纳米晶羟基磷灰石骨移植材料（Sybograf）联合可生物吸收胶原膜（Periocol）用于牙周骨内缺损的临床及影像学评估

Clinical and radiographic evaluation of Nano-crystalline hydroxyapatite bone graft (Sybograf) in combination with bioresorbable collagen membrane (Periocol) in periodontal intrabony defects.

作者信息

Singh Vijendra P, Nayak Dilip G, Uppoor Ashita S, Shah Dipen

机构信息

Department of Periodontology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India.

出版信息

Dent Res J (Isfahan). 2012 Jan;9(1):60-7. doi: 10.4103/1735-3327.92945.

BACKGROUND

Nanosized ceramics may represent a promising class of bone graft substitutes due to their improved osseointegrative properties. Nanocrystalline Hydroxyapatite (NcHA) bind to bone and stimulate bone healing by stimulation of osteoblast activity. The present study aims to explore the clinical and radiographical outcome of NcHA bonegraft (Sybograf(®)) with collagen membrane (Periocol(®)), in comparison with open flap debridement (OFD), in the treatment of intrabony periodontal defects.

MATERIALS AND METHODS

A parallel-group, randomized, controlled clinical trial was designed to conduct the study. Eighteen intrabony defects in 14 systemically healthy patients aged between 25 to 65 years were randomly assigned to test and control group. The plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) were recorded at baseline, and were reevaluated at 6 months. In addition to this, radiographic bone fill was assessed using digital software. At the test site, NcHA bone graft and collagen membrane was placed, whereas at the control site, only OFD was done. Recall appointments were made at 7 days, 30 days, and then at 3 months and 6 months.

RESULTS

The data were subjected to statistical analysis using the Mann-Whitney 'U' Test and Wilcoxon signed rank sum test. In the control group, the mean reduction of PPD was 3.22±1.09 mm (P=0.007) and CAL gain was 2.77±1.09 mm (P=0.007). In the test group, the mean PPD reduction of 4.33±0.5 mm (P=0.006) and mean gain in CAL was 3.77±0.66 mm (P=0.006) at 6 months. The mean increase in REC was 0.55±0.72 mm (P=0.025) in test, and 0.44±0.52 mm (P=0.046) in control group. The mean gain in radiographic defect fill was 2.07±0.67 mm (P=0.008) in test and 0.91±0.21 mm (P=0.007) in control group.

CONCLUSION

The nanocrystalline hydroxyapatite bone graft in combination with collagen membrane demonstrated clinical advantages beyond that achieved by OFD alone.

背景

纳米陶瓷因其改善的骨整合特性可能代表一类有前景的骨移植替代物。纳米晶羟基磷灰石（NcHA）与骨结合并通过刺激成骨细胞活性来促进骨愈合。本研究旨在探讨NcHA骨移植材料（Sybograf(®)）联合胶原膜（Periocol(®)）与开放性翻瓣清创术（OFD）相比，在治疗骨内牙周缺损中的临床和影像学结果。

材料与方法

设计一项平行组、随机、对照临床试验来开展本研究。将14例年龄在25至65岁之间的全身健康患者的18处骨内缺损随机分为试验组和对照组。在基线时记录菌斑指数、牙龈指数、探诊深度（PPD）、临床附着水平（CAL）和牙龈退缩（REC），并在6个月时重新评估。除此之外，使用数字软件评估影像学骨填充情况。在试验部位放置NcHA骨移植材料和胶原膜，而在对照部位仅进行开放性翻瓣清创术。在7天、30天、3个月和6个月时安排复诊。

结果

数据采用曼-惠特尼“U”检验和威尔科克森符号秩和检验进行统计分析。在对照组中，PPD的平均减少量为3.22±1.09mm（P = 0.007），CAL的平均增加量为2.77±1.09mm（P = 0.007）。在试验组中，6个月时PPD的平均减少量为4.33±0.5mm（P = 0.006），CAL的平均增加量为3.77±0.66mm（P = 0.006）。试验组REC的平均增加量为0.55±0.72mm（P = 0.025），对照组为0.44±0.52mm（P = 0.046）。试验组影像学缺损填充的平均增加量为2.07±0.67mm（P = 0.008），对照组为0.91±0.21mm（P = 0.007）。