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使用釉基质衍生物、引导组织再生术和开放式瓣清创术治疗骨内缺损的五年临床结果:病例系列

Five-year clinical results for treatment of intrabony defects with EMD, guided tissue regeneration and open-flap debridement: a case series.

作者信息

Mitani A, Takasu H, Horibe T, Furuta H, Nagasaka T, Aino M, Fukuda M, Fujimura T, Mogi M, Noguchi T

机构信息

Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.

出版信息

J Periodontal Res. 2015 Feb;50(1):123-30. doi: 10.1111/jre.12188. Epub 2014 May 12.

Abstract

BACKGROUND AND OBJECTIVE

Although regenerative periodontal surgery with EMD or guided tissue regeneration (GTR) has been shown to enhance periodontal regeneration, there are limited data on the long-term results following these treatment modalities. The purpose of the present study was to investigate the long-term clinical outcomes in intrabony defects following regenerative periodontal surgery with EMD or GTR compared with open-flap debridement (OFD).

MATERIAL AND METHODS

Data from 40 subjects (44 teeth), with no history of smoking or systemic diseases that could interfere with periodontal disease and who received one of three surgical procedures (EMD, GTR or OFD) for two- or three-wall intrabony defects, were analyzed. Postoperative reduction in probing pocket depth, gain in clinical attachment level, gingival recession and percentage bone fill were compared at 1, 3 and 5 years.

RESULTS

Reduction in probing pocket depth after GTR was significantly higher than after OFD at 1 and 3 years postoperatively, but there was no difference between the groups at 5 years. The gains in clinical attachment level for EMD (at 3 and 5 years) and for GTR (at 1, 3 and 5 years) were significantly greater than for OFD. Gingival recession after treatment with EMD and GTR showed a tendency toward positive results, whereas no such tendency was observed for OFD. Postoperative percentage bone fill for EMD and GTR was significantly greater than for OFD at 3 and 5 years.

CONCLUSIONS

This is a retrospective study and an exploratory report with a high risk of bias. Within the limits of the current study, it may be concluded that superior gains in clinical attachment level and improved percentage bone fill can be obtained with EMD and GTR when compared with OFD, and these can be maintained over a period of 5 years.

摘要

背景与目的

尽管使用釉基质衍生物(EMD)或引导组织再生术(GTR)的再生性牙周手术已被证明可促进牙周组织再生,但关于这些治疗方式的长期效果的数据有限。本研究的目的是调查与开放式翻瓣清创术(OFD)相比,采用EMD或GTR的再生性牙周手术治疗骨内缺损的长期临床疗效。

材料与方法

分析了40名受试者(44颗牙齿)的数据,这些受试者无吸烟史或可能干扰牙周疾病的全身性疾病,且因两壁或三壁骨内缺损接受了三种手术操作(EMD、GTR或OFD)之一。比较术后1年、3年和5年时探诊深度的减少、临床附着水平的增加、牙龈退缩情况及骨填充百分比。

结果

术后1年和3年时,GTR术后探诊深度的减少显著高于OFD术后,但5年时两组之间无差异。EMD组(3年和5年时)和GTR组(1年、3年和5年时)临床附着水平的增加显著大于OFD组。EMD和GTR治疗后牙龈退缩呈改善趋势,而OFD组未观察到这种趋势。术后3年和5年时,EMD和GTR的骨填充百分比显著高于OFD。

结论

这是一项回顾性研究和探索性报告,存在较高的偏倚风险。在本研究的局限性范围内,可以得出结论,与OFD相比,EMD和GTR在临床附着水平上有更好的增加,骨填充百分比有所改善,并且这些效果可以维持5年。

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