Caffesse R G, SMith B A, Duff B, Morrison E C, Merrill D, Becker W
University of Texas Health Science Center, Dental Branch, Houston.
J Periodontol. 1990 Aug;61(8):510-4. doi: 10.1902/jop.1990.61.8.510.
In the cases reported here, the response of Class II mandibular molar furcation defects to guided tissue regeneration (GTR) versus sham operation was evaluated. Base-line information, including probing pocket depth (PD) and clinical attachment level (CAL) measurements, was recorded after completion of the hygienic phase. Eleven experimental and six control furcations, randomly assigned, are included in this report. The furcations were surgically exposed, using a flap approach and the areas were debrided. On the experimental teeth, Gore-Tex periodontal material was adapted and sutured, using a suspensory suture. The flaps were then sutured tightly, assuring complete coverage to the material. For 1 month all patients were seen weekly and rinsed their mouths with an 0.12% chlorhexidine solution daily. After 4 to 6 weeks the Gore-Tex membranes were removed. Clinical measurements were repeated at 3 and 6 months following surgery. Changes from baseline in PD and CAL were calculated for each case. Results indicated that PD measurements were reduced by both procedures, but the reduction was better for GTR at 3 and 6 months. At six months the test sites showed 2.8 +/- 1.0 mm pocket reduction, while the control sites showed an average of 1.6 +/- 0.9 mm reduction in pocket depth. CAL recordings were improved by both treatments, but were better for GTR at 6 months, with an average gain in CAL of 1.8 mm for the GTR and 0.6 mm for the controls. These cases in which GTR was compared to sham-operated controls indicate that GTR can improve the response to therapy of Class II furcation defects.
在此报告的病例中,评估了Ⅱ类下颌磨牙根分叉病变对引导组织再生术(GTR)与假手术的反应。在完成口腔卫生阶段后,记录包括探诊深度(PD)和临床附着水平(CAL)测量在内的基线信息。本报告纳入了随机分配的11个试验性根分叉病变和6个对照性根分叉病变。采用翻瓣术将根分叉病变手术暴露,并对手术区域进行清创。在试验牙上,使用悬吊缝合方式适配并缝合戈尔特斯牙周材料。然后将瓣紧密缝合,确保材料完全覆盖。在1个月内,所有患者每周就诊,并每天用0.12%的氯己定溶液漱口。4至6周后取出戈尔特斯膜。术后3个月和6个月重复进行临床测量。计算每个病例相对于基线的PD和CAL变化。结果表明,两种手术方法均使PD测量值降低,但在3个月和6个月时,GTR的降低效果更好。在6个月时,试验部位的牙周袋深度减少了2.8±1.0mm,而对照部位的牙周袋深度平均减少了1.6±0.9mm。两种治疗方法均使CAL记录有所改善,但在6个月时GTR的效果更好,GTR组的CAL平均增加1.8mm,对照组为0.6mm。这些将GTR与假手术对照进行比较的病例表明,GTR可改善Ⅱ类根分叉病变的治疗反应。