Liñares Antonio, Cortellini Pierpaolo, Lang Niklaus P, Suvan Jean, Tonetti Maurizio S
Periodontology Unit, School of Dentistry, University of Santiago de Compostela, Santiago, Spain.
J Clin Periodontol. 2006 May;33(5):351-8. doi: 10.1111/j.1600-051X.2006.00911.x.
This study reports the secondary analysis of a randomized-controlled clinical trial designed to assess the efficacy of deproteinized bovine mineral and a collagen membrane in the treatment of intrabony defects. The specific aims of this report are (1) to analyse the radiographic bone changes 1 year after therapy and (2) to assess the association between radiographic defect angle and treatment outcomes.
Baseline and 12-month radiographs were collected from 120 patients with advanced chronic periodontitis from 10 centres in seven countries as part of a multi-centre clinical trial. All patients had at least one intrabony defect > or =3 mm in depth. The treatment consisted of simplified or modified papilla preservation flaps to access the defect. After debridement of the area, a deproteinized bovine mineral and a collagen membrane were applied in the test subjects, and omitted in the controls. Main outcome measures were radiographic bone fill and defect resolution 1 year after surgery.
One hundred and twenty pairs of radiographs were obtained, of which 110 pairs were measurable (57 tests and 53 controls). One year after treatment, radiographic resolution of the intrabony component was significantly higher in the test group (3.2+/-1.7 mm) when compared with the controls (1.7+/-1.9 mm). Multivariate analysis indicated that the treatment and the baseline radiographic depth of the intrabony defect significantly influenced the radiographic bone fill of the intrabony defect 1 year following treatment. The percentage of resolution of the defect was influenced by the treatment provided and the baseline plaque score. The baseline radiographic defect angle did not show a significant impact on the clinical and radiographic outcomes.
Regenerative periodontal surgery with a deproteinized bovine bone mineral and a collagen membrane offered additional benefits in terms of radiographic resolution of the intrabony defect and predictability of outcomes with respect to papilla preservation flaps alone.
本研究报告了一项随机对照临床试验的二次分析，该试验旨在评估脱蛋白牛骨矿物质和胶原膜在治疗骨内缺损中的疗效。本报告的具体目的是：（1）分析治疗1年后的影像学骨变化；（2）评估影像学缺损角度与治疗结果之间的关联。
作为一项多中心临床试验的一部分，从七个国家10个中心的120例晚期慢性牙周炎患者中收集了基线和12个月时的X线片。所有患者至少有一个深度≥3mm的骨内缺损。治疗包括采用简化或改良的乳头保留瓣来暴露缺损部位。在对该区域进行清创后，试验组患者应用脱蛋白牛骨矿物质和胶原膜，对照组则不使用。主要观察指标为术后1年的影像学骨填充和缺损修复情况。
共获得120对X线片，其中110对可测量（57例试验组和53例对照组）。治疗1年后，试验组骨内成分的影像学修复情况（3.2±1.7mm）显著高于对照组（1.7±1.9mm）。多变量分析表明，治疗方法和骨内缺损的基线影像学深度对治疗后1年骨内缺损的影像学骨填充有显著影响。缺损修复的百分比受所提供的治疗方法和基线菌斑评分的影响。基线影像学缺损角度对临床和影像学结果未显示出显著影响。
与仅采用乳头保留瓣相比，使用脱蛋白牛骨矿物质和胶原膜进行再生性牙周手术在骨内缺损的影像学修复及结果可预测性方面具有额外的优势。
