Private Practice for Periodontology, Aachen, Germany.
Private Practice, Hattingen, Germany.
J Clin Periodontol. 2017 May;44(5):520-529. doi: 10.1111/jcpe.12723. Epub 2017 Apr 27.
Evaluation of the long-term effectiveness of regenerative treatment of intra-bony defects in periodontal practice.
A total of 1,008 intra-bony defects in 176 patients were analysed after using collagen-added deproteinized bovine bone mineral (DBBMc) with or without collagen membrane (CM) or enamel matrix derivative (EMD). Defects were classified as one- and two-wall and as shallow (≤6 mm), moderate (>6 and <11 mm) and deep (≥11 mm). Radiographic bone level changes were evaluated after 1 year, 2 to 4 years and 5 to 10 years.
Mean radiographic defect fill was 3.8 mm after 1 year and remained stable up to 10 years. Deep and moderate defects showed a higher degree of fill than shallow defects (53.3%, 49.2%, 42.9%). Tooth loss amounted to 2.6%, was dependent on initial defect size (1.2% shallow, 1.4% moderate, 5.7% deep defects) and occurred mainly due to endodontic reasons.
Within the limits of the retrospective study design, the findings indicate that periodontal treatment using DBBMc with or without CM or EMD can lead to long-term defect reduction and tooth survival for up to 10 years in the setting of a periodontal practice.
评估再生治疗在牙周治疗中治疗骨内缺损的长期效果。
共分析了 176 名患者的 1008 个骨内缺损,这些缺损分别使用添加胶原的脱蛋白牛骨矿物质(DBBMc)联合或不联合胶原膜(CM)或釉基质衍生物(EMD)进行治疗。将缺损分为一壁和两壁缺损以及浅(≤6mm)、中(>6mm 且<11mm)和深(≥11mm)缺损。在 1 年、2 至 4 年和 5 至 10 年后评估放射学骨水平变化。
在 1 年后,平均放射学缺损填充为 3.8mm,直至 10 年仍保持稳定。深和中缺损的填充程度高于浅缺损(53.3%、49.2%、42.9%)。牙齿缺失率为 2.6%,与初始缺损大小有关(浅缺损为 1.2%,中缺损为 1.4%,深缺损为 5.7%),主要因牙髓原因导致牙齿缺失。
在回顾性研究设计的限制范围内,研究结果表明,在牙周治疗中,使用 DBBMc 联合或不联合 CM 或 EMD 治疗可导致长期的缺损减少和牙齿存活,最长可达 10 年。