Stein Jamal M, Fickl Stefan, Yekta Sareh Said, Hoischen Ulrich, Ocklenburg Christina, Smeets Ralf
Department of Operative Dentistry, Periodontology, and Preventive Dentistry, University Hospital Aachen, Aachen, Germany.
J Periodontol. 2009 Nov;80(11):1774-82. doi: 10.1902/jop.2009.090229.
The aim of this study was to compare the clinical outcome of a novel biphasic calcium composite (BCC) biomaterial versus autogenous bone spongiosa (ABS) or open flap debridement (OFD) for the treatment of intrabony periodontal defects.
Forty-five subjects with at least one intrabony defect with a probing depth (PD) >or=7 mm and a vertical radiographic bone loss >or=3 mm were enrolled in the study. Subjects were randomly assigned to treatment with BCC (n = 15), ABS (n = 15), or OFD (n = 15). Clinical parameters were recorded at baseline and 12 months after surgery and included the plaque index, gingival index, PD, clinical attachment level (CAL), and gingival recession.
In all treatment groups, significant PD reductions and CAL gains occurred during the study period (P <0.0001). At 12 months, patients treated with BCC exhibited a mean PD reduction of 3.6 +/- 0.7 mm and a mean CAL gain of 3.0 +/- 0.8 mm compared to baseline. Corresponding values for patients treated with ABS were 3.4 +/- 0.8 mm and 2.9 +/- 0.9 mm, whereas OFD sites produced values of 2.8 +/- 0.8 mm and 1.6 +/- 0.7 mm. Compared to OFD, the additional CAL gain was significantly greater in patients treated with BCC (P = 0.002) and ABS (P = 0.001). The additional PD reduction was significant for the BCC group (P = 0.011) and borderline significant for the ABS group (P = 0.059). There were no significant differences of PD and CAL changes between BCC and ABS groups.
The clinical benefits of BCC were equivalent to ABS and superior to OFD alone. BCC may be an appropriate alternative to conventional graft materials.
本研究旨在比较一种新型双相钙复合物(BCC)生物材料与自体骨松质(ABS)或开放性翻瓣清创术(OFD)治疗骨内牙周缺损的临床疗效。
45名受试者至少有一处骨内缺损,探诊深度(PD)≥7mm且垂直方向影像学骨吸收≥3mm,纳入本研究。受试者被随机分为接受BCC治疗组(n = 15)、ABS治疗组(n = 15)或OFD治疗组(n = 15)。在基线和术后12个月记录临床参数,包括菌斑指数、牙龈指数、PD、临床附着水平(CAL)和牙龈退缩。
在所有治疗组中,研究期间PD均显著降低,CAL均显著增加(P <0.0001)。在12个月时,与基线相比,接受BCC治疗的患者平均PD降低3.6±0.7mm,平均CAL增加3.0±0.8mm。接受ABS治疗患者的相应值为3.4±0.8mm和2.9±0.9mm,而OFD部位的值为2.8±0.8mm和1.6±0.7mm。与OFD相比,接受BCC治疗的患者额外的CAL增加显著更大(P = 0.002),接受ABS治疗的患者也是如此(P = 0.001)。BCC组额外的PD降低显著(P = 0.011),ABS组接近显著(P = 0.059)。BCC组和ABS组之间PD和CAL变化无显著差异。
BCC的临床益处与ABS相当,且优于单独的OFD。BCC可能是传统移植材料的合适替代品。