Department of Oral and Dental Sciences, University of Bologna, Bologna, Italy.
J Periodontol. 2011 Oct;82(10):1404-13. doi: 10.1902/jop.2011.100466. Epub 2011 Feb 22.
Mandibular second molar (M2) periodontal defects after third molar (M3) removal in high-risk patients are a clinical dilemma for clinicians. This study compares the healing of periodontal intrabony defects at distal surfaces of mandibular M2s using bioabsorbable and non-resorbable membranes.
Eleven patients with bilateral probing depths (PDs) ≥6 mm distal to mandibular M2s and intrabony defects ≥3 mm, related to the total impaction of M3s, were treated with M3 extraction and covering of the surgical bone defect with a bioabsorbable collagen barrier on one side and a non-resorbable expanded polytetrafluoroethylene (ePTFE) barrier contralaterally. The PD, clinical attachment level (CAL), M2 mobility, and furcation class probing were evaluated preoperatively and 3, 6, and 9 months postoperatively. Intraoral periapical radiographs were taken immediately preoperatively and 3 and 9 months postoperatively.
Both treatment modalities were successful. At 9 months, the mean PD reduction was 5.2 ± 3.9 mm for bioabsorbable sites and 5.5 ± 3.0 mm for non-resorbable sites; the CAL gain was 5.9 ± 3.3 mm and 5.5 ± 3.4 mm, respectively. The outcome difference between the two sites for PD and CAL did not differ statistically (P >0.05) at any assessment time.
Bioabsorbable collagen membranes in guided tissue regeneration treatment of intrabony defects distal to the mandibular M2 obtained the same marked PD reductions and CAL gains as non-resorbable ePTFE membranes after M3 extraction.
在高危患者中,第三磨牙(M3)拔除后下颌第二磨牙(M2)的牙周缺损是临床医生面临的一个难题。本研究比较了使用可吸收和不可吸收膜治疗下颌 M2 远中面牙周骨内缺损的愈合情况。
11 例双侧下颌 M2 远中探诊深度(PD)≥6mm,且存在骨内缺损≥3mm的患者,M3 均完全埋伏阻生,采用 M3 拔除术,一侧用可吸收胶原屏障覆盖手术骨缺损,另一侧用不可吸收的膨化聚四氟乙烯(ePTFE)屏障覆盖。在术前、术后 3、6 和 9 个月评估 PD、临床附着水平(CAL)、M2 动度和分叉区探诊,并在术前、术后 3 和 9 个月拍摄口腔根尖片。
两种治疗方法均成功。9 个月时,可吸收部位的平均 PD 减少量为 5.2±3.9mm,不可吸收部位为 5.5±3.0mm;CAL 增加量分别为 5.9±3.3mm 和 5.5±3.4mm。两种部位在 PD 和 CAL 方面的结果差异在任何评估时间均无统计学意义(P>0.05)。
在 M3 拔除后,引导组织再生治疗下颌 M2 远中面骨内缺损时,可吸收胶原膜可获得与不可吸收 ePTFE 膜相同的显著 PD 减少和 CAL 增加。