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牙周骨内缺损单瓣手术入路后牙龈边缘形态的变化

Change in the Gingival Margin Profile After the Single Flap Approach in Periodontal Intraosseous Defects.

作者信息

Farina Roberto, Simonelli Anna, Minenna Luigi, Rasperini Giulio, Schincaglia Gian Pietro, Tomasi Cristiano, Trombelli Leonardo

机构信息

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

Operative Unit of Dentistry, University Hospital, Ferrara, Italy.

出版信息

J Periodontol. 2015 Sep;86(9):1038-46. doi: 10.1902/jop.2015.150040. Epub 2015 Apr 30.

Abstract

BACKGROUND

The aim of the present study is to evaluate the association of patient-related and site-specific factors, as well as the adopted treatment modality, with the change in buccal (bREC) and interdental (iREC) gingival recession observed at 6 months after treatment of periodontal intraosseous defects with the single flap approach (SFA).

METHODS

Sixty-six patients contributing 74 intraosseous defects accessed with a buccal SFA and treated with different modalities were selected retrospectively. A two-level (patient and site) model was constructed, with the 6-month changes in bREC and iREC as the dependent variables.

RESULTS

(1) Significant 6-month increases in bREC (-0.6 ± 0.7 mm) and iREC (-0.9 ± 1.1 mm) were observed. (2) bREC change was significantly predicted by presurgery interproximal probing depth (PD) and depth of osseous dehiscence at the buccal aspect. (3) iREC change was significantly predicted by presurgery interproximal PD and the treatment modality, with defects treated with SFA in combination with a graft material and a bioactive agent being less prone to iREC increase compared to defects treated with SFA alone.

CONCLUSIONS

After buccal SFA, greater post-surgery increase in bREC must be expected for deep intraosseous defects associated with a buccal dehiscence. The combination of a graft material and a bioactive agent in adjunct to the SFA may limit the postoperative increase in iREC.

摘要

背景

本研究的目的是评估患者相关因素、特定部位因素以及所采用的治疗方式与采用单瓣法(SFA)治疗牙周骨内缺损6个月时观察到的颊侧(bREC)和牙间(iREC)牙龈退缩变化之间的关联。

方法

回顾性选取66例患者,其74处骨内缺损采用颊侧SFA入路并接受了不同治疗方式。构建了一个两级(患者和部位)模型,以bREC和iREC的6个月变化作为因变量。

结果

(1)观察到bREC(-0.6±0.7mm)和iREC(-0.9±1.1mm)在6个月时有显著增加。(2)术前邻间探诊深度(PD)和颊侧骨缺损深度可显著预测bREC变化。(3)术前邻间PD和治疗方式可显著预测iREC变化,与单纯采用SFA治疗的缺损相比,采用SFA联合移植材料和生物活性剂治疗的缺损iREC增加的可能性较小。

结论

颊侧SFA术后,对于伴有颊侧骨缺损的深部骨内缺损,术后bREC增加幅度更大。SFA联合移植材料和生物活性剂可能会限制术后iREC的增加。

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