Stahl S S, Froum S
Department of Periodontics, College of Dentistry, New York University, New York 10010.
J Clin Periodontol. 1991 Feb;18(2):149-52. doi: 10.1111/j.1600-051x.1991.tb01705.x.
4 vertical lesions at 3 teeth in 2 volunteer adults with severe periodontitis were treated by open surgical debridement, osseous allografts and barrier membranes. Roots were notched at both gingival margins and the deepest visible calculus and flaps were sutured coronally. Patients were placed on 0.12% chlorhexidine gluconate 2x daily post-surgery, and blocks were harvested 5 to 6 weeks after surgery. No abnormal clinical responses were noted during the observation period. In the 4 sites, the average preoperative pocket depth was 9.4 mm; the post-operative pocket depth averaged 4.9 mm, recession averaged 0.9 mm and gain in clinical closure averaged 3.6 mm. Histologically, new cementum measured coronally-apically at the treated sites varied from 0.0 mm to 1.7 mm, with an average of 1.1 mm. Osseous remodelling and crestal osteogenesis were seen in association with cementogenesis. The newly deposited cementum showed insertion of functional oriented fibers. New attachment was present within 2 out of 4 calculus notches in this sample.
对2名患有严重牙周炎的成年志愿者口腔内3颗牙齿上的4处垂直性病变进行了开放性手术清创、异体骨移植和屏障膜治疗。在牙龈边缘和可见最深牙结石处对牙根进行刻痕处理，并将瓣向冠方缝合。术后患者每天使用2次0.12%葡萄糖酸氯己定，术后5至6周采集组织块。观察期内未观察到异常临床反应。在这4个部位，术前平均牙周袋深度为9.4毫米；术后平均牙周袋深度为4.9毫米，牙龈退缩平均为0.9毫米，临床愈合平均增加3.6毫米。组织学检查显示，治疗部位从冠部到根尖部新形成的牙骨质厚度在0.0毫米至1.7毫米之间，平均为1.1毫米。观察到骨重塑和牙槽嵴成骨与牙骨质生成相关。新沉积的牙骨质显示有功能定向纤维的附着。该样本中4处牙结石刻痕中有2处出现了新附着。
