Department of Periodontology, School of Dentistry, Federal Fluminense University, Niteroi, Rio de Janeiro, Brazil.
J Periodontol. 2013 Jan;84(1):51-7. doi: 10.1902/jop.2012.110363. Epub 2012 Jul 6.
Treatment of molar furcation defects remains a considerable challenge in clinical practice. The degree of success in the management of furcation involvement is highly variable and related to the baseline clinical status of these defects. The identification of clinical parameters influential to the treatment outcomes is critical to optimize the results of surgical periodontal therapy. The impact of the endodontic treatment (ET) of the tooth on the healing potential of the periodontium is controversial. Therefore, the objective of this study is to evaluate the clinical response of buccal Class II furcation defects to open-flap debridement (OFD) and to determine the influence of ET in the clinical outcomes of therapy.
Sixty patients were divided into two treatment groups (n = 30): 1) OFD; and 2) OFD in endodontically treated teeth (OFD + ET). The clinical variables evaluated were plaque (full-mouth plaque score), bleeding on probing, gingival recession, probing depth (PD), and vertical (VAL) and horizontal (HAL) attachment levels. Reevaluation was performed 12 months after the surgical procedures.
Both treatments resulted in improvements in all the clinical variables evaluated. Postoperative measurements from OFD-treated and OFD + ET-treated sites showed, respectively, 1.2 ± 1.2 and 1.3 ± 1.3 mm reduction in PD, 0.6 ± 0.8 and 0.7 ± 0.6 mm VAL gains, and 0.7 ± 1.1 and 0.8 ± 1.6 mm HAL gains. No significant differences were found between the groups.
The present findings demonstrate that adequate endodontic therapy performed ≥6 months before surgical treatment does not significantly influence the clinical parameters of healing of human mandibular buccal Class II furcation defects.
磨牙分叉区缺损的治疗仍然是临床实践中的一大挑战。分叉区病变管理的成功率差异很大,与这些缺损的基线临床状况有关。确定对治疗结果有影响的临床参数对于优化牙周手术治疗的结果至关重要。牙髓治疗(ET)对牙周组织愈合潜力的影响存在争议。因此,本研究的目的是评估颊侧 II 类分叉缺损在翻瓣清创术(OFD)下的临床反应,并确定 ET 对治疗结果的影响。
60 名患者分为两组(n = 30):1)OFD;2)牙髓治疗牙的 OFD(OFD+ET)。评估的临床变量包括菌斑(全口菌斑评分)、探诊出血、牙龈退缩、探诊深度(PD)以及垂直(VAL)和水平(HAL)附着水平。手术 12 个月后进行重新评估。
两种治疗方法均改善了所有评估的临床变量。OFD 治疗和 OFD+ET 治疗部位的术后测量值分别显示 PD 减少 1.2±1.2 和 1.3±1.3mm,VAL 增加 0.6±0.8 和 0.7±0.6mm,HAL 增加 0.7±1.1 和 0.8±1.6mm。两组之间无显著差异。
本研究结果表明,在手术治疗前≥6 个月进行适当的牙髓治疗不会显著影响下颌颊侧 II 类分叉缺损愈合的临床参数。