Rattanasuwan Kanyawat, Lertsukprasert Krittawat, Rassameemasmaung Supanee, Komoltri Chulaluk
Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi, Bangkok, 10400, Thailand.
Division of Clinical Epidemiology, Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Odontology. 2017 Apr;105(2):191-201. doi: 10.1007/s10266-016-0250-9. Epub 2016 May 19.
This study aimed to evaluate the long-term outcome of the regenerative periodontal therapy of an intrabony defect in terms of tooth survival and clinical attachment level (CAL) stability. The association between failure and patient as well as tooth variables was assessed. Treatment records of the patients who received regenerative surgery and re-evaluation at 1-year post-surgery were screened. Patient and tooth variables, defect characteristics, and types of treatments were collected. Periodontal parameters were retrieved before regenerative surgery (baseline), 1-year post-surgery, and every visits of supportive periodontal treatment (SPT) until failure, including tooth loss or CAL loss ≥2 mm was found. In this study, treatment records from 89 patients were included. These patients continued SPT from 0.5-11.16 years. Of these patients, 92.1 % survived from tooth loss, while 61.8 % survived from CAL loss ≥2 mm compared to 1-year post-surgery. At the sites with residual pocket depth <5 mm, patients attending SPT >80 % had a significantly less percentage of teeth with CAL loss ≥2 mm compared to 1-year post-surgery than those attending SPT <80 %. However, at the sites with residual pocket depth ≥5 mm, no significant difference in the percentage of teeth with CAL loss ≥2 mm was found between patients attending SPT >80 % or <80 %. Smoking, patient's compliance, and residual pocket depth after regenerative surgery were significantly associated with tooth loss. However, these factors were not significantly associated with CAL loss compared to baseline or 1-year post-surgery.
本研究旨在从牙齿留存率和临床附着水平(CAL)稳定性方面评估骨内缺损再生性牙周治疗的长期效果。评估了治疗失败与患者及牙齿变量之间的关联。筛选了接受再生手术并在术后1年进行重新评估的患者的治疗记录。收集了患者和牙齿变量、缺损特征及治疗类型。在再生手术前(基线)、术后1年以及直至治疗失败(包括出现牙齿脱落或CAL丧失≥2 mm)的每次支持性牙周治疗(SPT)就诊时,获取牙周参数。本研究纳入了89例患者的治疗记录。这些患者持续接受SPT的时间为0.5至11.16年。在这些患者中,与术后1年相比,92.1%的患者未出现牙齿脱落,而61.8%的患者未出现CAL丧失≥2 mm。在残余袋深<5 mm的部位,接受SPT>80%的患者中,与术后1年相比,CAL丧失≥2 mm的牙齿百分比显著低于接受SPT<80%的患者。然而,在残余袋深≥5 mm的部位,接受SPT>80%或<80%的患者中,CAL丧失≥2 mm的牙齿百分比未发现显著差异。吸烟、患者依从性和再生手术后的残余袋深与牙齿脱落显著相关。然而,与基线或术后1年相比,这些因素与CAL丧失无显著关联。