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羟基磷灰石/β-磷酸三钙和釉基质衍生物治疗近中Ⅱ类牙周袋骨缺损的随机临床试验

Hydroxyapatite/β-tricalcium phosphate and enamel matrix derivative for treatment of proximal class II furcation defects: a randomized clinical trial.

机构信息

Department of Prosthodontics and Periodontics, Piracicaba Dental School, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.

出版信息

J Clin Periodontol. 2013 Mar;40(3):252-9. doi: 10.1111/jcpe.12054.

Abstract

OBJECTIVE

To clinically evaluate proximal furcations treated with hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) isolated or combined with enamel matrix derivative (EMD).

MATERIAL AND METHODS

Thirty patients, presenting at least one proximal class II furcation defect, probing pocket depth (PPD) ≥5 mm and bleeding on probing, were included. The defects were assigned to the HA/β-TCP group (n = 15); open-flap debridement (OFD) + HA/β-TCP filling, or, HA/β-TCP-EMD group (n = 15); OFD + HA/β-TCP + EMD filling. Plaque (PI) and gingival index (GI), PPD, relative gingival margin position (RGMP), vertical and horizontal attachment level (RVAL and RHAL), vertical and horizontal bone level (RVBL and RHBL), and furcation diagnosis were evaluated at baseline and at 6 months.

RESULTS

Both groups presented improvements after therapies (p < 0.05); however, no inter-group differences could be seen in any single parameter (p > 0.05). At 6 months, the gains in rVCAL in the HA/β-TCP and HA/β-TCP-EMD groups were 1.47 ± 0.99 and 2.10 ± 0.87 mm, while the RHCAL gains were 1.47 ± 1.46 and 1.57 ± 1.58 mm (p > 0.05). The RVBL and RHBL gains for the HA/β-TCP and HA/β-TCP-EMD group were 1.47 ± 1.13 and 1.70 ± 1.26 mm, and 1.90 ± 1.11 and 1.70 ± 1.37 mm respectively (p > 0.05). The HA/β-TCP-EMD group showed seven closed furcations versus four in the HA/β-TCP group (p > 0.05).

CONCLUSION

Both treatments lead to improvements in all clinical variables studied in the present trial. However, the closure of proximal class II furcation defects is still unpredictable.

摘要

目的

临床评估单独或联合使用羟磷灰石/β-磷酸三钙(HA/β-TCP)与 enamel matrix derivative(EMD)治疗近中根分叉。

材料和方法

共纳入 30 名患者,这些患者至少有一个近中 II 类根分叉缺损,探诊袋深度(PPD)≥5mm,探诊时有出血。将这些缺损分为 HA/β-TCP 组(n=15);开放瓣清创术(OFD)+HA/β-TCP 填充,或 HA/β-TCP-EMD 组(n=15);OFD+HA/β-TCP+EMD 填充。在基线和 6 个月时评估菌斑指数(PI)和牙龈指数(GI)、PPD、相对牙龈边缘位置(RGMP)、垂直和水平附着水平(RVAL 和 RHAL)、垂直和水平骨水平(RVBL 和 RHBL)以及根分叉诊断。

结果

两组治疗后均有改善(p<0.05);但在任何单一参数上均未见组间差异(p>0.05)。在 6 个月时,HA/β-TCP 和 HA/β-TCP-EMD 组的 rVCAL 增加分别为 1.47±0.99mm 和 2.10±0.87mm,而 RHCAL 增加分别为 1.47±1.46mm 和 1.57±1.58mm(p>0.05)。HA/β-TCP 和 HA/β-TCP-EMD 组的 RVBL 和 RHBL 增加分别为 1.47±1.13mm 和 1.70±1.26mm,1.90±1.11mm 和 1.70±1.37mm(p>0.05)。HA/β-TCP-EMD 组有 7 个闭合的近中根分叉,而 HA/β-TCP 组有 4 个(p>0.05)。

结论

两种治疗方法均能改善本试验研究的所有临床变量。然而,近中 II 类根分叉缺损的闭合仍然是不可预测的。

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