Aimetti M, Romano F, Pigella E, Pranzini F, Debernardi C
Department of Biomedical Sciences and Human Oncology, Section of Periodontology, University of Turin, Turin, Italy.
J Periodontol. 2005 Aug;76(8):1354-61. doi: 10.1902/jop.2005.76.8.1354.
The regenerative therapy of non-contained intrabony defects achieves better results when bioabsorbable membranes are combined with a filling material. The purpose of the present study was to analyze clinical and radiographic effectiveness of a space-making bioabsorbable membrane in the treatment of wide and shallow intrabony defects characterized by a relevant 1-wall component.
Eighteen pairs of angular bone defects were selected in 18 healthy, non-smoking patients (age range 30 to 66 years). Prior to the surgical phase, patients were enrolled in a strict periodontal program including oral hygiene instructions and scaling and root planing (presurgical full-mouth plaque score <10%). Using a split-mouth design, 18 sites were randomly assigned to receive guided tissue regeneration (GTR) using a bioabsorbable membrane (test group) and 18 to receive open flap debridement alone (control group). Clinical treatment outcome was evaluated 12 months postoperatively for changes in probing depth (PD), clinical attachment level (CAL), and position of gingival margin (REC) and radiographically for bone changes.
Open flap debridement and GTR yielded statistically significant (P<0.0001) PD reduction (2.39+/- 0.92 mm and 3.44+/- 0.78 mm), CAL gain (1.50+/- 0.99 mm and 2.89 +/- 0.90 mm), increased REC (-0.89 +/- 0.58 mm and -0.56 +/- 0.92 mm) and bone fill (1.05+/- 0.94 mm and 2.13+/- 1.21 mm) when 12-month data were compared to baseline. The differences between test and control groups were statistically significant for all parameters (P<0.007) except for REC (P=0.25).
The use of this bioabsorbable membrane would seem to be effective in the treatment of intrabony defects with unfavorable architecture without the use of filling materials.
当生物可吸收膜与填充材料联合使用时,非包容性骨内缺损的再生治疗可取得更好的效果。本研究的目的是分析一种制造空间的生物可吸收膜在治疗具有相关单壁成分的宽而浅的骨内缺损中的临床和影像学效果。
在18名健康、不吸烟的患者(年龄范围30至66岁)中选择了18对角形骨缺损。在手术阶段之前,患者参加了严格的牙周治疗计划,包括口腔卫生指导以及龈下刮治和根面平整(术前全口菌斑评分<10%)。采用分口设计,18个部位被随机分配接受使用生物可吸收膜的引导组织再生(试验组),18个部位仅接受开放瓣清创术(对照组)。术后12个月评估临床治疗结果,观察探诊深度(PD)、临床附着水平(CAL)和龈缘位置(REC)的变化,并通过影像学观察骨改变。
与基线相比,12个月时,开放瓣清创术和引导组织再生在PD降低(分别为2.39±0.92mm和3.44±0.78mm)、CAL增加(分别为1.50±0.99mm和2.89±0.90mm)、REC增加(分别为-0.89±0.58mm和-0.56±0.92mm)以及骨填充(分别为1.05±0.94mm和2.13±1.21mm)方面均有统计学意义(P<0.0001)。除REC外(P=0.25),试验组和对照组之间所有参数的差异均有统计学意义(P<0.007)。
在不使用填充材料的情况下,使用这种生物可吸收膜似乎对治疗结构不佳的骨内缺损有效。