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牙周再生治疗中单次瓣法与双次瓣法的比较

Single versus double flap approach in periodontal regenerative treatment.

作者信息

Schincaglia Gian Pietro, Hebert Eric, Farina Roberto, Simonelli Anna, Trombelli Leonardo

机构信息

Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, USA.

Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.

出版信息

J Clin Periodontol. 2015 Jun;42(6):557-66. doi: 10.1111/jcpe.12409. Epub 2015 May 29.

Abstract

AIM

to compare the outcomes of a regenerative strategy based on recombinant human platelet-derived growth factor-BB (rhPDGF-BB, 0.3 mg/ml) and β-tricalcium phosphate (β-TCP) in the treatment of intraosseous defects accessed with the Single Flap Approach (SFA) versus Double Flap Approach based on papilla preservation techniques (DFA).

MATERIALS AND METHODS

Fifteen and 13 defects, randomly assigned to SFA or DFA, respectively, were grafted with rhPDGF-BB + β-TCP. Probing parameters were assessed before and 6 months after surgery. Pain (VAS(pain)) was self-reported using a visual analogue scale.

RESULTS

Twelve SFA sites and DFA 6 sites showed complete flap closure at 2 weeks post-surgery. No significant differences in 6-month changes in probing parameters and radiographic defect fill were found between groups. Significantly lower VAS(pain) was observed in SFA group compared to DFA group at day +1, +2 and +6. A significantly greater number of analgesics were consumed in the DFA group compared to the SFA group at day +1.

CONCLUSIONS

When combined with rhPDGF-BB and β-TCP, the SFA may result in similar clinical outcomes, better quality of early wound healing, and lower pain and consumption of analgesics during the first postoperative days compared to the DFA.

摘要

目的

比较基于重组人血小板衍生生长因子-BB(rhPDGF-BB,0.3mg/ml)和β-磷酸三钙(β-TCP)的再生策略在采用单瓣入路(SFA)与基于乳头保留技术的双瓣入路(DFA)治疗骨内缺损时的效果。

材料与方法

分别随机分配至SFA或DFA的15处和13处缺损,采用rhPDGF-BB +β-TCP进行移植。在手术前和术后6个月评估探诊参数。使用视觉模拟量表自我报告疼痛(VAS(疼痛))。

结果

12个SFA位点和6个DFA位点在术后2周显示皮瓣完全闭合。两组之间在6个月时探诊参数变化和影像学缺损填充方面未发现显著差异。在术后第1天、第2天和第6天,SFA组的VAS(疼痛)明显低于DFA组。在术后第1天,DFA组消耗的镇痛药数量明显多于SFA组。

结论

与DFA相比,当与rhPDGF-BB和β-TCP联合使用时,SFA可能会产生相似的临床效果,早期伤口愈合质量更好,且术后第一天的疼痛和镇痛药消耗量更低。

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