Rosen Paul S, Froum Stuart J, Cohen D Walter
Int J Periodontics Restorative Dent. 2015 Jul-Aug;35(4):453-60. doi: 10.11607/prd.2314.
This retrospective case series describes a layered regenerative approach for five Class III and one borderline Class IV furcation, involving treatment consisting of root management that included conditioning with tetracycline solution followed by the topical application of recombinant platelet-derived growth factor BB. A composite allograft with mesenchymal stem cells was subsequently placed into the furcation and covered by a barrier derived from human amnion-chorion with flaps advanced to completely cover the site. Three furcations, including the one diagnosed as Class IV, had complete closure, two were converted to Class I, and in one instance, there was no improvement. This regenerative algorithm for mandibular Class III furcations may present the potential to save these teeth by altering the prognosis, which has traditionally been poor to hopeless, resulting in many of these teeth routinely being extracted.
本回顾性病例系列描述了一种针对5例Ⅲ类和1例临界Ⅳ类根分叉病变的分层再生治疗方法,治疗包括牙根处理,先用四环素溶液预处理,然后局部应用重组血小板衍生生长因子BB。随后将含有间充质干细胞的复合同种异体移植物植入根分叉,并用人羊膜-绒毛膜来源的屏障覆盖,推进瓣以完全覆盖该部位。包括诊断为Ⅳ类的1例在内,有3例根分叉完全闭合,2例转变为Ⅰ类,1例无改善。这种下颌Ⅲ类根分叉病变的再生治疗方案可能通过改变预后而具有保留这些牙齿的潜力,传统上这些牙齿的预后很差甚至无望,导致许多此类牙齿常规被拔除。