School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
Aust Dent J. 2009 Sep;54 Suppl 1:S118-28. doi: 10.1111/j.1834-7819.2009.01150.x.
The ultimate goal of periodontal therapy is the regeneration of the tissues destroyed as a result of periodontal disease. Currently, two clinical techniques, based on the principles of "guided tissue regeneration" (GTR) or utilization of the biologically active agent "enamel matrix derivative" (EMD), can be used for the regeneration of intrabony and Class II mandibular furcation periodontal defects. In cases where additional support and space-making requirements are necessary, both of these procedures can be combined with a bone replacement graft. There is no evidence that the combined use of GTR and EMD results in superior clinical results compared to the use of each material in isolation. Great variability in clinical outcomes has been reported in relation to the use of both EMD and GTR, and these procedures can be generally considered to be unpredictable. Careful case selection and treatment planning, including consideration of patient, tooth, site and surgical factors, is required in order to optimize the outcomes of treatment. There are limited data available for the clinical effectiveness of other biologically active molecules, such as growth factors and platelet concentrates, and although promising results have been reported, further clinical trials are required in order to confirm their effectiveness. Current active areas of research are centred on tissue engineering and gene therapy strategies which may result in more predictable regenerative outcomes in the future.
牙周病治疗的最终目标是再生因牙周病而受损的组织。目前，有两种基于“引导组织再生”（GTR）原理或利用生物活性剂“釉基质衍生物”（EMD）的临床技术可用于再生牙槽骨内和下颌第二类根分叉牙周缺损。在需要额外支持和空间形成的情况下，这两种方法都可以与骨替代移植物结合使用。没有证据表明 GTR 和 EMD 的联合使用比单独使用每种材料的临床效果更好。有关 EMD 和 GTR 的使用，报告的临床结果存在很大差异，这些方法通常被认为是不可预测的。为了优化治疗效果，需要仔细选择病例并进行治疗计划，包括考虑患者、牙齿、部位和手术因素。其他生物活性分子（如生长因子和血小板浓缩物）的临床效果数据有限，尽管已经报告了有希望的结果，但仍需要进一步的临床试验来证实其有效性。目前的研究重点是组织工程和基因治疗策略，这可能会在未来带来更可预测的再生结果。
