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使用自体骨膜移植物作为屏障治疗下颌磨牙Ⅱ度根分叉病变。

The use of autogenous periosteal grafts as barriers for the treatment of Class II furcation involvements in lower molars.

作者信息

Lekovic V, Kenney E B, Carranza F A, Martignoni M

机构信息

University of Belgrade, School of Dentistry, Belgrade, Yugoslavia.

出版信息

J Periodontol. 1991 Dec;62(12):775-80. doi: 10.1902/jop.1991.62.12.775.

Abstract

This study clinically analyzed the efficacy of a connective tissue graft including the periosteum used as a barrier to enhance new attachment and osseous regeneration. Fifteen patients, with no systemic diseases, and adult periodontitis including 2 Class II furcation involvements in lower molars comprised the study group. After completion of the initial phase of therapy, all patients were treated with full-thickness periodontal flaps, using sulcular incisions, and thorough scaling and root planing. One furca, selected at random, had a connective tissue graft, obtained from the palate and including the periosteum, placed over the furca with the flap sutured over the top of this graft. Control furcas received no graft and the flap was sutured in its original position. Both molars were treated in the same session. The following presurgical measurements were made: probing pocket depth, attachment level, gingival recession, sulcular bleeding index, and plaque index. The horizontal and vertical dimensions of the osseous defects were recorded after flap elevation and debridement. Six months later all clinical parameters were again measured and reentry flaps were performed to measure the bony defects. No statistically significant differences were found preoperatively between control and experimental molars with respect to soft tissue and osseous measurements. Six months after surgery, the experimental molars showed, in comparison to the controls, significant reduction in pocket depth and gain in attachment level as well as in vertical and horizontal measurements of the inter-radicular osseous defect.

摘要

本研究对一种包含骨膜的结缔组织移植物作为屏障以促进新附着和骨再生的疗效进行了临床分析。15名无全身疾病且患有成人牙周炎(包括2例下颌磨牙Ⅱ度根分叉病变)的患者组成了研究组。在完成初始治疗阶段后,所有患者均采用沟内切口行全厚牙周瓣手术,并进行彻底的龈下刮治和根面平整。随机选择一个根分叉,取自腭部并包含骨膜的结缔组织移植物覆盖于该根分叉上方,然后将瓣缝合于移植物上方。对照根分叉不植入移植物,瓣缝合于原位。两颗磨牙在同一次手术中进行治疗。术前进行了以下测量:探诊袋深度、附着水平、牙龈退缩、龈沟出血指数和菌斑指数。在翻开瓣并清创后记录骨缺损的水平和垂直尺寸。6个月后再次测量所有临床参数,并进行再次翻开瓣手术以测量骨缺损。术前对照磨牙和实验磨牙在软组织和骨测量方面未发现统计学上的显著差异。术后6个月,与对照磨牙相比,实验磨牙的袋深度显著减小,附着水平增加,根间骨缺损的垂直和水平测量值也有所改善。

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