硫酸钙植入物和屏障膜与胶原屏障膜或单纯开放性龈瓣清创术治疗牙周骨内缺损的比较：一项为期12个月的随机对照临床试验

Surgical treatment of periodontal intrabony defects with calcium sulfate implant and barrier versus collagen barrier or open flap debridement alone: a 12-month randomized controlled clinical trial.

作者信息

Paolantonio Michele, Perinetti Giuseppe, Dolci Marco, Perfetti Giorgio, Tetè Stefano, Sammartino Gilberto, Femminella Beatrice, Graziani Filippo

机构信息

Department of Periodontology, University G. D'Annunzio School of Dentistry, Chieti, Italy.

出版信息

J Periodontol. 2008 Oct;79(10):1886-93. doi: 10.1902/jop.2008.080076.

DOI:10.1902/jop.2008.080076

PMID:18834243

Abstract

BACKGROUND

This randomized controlled clinical trial was designed to compare the clinical outcomes of guided tissue regeneration with calcium sulfate graft and membrane (CS) versus guided tissue regeneration with collagen membrane (CM) or open flap debridement (OFD) only in terms of clinical attachment gain in periodontal intrabony defects.

METHODS

Fifty-one systemically healthy, non-smoking subjects affected by moderate to severe chronic periodontitis were recruited. The subjects had one deep intrabony defect with a probing depth (PD) > or =6 mm and were randomly divided into three equal groups (17 subjects per group). Subjects were surgically treated with OFD (OFD group), OFD with CS (CS group), or OFD and CM (CM group). One year after surgical treatment, a complete clinical examination and a surgical reentry were performed. The pre- and post-therapy clinical parameters, including PD, clinical attachment level (CAL), gingival recession (GR), and intrasurgical parameters (defect bone level [DBL]), were compared.

RESULTS

After 1 year, the clinical and intrasurgical parameters showed statistically significant changes from baseline within each group for all of the evaluated parameters (PD and CAL, P <0.001; GR and DBL, P <0.05). Differences (PD, CAL, and DBL, P <0.001; GR, P <0.05) were also seen across the three groups. The CM and CS groups had significantly smaller PD, CAL, and DBL values than subjects treated with only OFD. Groups treated with regenerative techniques had a significantly greater PD reduction and CAL and DBL gain compared to the OFD group. No significant differences were seen between CM and CS. Conversely, the CM group showed a significantly greater GR increase compared to OFD and CS.

CONCLUSIONS

Both regenerative treatments produced additional clinical benefits over OFD alone. Moreover, the use of CS may minimize post-surgical recession.

摘要

背景

本随机对照临床试验旨在比较仅在牙周骨内缺损的临床附着增加方面，硫酸钙移植物和膜引导组织再生（CS）与胶原膜引导组织再生（CM）或开放瓣清创术（OFD）的临床结果。

方法

招募了51名患有中度至重度慢性牙周炎的全身健康、不吸烟的受试者。这些受试者有一个探诊深度（PD）≥6mm的深骨内缺损，并被随机分为三组（每组17名受试者）。受试者接受了OFD手术治疗（OFD组）、OFD联合CS手术治疗（CS组）或OFD联合CM手术治疗（CM组）。手术治疗一年后，进行了全面的临床检查和再次手术。比较了治疗前后的临床参数，包括PD、临床附着水平（CAL）、牙龈退缩（GR）和手术中参数（缺损骨水平[DBL]）。

结果

1年后，所有评估参数（PD和CAL，P<0.001；GR和DBL，P<0.05）的临床和手术中参数在每组内与基线相比均有统计学意义的变化。三组之间也存在差异（PD、CAL和DBL，P<0.001；GR，P<0.05）。CM组和CS组的PD、CAL和DBL值明显低于仅接受OFD治疗的受试者。与OFD组相比，采用再生技术治疗的组PD减少明显更多，CAL和DBL增加明显更多。CM组和CS组之间未见显著差异。相反，与OFD组和CS组相比，CM组的GR增加明显更多。