Reddy B Ravinder, Sudhakar J, Rajesh Nichenametla, Sandeep V, Reddy Y Muralidhar, Gnana Sagar W R
Department of Periodontology, Nanded Rural Dental College and Research Centre, Nanded, Maharashtra, India.
Department of Periodontology, G.Pullareddy Dental College, Kurnool, Andhra Pradesh, India.
J Int Soc Prev Community Dent. 2016 Dec;6(Suppl 3):S248-S253. doi: 10.4103/2231-0762.197207.
Several materials have been introduced as bone grafts, i.e., autografts, allograft, xenografts, and alloplastic grafts, and studies have shown them to produce greater clinical bone defect fill than open flap debridement alone. The aim of this clinical and radiological 6-month study was to compare and evaluate the clinical outcome of deep intraosseous defects following reconstructive surgery with the use of mineralized cancellous bone allograft (Puros) or autogenous bone.
Ten patients with 12 sites exhibiting signs of moderate generalized chronic periodontitis were enrolled in the study. The investigations were confined to two and three-walled intra bony defects with a preoperative probing depth of ≥5 mm. Six of these defects were treated with Puros (group A) the remaining six were treated with autogenous bone graft (group B). Allocation to the two groups was randomized. The clinical parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and bone fill, were recorded at different time intervals at the baseline, 1 month, 3 months, and 6 months. Intraoral radiographs were taken using standardized paralleling cone technique at baseline, 1, 3, and 6 months. Statistical analysis was done by using the one-way analysis of variance (ANOVA) followed by Tukey highly significant difference.
Both groups resulted in decrease in probing depth (group A, 3.0 mm; group B, 2.83 mm) and gain in clinical attachment level (group A, 3.33 mm; group B, 3.0 mm) over a period of 6 months, which was statistically insignificant.
Within the limitations of the present study, it can be concluded that both mineralized cancellous bone allograft (Puros) or autogenous bone result in significant clinical improvements.
已有多种材料被用作骨移植材料,即自体骨移植、同种异体骨移植、异种骨移植和人工合成骨移植,研究表明这些材料比单纯开放瓣清创术能产生更大的临床骨缺损填充效果。本临床和影像学6个月研究的目的是比较和评估使用矿化松质骨同种异体骨(Puros)或自体骨进行重建手术后深部骨内缺损的临床结果。
10例患者共12个部位表现出中度广泛性慢性牙周炎症状,纳入本研究。研究仅限于术前探诊深度≥5mm的二壁和三壁骨内缺损。其中6个缺损用Puros治疗(A组),其余6个缺损用自体骨移植治疗(B组)。两组的分配是随机的。在基线、1个月、3个月和6个月的不同时间间隔记录临床参数,包括菌斑指数(PI)、牙龈指数(GI)、探诊袋深度(PPD)、临床附着水平(CAL)和骨填充情况。在基线、1个月、3个月和6个月时使用标准化平行投照技术拍摄口腔内X光片。采用单因素方差分析(ANOVA),随后进行Tukey高度显著差异分析。
两组在6个月内探诊深度均降低(A组,3.0mm;B组,2.83mm),临床附着水平均增加(A组,3.33mm;B组,3.0mm),差异无统计学意义。
在本研究的局限性内,可以得出结论,矿化松质骨同种异体骨(Puros)或自体骨均能带来显著的临床改善。