levels while producing little or no increase in recession.
微创手术（MIS）是一种采用非常小切口的手术技术，适用于牙周缺损的再生治疗。釉基质蛋白（EMP）已被证明可促进牙周再生。本研究旨在确定EMP与MIS方法联合使用的效果。
来自两家私人牙周诊所的慢性牙周炎患者，在接受非手术治疗后，有一个或多个探诊深度（PD）≥6mm的部位被纳入研究。采用MIS方法进行手术入路。手术清创后，将EMP放入骨缺损处。至少11个月后对手术部位进行重新评估。
对16例患者的160个部位进行了手术治疗。两个诊所的结果未发现显著差异，因此将数据合并。基于受试者均值，平均PD减少量（P = 0.002）和附着水平改善量（P = 0.012）显著大于3mm，术后平均PD为3.17mm，附着水平为4.05mm。术后退缩的平均变化可忽略不计（0.01mm）。所有部位均被认为临床成功。
MIS与EMP联合使用可显著降低探诊深度，改善附着水平，同时退缩增加很少或没有增加。
