Department of Periodontology, Semmelweis University, Budapest, Hungary.
J Periodontol. 2013 Jun;84(6):749-57. doi: 10.1902/jop.2012.120238. Epub 2012 Aug 8.
The purpose of the present study is to evaluate the 10-year results following treatment of intrabony defects treated with an enamel matrix protein derivative (EMD) combined with either a natural bone mineral (NBM) or β-tricalcium phosphate (β-TCP).
Twenty-two patients with advanced chronic periodontitis and displaying one deep intrabony defect were randomly treated with a combination of either EMD + NBM or EMD + β-TCP. Clinical evaluations were performed at baseline and at 1 and 10 years. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level (CAL). The primary outcome variable was CAL.
The defects treated with EMD + NBM demonstrated a mean CAL change from 8.9 ± 1.5 mm to 5.3 ± 0.9 mm (P <0.001) and to 5.8 ± 1.1 mm (P <0.001) at 1 and 10 years, respectively. The sites treated with EMD + β-TCP showed a mean CAL change from 9.1 ± 1.6 mm to 5.4 ± 1.1 mm (P <0.001) at 1 year and 6.1 ± 1.4 mm (P <0.001) at 10 years. At 10 years two defects in the EMD + NBM group had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. In the EMD + β-TCP group three defects had lost 2 mm, whereas two other defects had lost 1 mm of the CAL gained at 1 year. Compared with baseline, at 10 years, a CAL gain of ≥3 mm was measured in 64% (i.e., seven of 11) of the defects in the EMD + NBM group and in 82% (i.e., nine of 11) of the defects in the EMD + β-TCP group. No statistically significant differences were found between the 1- and 10-year values in either of the two groups. Between the treatment groups, no statistically significant differences in any of the investigated parameters were observed at 1 and 10 years.
Within their limitations, the present findings indicate that the clinical improvements obtained with regenerative surgery using EMD + NBM or EMD + β-TCP can be maintained over a period of 10 years.
本研究的目的是评估使用 enamel matrix protein derivative (EMD) 联合天然骨矿物质 (NBM) 或 β-tricalcium phosphate (β-TCP) 治疗骨内缺损 10 年后的结果。
22 名患有晚期慢性牙周炎且有一个深骨内缺损的患者，随机接受 EMD+NBM 或 EMD+β-TCP 的联合治疗。在基线和 1 年及 10 年时进行临床评估。评估的参数包括菌斑指数、探诊出血、探诊深度、牙龈退缩和临床附着水平 (CAL)。主要结局变量为 CAL。
用 EMD+NBM 治疗的缺损，CAL 从 8.9±1.5mm 分别变化到 5.3±0.9mm（P<0.001）和 5.8±1.1mm（P<0.001），分别在 1 年和 10 年时。用 EMD+β-TCP 治疗的缺损，CAL 从 9.1±1.6mm 变化到 5.4±1.1mm（P<0.001），在 1 年时，和 6.1±1.4mm（P<0.001），在 10 年时。在 10 年时，EMD+NBM 组有两个缺损失去了 2mm，而另外两个缺损则失去了 1mm 第 1 年获得的 CAL。在 EMD+β-TCP 组中，有三个缺损失去了 2mm，而另外两个缺损则失去了 1mm 第 1 年获得的 CAL。与基线相比，在 10 年时，EMD+NBM 组有 64%（即 11 个缺损中的 7 个）和 EMD+β-TCP 组有 82%（即 11 个缺损中的 9 个）的缺损 CAL 获得量增加了≥3mm。在这两个组中，1 年和 10 年之间的数值均无统计学差异。在治疗组之间，在 1 年和 10 年时，任何研究参数均无统计学差异。
在其局限性内，本研究结果表明，使用 EMD+NBM 或 EMD+β-TCP 进行再生手术后获得的临床改善可维持 10 年。
