Carnevale Gianfranco, Cairo Francesco, Nieri Michele, Tonetti Maurizio S
J Clin Periodontol. 2008 Feb;35(2):133-8. doi: 10.1111/j.1600-051X.2007.01178.x.
The Aims of this retrospective study were: (i) to describe the applicability of Fibre Retention Osseous Resective Surgery (FibReORS) to infrabony defects with different radiographic depths and (ii) to identify significant anatomical elements associated with the decision of tooth extraction or application of FibReORS in the context of a treatment approach aimed at pocket elimination.
Baseline radiographs with detectable infrabony defects were collected from 68 periodontal patients. Selected teeth with radiographic evidence of infrabony defects had probing depths (PD) >4 mm at revaluation following non-surgical periodontal therapy. Teeth were then surgically treated with FibReORS or extracted on the basis of the decision making of an experienced periodontist and in the context of the overall treatment plan. The total root length and the defect depth were quantified for each selected tooth using radiographic reference points.
A total of 324 teeth with infrabony defects were identified. Fifty-three (16%) teeth with a mean radiographic infrabony defect of 8.5+/-1.7 mm (range 6-12 mm) were extracted; 271 (84%) teeth with a mean infrabony defect of 3.0+/-1.4 mm (1-8 mm) were surgically treated, achieving PD < or =3 mm in all sites at 6-month follow-up. Surgically treated teeth showed baseline radiographic infrabony defects < or =4 mm in 86% of the cases. Logistic multilevel modelling indicated that the probability of extraction was influenced by root length (p=0.0230) and by the radiographic defect depth (p=0.0112).
FibReORS is applicable in the treatment of shallow to moderate bony defects and deeper defects associated with longer roots.
本回顾性研究的目的是：（i）描述纤维保留骨切除术（FibReORS）在不同影像学深度的骨下袋缺损中的适用性，以及（ii）在旨在消除牙周袋的治疗方法背景下，确定与拔牙或应用FibReORS决策相关的重要解剖学因素。
收集了68例牙周病患者具有可检测到的骨下袋缺损的基线X线片。在非手术牙周治疗后的复查中，有骨下袋缺损影像学证据的选定牙齿探诊深度（PD）>4mm。然后根据经验丰富的牙周病医生的决策并结合整体治疗计划，对这些牙齿进行FibReORS手术治疗或拔除。使用X线参考点对每个选定牙齿的总根长和缺损深度进行量化。
共识别出324颗有骨下袋缺损的牙齿。53颗（16%）平均影像学骨下袋缺损为8.5±1.7mm（范围6 - 12mm）的牙齿被拔除；271颗（84%）平均骨下袋缺损为3.0±1.4mm（1 - 8mm）的牙齿接受了手术治疗，在6个月随访时所有部位的PD≤3mm。接受手术治疗的牙齿在86%的病例中基线影像学骨下袋缺损≤4mm。逻辑多水平模型表明，拔牙的概率受根长（p = 0.0230）和影像学缺损深度（p = 0.0112）的影响。
FibReORS适用于治疗浅至中度骨缺损以及与较长牙根相关的较深缺损。
