Stahl S S, Froum S
Department of Periodontics, College of Dentistry, New York University, New York 10010.
J Clin Periodontol. 1991 Oct;18(9):685-9. doi: 10.1111/j.1600-051x.1991.tb00110.x.
6 suprabony pockets in 2 adult patients were treated with debridement and citric acid root demineralization. Following these procedures, coronal positioning of the marginal flaps was performed at 2 sites. At 4 sites, the marginal flaps were sutured coronally using orthodontic brackets as anchors. At 1 additional site, root debridement only was performed and the margin was placed at about crestal level. Prior to root planing, all roots were notched both at the level of the gingival margin and the most apically positioned calculus. Blocks were harvested 7 and 18 weeks postsurgery and prepared for histologic analysis. Clinical results showed a gain in probing attachment in both coronally positioned sites (average = 1.8 mm) and coronally anchored sites (average = 4.5 mm). The additional debrided-only site showed a gain in probing attachment of 0.1 mm. Histologically, new cementum with functionally inserted fibers was seen within the calculus notch in all coronally anchored sites. This new attachment was associated with crestal osteogenesis. In the 2 coronally positioned and root demineralized sites, new attachment was seen within the calculus notch in 1 out of the 2 specimens evaluated. Within the limits of the evidence presented, coronal anchorage of flaps enhanced probing attachment and new attachment when used in conjunction with root demineralization.
对2名成年患者的6个骨上袋进行了清创和柠檬酸根脱矿治疗。在这些操作之后，在2个部位进行了边缘瓣的冠向定位。在4个部位，使用正畸托槽作为锚定物将边缘瓣冠向缝合。在另外1个部位，仅进行了牙根清创，边缘置于约牙槽嵴顶水平。在根面平整之前，所有牙根在牙龈边缘和最根尖部牙结石水平处都做了切口。在术后7周和18周采集组织块并准备进行组织学分析。临床结果显示，在冠向定位部位（平均 = 1.8 mm）和冠向锚定部位（平均 = 4.5 mm），探诊附着水平均有增加。仅进行清创的额外部位探诊附着增加了0.1 mm。组织学上，在所有冠向锚定部位的牙结石切口中均可见到具有功能性插入纤维的新牙骨质。这种新附着与牙槽嵴顶成骨有关。在2个冠向定位且牙根脱矿的部位，在评估的2个标本中有1个在牙结石切口中见到了新附着。在所提供证据的范围内，当与牙根脱矿联合使用时，瓣的冠向锚定增强了探诊附着和新附着。
