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侵袭性牙周炎患者使用无机骨基质/p-15或引导组织再生治疗骨内缺损。

Treatment of intrabony defects with anorganic bone matrix/p-15 or guided tissue regeneration in patients with aggressive periodontitis.

作者信息

Queiroz Adriana C, Nóbrega Priscila Brasil da, Oliveira Fabíola S, Novaes Arthur B, Taba Mário, Palioto Daniela B, Grisi Márcio F M, Souza Sergio L S

机构信息

Dental School, Federal University of Amazonas, Manaus, AM, Brazil.

出版信息

Braz Dent J. 2013;24(3):204-12. doi: 10.1590/0103-6440201302169.

Abstract

Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.

摘要

骨内牙周缺损带来了特殊的治疗难题,尤其是在广泛侵袭性牙周炎(G-AgP)患者中。针对这种临床情况,已采用再生治疗方法。本研究的目的是比较G-AgP患者骨内牙周缺损采用无机骨基质/细胞结合肽(ABM/P-15)或引导组织再生(GTR)的治疗效果。选取了15例患者,每人有两个深度≥3mm的骨内缺损。患者被随机分配接受ABM/P-15或GTR治疗。在基线以及术后3个月和6个月时,记录临床和影像学参数以及牙龈液中IL-1β和IL-6的浓度。两组的探诊袋深度均显著降低(p<0.001)(ABM/P-15组为2.27±0.96mm,GTR组为2.57±1.06mm)。还观察到临床附着水平的增加(ABM/P-15组为1.87±0.94mm,GTR组为2.09±0.88mm)。两组之间的临床参数无统计学显著差异。ABM/P-15组的影像学骨填充(2.49mm)比GTR组(0.73mm)更明显。在减影X线片中,ABM/P-15组密度增加区域占基线缺损的93.16%,而GRT组为62.03%。在IL-1β和IL-6定量的组间和组内比较中,无统计学显著差异。G-AgP患者的骨内牙周缺损采用ABM/P-15和GTR治疗可显著改善临床效果。使用ABM/P-15可促进更好的影像学骨填充。

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