Khanna Rashmi, Khanna Rajeev, Pardhe Nilesh Dinesh, Srivastava Nancy, Bajpai Manas, Gupta Shailendra
Associate Professor, Department of Periodontics, NIMS Dental College and Hospital , Jaipur, Rajasthan, India .
Associate Professor, Department of Pharmacy, Swasthya Kalyan Homeopathy Medical College and Research Centre , Jaipur, Rajasthan, India .
J Clin Diagn Res. 2016 Sep;10(9):ZC47-ZC51. doi: 10.7860/JCDR/2016/18333.8487. Epub 2016 Sep 1.
Although many different types of Guided Tissue Regeneration (GTR) membranes (resorbable/non-resorbable, including titanium mesh) have been used in the field of Periodontics till now, but this is the first and only clinical study testing the effectiveness of an ultra thin pure Titanium Membrane (Ultra Ti) as a GTR membrane in infra-bony periodontal defects.
To compare the efficacy of GTR in intra-bony defects with newly introduced non-resorbable barrier membrane, made of titanium called "Ultra-Ti GTR Membrane" versus open flap debridement.
A prospective, randomized, controlled, clinical split mouth study was designed wherein each patient received both the control and test treatment. Two similar defects were selected in each of the 12 patients and were randomly assigned to one of the two treatments. Both the surgeries consisted of identical procedures except for the omission of the barrier membrane in the control sites. Full mouth Plaque Index (PI), Gingival Index (GI), Pocket Probing Depth (PPD) and Relative Attachment Level (RAL) were recorded before surgery and after 6 months and 9 months along with hard tissue measurements at the time of surgery and then at re-entry after 9 months. Radiographs were also taken before surgery and 9 months post operatively. Student's paired t-test and unpaired t-test (SPSS software version 9) were used to analyze the results.
Nine months after treatment, the test defects gained 4.375 ± 1.189mm of RAL, while the control defects yielded a significantly lower RAL gain of 3.417 ± 0.996mm. Pocket reduction was also significantly higher in the test group (4.917 ± 0.996mm) when compared with the controls (3.83 ± 0.718mm). There was a significant bone fill (54.69% of defect fill) obtained in the test site, unlike the control site (8.91%).
The present study demonstrated that GTR with "Ultra-Ti GTR Membrane" resulted in a significant added benefit in comparison with open flap debridement.
尽管迄今为止在牙周病学领域已使用了许多不同类型的引导组织再生(GTR)膜(可吸收/不可吸收,包括钛网),但这是第一项也是唯一一项测试超薄纯钛膜(Ultra Ti)作为GTR膜治疗骨下牙周缺损有效性的临床研究。
比较采用新推出的由钛制成的不可吸收屏障膜“Ultra-Ti GTR膜”进行引导组织再生治疗骨内缺损与开放性翻瓣清创术的疗效。
设计了一项前瞻性、随机、对照、临床双侧对照研究,其中每位患者均接受对照治疗和试验治疗。在12名患者中,为每名患者选择两个相似的缺损,并随机分配至两种治疗方法之一。除了对照部位不使用屏障膜外,两种手术均包括相同的操作步骤。在手术前、6个月和9个月后记录全口菌斑指数(PI)、牙龈指数(GI)、牙周袋探诊深度(PPD)和相对附着水平(RAL),并在手术时以及9个月后再次切开时进行硬组织测量。术前和术后9个月也拍摄了X光片。使用学生配对t检验和非配对t检验(SPSS软件版本9)分析结果。
治疗9个月后,试验组缺损的相对附着水平增加了4.375±1.189mm,而对照组缺损的相对附着水平增加明显较低,为3.417±0.996mm。与对照组(3.83±0.718mm)相比,试验组的牙周袋减少也明显更高(4.917±0.996mm)。试验部位获得了显著的骨填充(占缺损填充的54.69%),与对照部位(8.91%)不同。
本研究表明,与开放性翻瓣清创术相比,使用“Ultra-Ti GTR膜”进行引导组织再生带来了显著的额外益处。