Sculean Anton, Kiss Alice, Miliauskaite Asta, Schwarz Frank, Arweiler Nicole B, Hannig Matthias
Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.
J Clin Periodontol. 2008 Sep;35(9):817-24. doi: 10.1111/j.1600-051X.2008.01295.x. Epub 2008 Jul 21.
Surgery utilizing an enamel matrix protein derivative (EMD) or guided tissue regeneration (GTR) has been shown to promote periodontal regeneration.
To evaluate the 10-year results following treatment with EMD, GTR, EMD+GTR, and open flap debridement (OFD).
Thirty-eight patients out of an initial group of 56 participants were treated with one of the four modalities. Results were evaluated before surgery, at 1 year, and at 10 years. Primary outcome variable was CAL change.
Treatment with EMD yielded a mean CAL gain of 3.4+/-1.0 mm (p<0.001) and 2.9+/-1.4 mm (p<0.001) at 1 and 10 years, respectively. GTR resulted in a mean CAL gain of 3.2+/-1.4 (p<0.001) at 1 year and 2.8+/-1.2 mm (p<0.001) at 10 years. Mean CAL gain in the EMD+GTR group was of 3.3+/-1.1 mm (p<0.001) and 2.9+/-1.2 mm (p<0.001) at 1 and 10 years, respectively. Treatment with OFD demonstrated a mean CAL gain of 2.0+/-1.2 mm (p<0.01) at 1 year and 1.8+/-1.1 mm (p<0.01) at 10 years. Compared with OFD, the three regenerative treatments resulted in statistically significant (p<0.05) higher CAL gain, at both 1 and 10 years. The CAL change between 1 and 10 years did not present statistically significant differences in any of the four groups.
The present results indicate that the clinical outcomes obtained with all four approaches can be maintained over a period of 10 years.
利用釉基质蛋白衍生物(EMD)或引导组织再生(GTR)进行的手术已被证明可促进牙周组织再生。
评估采用EMD、GTR、EMD + GTR及开放瓣清创术(OFD)治疗10年后的效果。
最初的56名参与者中有38名患者接受了这四种治疗方式中的一种。在手术前、1年及10年时对结果进行评估。主要结局变量为临床附着丧失(CAL)的变化。
EMD治疗在1年和10年时的平均CAL增加分别为3.4±1.0毫米(p<0.001)和2.9±1.4毫米(p<0.001)。GTR在1年时的平均CAL增加为3.2±1.4(p<0.001),在10年时为2.8±1.2毫米(p<0.001)。EMD + GTR组在1年和10年时的平均CAL增加分别为3.3±1.1毫米(p<0.001)和2.9±1.2毫米(p<0.001)。OFD治疗在1年时的平均CAL增加为2.0±1.2毫米(p<0.01),在10年时为1.8±1.1毫米(p<0.01)。与OFD相比,这三种再生治疗在1年和10年时均导致CAL增加具有统计学显著差异(p<0.05)。在这四种治疗组中,1年至10年期间的CAL变化均无统计学显著差异。
目前的结果表明,这四种治疗方法所获得的临床疗效在10年期间均可维持。