Department of Periodontology and Oral Implantology, Dental School, University of Ghent, Ghent, Belgium.
J Clin Periodontol. 2012 Oct;39(10):979-86. doi: 10.1111/j.1600-051X.2012.01924.x. Epub 2012 Jul 30.
To evaluate the clinical and aesthetic outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and a collagen-enriched bovine-derived xenograft (1); to identify risk factors for failure (clinical attachment level (CAL) gain ≤ 1 mm) and advanced gingival recession (REC) increase (>1 mm) (2).
Ninety-five non-smoking patients, with ≤ 25% full-mouth plaque and bleeding presenting ≥ 6 months after initial periodontal therapy with ≥ 1 isolated inter-dental infrabony defect were recruited. Patients were consecutively treated by the same clinician using minimally invasive surgery and a collagen-enriched bovine-derived xenograft. Clinical, radiographic and aesthetic data were collected before surgery and up to 1 year. Multivariate analyses were used to identify risk factors for failure and advanced REC increase.
Eighty-four patients (39 men, 45 women; mean age 53) complied and demonstrated mean probing depth (PD) of 7.8 mm, CAL of 10.0 mm and defect depth of 5.2 mm before surgery. At 1 year, postsurgery mean PD reduction was 3.5 mm (range 0.0-8.0), CAL gain was 3.1 mm (range 0.0-7.0) and radiographic defect fill was 53% (range 0-100). Forty-nine percentage showed ≥ 4 mm CAL gain, whereas 15% were considered failures. Mean inter-dental and midfacial REC increase was 0.3 mm (range-2.0-2.0) and 0.5 mm (range-1.5-2.0) respectively. Midfacial REC increase and contour deterioration contributed most to a small, yet significant reduction in the Pink Esthetic Score from 10.06 to 9.42 (p = 0.002). Risk factors for failure included defects with a non-supportive anatomy (OR: ≥ 10.4), plaque (OR: 14.7) and complication(s) (OR: 12.0). Risk factors for advanced midfacial REC increase included defects with a non-supportive anatomy (OR: 58.8) and a thin-scalloped gingival biotype (OR: 76.9).
RPT using minimally invasive surgery and a collagen-enriched bovine-derived xenograft demonstrated favourable clinical outcome after 1 year, even though soft tissue aesthetics could not be fully preserved. Defects with a non-supporting anatomy may be at risk for failure and advanced midfacial recession.
评估使用微创外科手术和富含胶原蛋白的牛源性异种移植物的再生牙周治疗（RPT）的临床和美学效果（1）；确定失败（临床附着水平（CAL）增加≤1 毫米）和先进的牙龈退缩（REC）增加（>1 毫米）的风险因素（2）。
共招募了 95 名不吸烟的患者，他们在初始牙周治疗后≥6 个月，全口菌斑≤25%，出血，且有≥1 个孤立的牙周内骨缺损。由同一名临床医生连续使用微创外科手术和富含胶原蛋白的牛源性异种移植物对患者进行治疗。在手术前和 1 年内收集临床、放射影像学和美学数据。使用多变量分析来确定失败和先进 REC 增加的风险因素。
84 名患者（39 名男性，45 名女性；平均年龄 53 岁）符合条件，术前平均探诊深度（PD）为 7.8 毫米，CAL 为 10.0 毫米，缺损深度为 5.2 毫米。在 1 年时，术后平均 PD 降低 3.5 毫米（范围 0.0-8.0），CAL 增加 3.1 毫米（范围 0.0-7.0），放射影像学缺损填充率为 53%（范围 0-100）。49%的患者显示 CAL 增加≥4 毫米，而 15%的患者被认为失败。牙间和中面部 REC 平均增加 0.3 毫米（范围-2.0-2.0）和 0.5 毫米（范围-1.5-2.0）。中面部 REC 增加和轮廓恶化导致 Pink 美学评分从 10.06 降至 9.42（p=0.002），评分虽略有下降，但差异具有统计学意义。失败的风险因素包括非支持性解剖结构的缺损（OR：≥10.4）、斑块（OR：14.7）和并发症（OR：12.0）。中面部 REC 增加的风险因素包括非支持性解剖结构的缺损（OR：58.8）和薄龈生物型（OR：76.9）。
使用微创外科手术和富含胶原蛋白的牛源性异种移植物的 RPT 在 1 年后显示出良好的临床效果，尽管软组织美学效果无法完全保留。非支持性解剖结构的缺损可能存在失败和先进中面部退缩的风险。
