Lal Nand, Dixit Jaya
Associate Professor, Department of Periodontology, Faculty of Dental Sciences, CSM Medical University, Lucknow, Uttar Pradesh - 226003, India.
Professor, Department of Periodontology, Faculty of Dental Sciences, CSM Medical University, Lucknow, Uttar Pradesh - 226003, India.
J Oral Biol Craniofac Res. 2012 Jan-Apr;2(1):36-40. doi: 10.1016/S2212-4268(12)60009-8.
Osseous defects in periodontal diseases require osseous grafts and guided tissue regeneration (GTR) using barrier membranes. The present study was undertaken with the objectives to clinically evaluate the osteogenic potential of hydroxyapatite (HA), cissus quadrangularis (CQ), and oxidized cellulose membrane (OCM) and compare with normal bone healing.
Twenty subjects with periodontitis in the age group ranging from 20 years to 40 years were selected from our outpatient department on the basis of presence of deep periodontal pockets, clinical probing depth ≥5 mm, vertical osseous defects obvious on radiograph and two- or three-walled involvement seen on surgical exposure. Infrabony defects were randomly divided into four groups on the basis of treatment to be executed, such that each group comprised 5 defects. Group I was control, II received HA, III received CQ and IV received OCM. Probing depth and attachment level were measured at regular months after surgery. Defects were re-exposed using crevicular incisions at 6 months.
There was gradual reduction in the mean probing pocket depth in all groups, but highly significant in the site treated with HA. Gain in attachment level was higher in sites treated with HA, 3.2 mm at 6 months.
Hydroxyapatite and OCM showed good reduction in pocket depth, attachment level gain and osseous defect fill. Further study should be conducted by using a combination of HA and OCM in periodontal osseous defects with growth factors and stem cells.
牙周疾病中的骨缺损需要使用屏障膜进行骨移植和引导组织再生(GTR)。本研究旨在临床评估羟基磷灰石(HA)、四角金(CQ)和氧化纤维素膜(OCM)的成骨潜力,并与正常骨愈合进行比较。
从我们的门诊部挑选了20名年龄在20岁至40岁之间的牙周炎患者,入选标准为存在深牙周袋、临床探诊深度≥5mm、X线片显示垂直骨缺损明显且手术暴露可见两壁或三壁受累。根据治疗方案将骨下袋缺损随机分为四组,每组包含5个缺损。第一组为对照组,第二组接受HA治疗,第三组接受CQ治疗,第四组接受OCM治疗。术后定期测量探诊深度和附着水平。在6个月时使用龈沟切口再次暴露缺损部位。
所有组的平均探诊袋深度均逐渐降低,但在接受HA治疗的部位降低极为显著。接受HA治疗的部位附着水平增加更高,6个月时为3.2mm。
羟基磷灰石和OCM在袋深度降低、附着水平增加和骨缺损填充方面表现良好。应进一步开展研究,将HA和OCM与生长因子和干细胞联合用于牙周骨缺损。