Rajesh J B, Nandakumar K, Varma H K, Komath Manoj
General Hospital, Alappuzha, Kerala, India.
Indian J Dent Res. 2009 Oct-Dec;20(4):471-9. doi: 10.4103/0970-9290.59459.
Calcium phosphate cements (CPC) are apparently good candidates for periodontal treatment by virtue of their biocompatibility, mouldability and osteoconductivity. However, the clinical efficacy in this regard has not been established. This study is aimed at the evaluation of the efficacy of a formulation of CPC in healing human periodontal intraosseous defects in comparison with hydroxyapatite ceramic granules.
In this clinical study, 60 patients with periodontal defects were divided into 2 test groups and 1 control group. The defect sites in the test groups were repaired with CPC and hydroxyapatite ceramic granules (HAG). Debridement alone was given in the control group. The progress was assessed at 3, 6, 9 and 12 months observation intervals through soft tissue parameters (probing depth, attachment level and gingival recession).
CPC showed significantly better outcome. Probing depth reduction values of CPC, HAG and Control at 6 months were 5.40 +/- 1.43, 3.75 +/- 1.71 and 2.90 +/- 1.48, and those at 12 months were 6.20 +/- 1.80, 4.5 +/- 1.91 and 2.95 +/- 1.73. Clinical attachment gain values of CPC, HAG and Control at 6 months were 5.15 +/- 1.50, 3.45 +/- 1.96 and 2.25 +/- 1.52, and those at 12 months were 5.80 +/- 2.02, 3.55 +/- 2.06 and 2.30 +/- 1.78, In both cases the P value was < 0.001 showing high significance. The gingival recession over 12 months, for the CPC group is lesser than that in the HAG group and the value for the control group is marginally higher than both. Soft-tissue measurements were appended by postoperative radiographs and surgical re-entry in selected cases.
Calcium phosphate cement is found to be significantly better than hydroxyapatite ceramic granules. The material could be considered as a "barrier-graft".
磷酸钙骨水泥（CPC）因其生物相容性、可模塑性和骨传导性，显然是牙周治疗的理想材料。然而，其在这方面的临床疗效尚未得到证实。本研究旨在评估一种磷酸钙骨水泥配方与羟基磷灰石陶瓷颗粒相比，在治疗人类牙周骨内缺损方面的疗效。
在这项临床研究中，60例牙周缺损患者被分为2个试验组和1个对照组。试验组的缺损部位用磷酸钙骨水泥和羟基磷灰石陶瓷颗粒（HAG）修复。对照组仅进行清创。通过软组织参数（探诊深度、附着水平和牙龈退缩）在3、6、9和12个月的观察间隔评估进展情况。
磷酸钙骨水泥显示出明显更好的效果。磷酸钙骨水泥、羟基磷灰石陶瓷颗粒和对照组在6个月时的探诊深度减少值分别为5.40±1.43、3.75±1.71和2.90±1.48，在12个月时分别为6.20±1.80、4.5±1.91和2.95±1.73。磷酸钙骨水泥、羟基磷灰石陶瓷颗粒和对照组在6个月时的临床附着增加值分别为5.15±1.50、3.45±1.96和2.25±1.52，在12个月时分别为5.80±2.02、3.55±2.06和2.30±1.78。在这两种情况下，P值均<0.001，显示出高度显著性。在12个月内，磷酸钙骨水泥组的牙龈退缩小于羟基磷灰石陶瓷颗粒组，对照组的值略高于两者。在选定病例中，术后X线片和再次手术补充了软组织测量。
发现磷酸钙骨水泥明显优于羟基磷灰石陶瓷颗粒。该材料可被视为一种“屏障移植物”。
