Gojkov-Vukelic Mirjana, Hadzic Sanja, Pasic Enes
Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Sarajevo, Bosnia and Hercegovina.
Med Arch. 2017 Jun;71(3):208-211. doi: 10.5455/medarh.2017.71.208-211.
One of the most important goals of periodontitis therapy is the elimination of deep periodontal pockets. In regenerative periodontal therapy, different types of bone grafts, membranes, growth factors, etc. are used to improve regeneration of lost periodontal tissue. The aim of this study was to evaluate the effect of surgical therapy supported by the use of bone replacement material in the treatment of deep intrabony pockets, compared to surgical treatment (flap surgery) without the use of bone replacement in advanced periodontitis.
The study included 50 patients of both sexes with advanced periodontitis, divided into two groups. After initial periodontal therapy was performed, plaque index (PI), papillary bleeding index (PBI) were verified, and depth of periodontal pockets was measured in both groups. One group (group 1) of the patients underwent surgical therapy, open flap surgery, while the other group (group 2) underwent the same surgical treatment method (open flap surgery), during which bone defects were filled with bone replacement material.
The results showed that both group 1 and group 2 experienced improvements after periodontal surgical therapy. In group 1, there are no statistically significant changes in all three plaque index measurements (PI), while there has been a significant reduction in PI in group 2 following the surgery. For the PBI index, it was determined that there were statistically significant changes in values in group 1, both after surgical procedures and six months later, as well as in group 2. Statistical analysis of the results of the probing depth of pockets has shown that there are significant changes in the measurement of the depth of periodontal pocket one month after the surgery, as well as six months later, meaning that there has been a significant reduction in the depth of the periodontal pocket one month following the surgery as well as six months later, for both groups. However, we did not determine a statistically significant difference in the probing depth of pockets between these two groups.
Six months after a surgical therapy, clinical parameters showed a reduction of the probing depth of the periodontal pocket in both examined groups. The use of bone replacement did not yield significantly better results in reducing the depth of probing compared to the standard flap surgery. We believe that future research should focus on testing the effectiveness of new regenerative methods and materials (bone replacements with various properties, membranes, and surgical methods) that will result in better treatment results with predictable outcomes.
牙周炎治疗的最重要目标之一是消除深牙周袋。在牙周再生治疗中,使用不同类型的骨移植材料、膜、生长因子等来促进丧失的牙周组织再生。本研究的目的是评估在晚期牙周炎中,与不使用骨替代材料的手术治疗(翻瓣手术)相比,使用骨替代材料辅助的手术治疗对深骨内袋的治疗效果。
该研究纳入了50例患有晚期牙周炎的男女患者,分为两组。在进行初始牙周治疗后,对两组患者的菌斑指数(PI)、牙龈乳头出血指数(PBI)进行核实,并测量牙周袋深度。一组患者(第1组)接受手术治疗,即开放性翻瓣手术,而另一组患者(第2组)接受相同的手术治疗方法(开放性翻瓣手术),在此过程中用骨替代材料填充骨缺损。
结果显示,第1组和第2组在牙周手术治疗后均有改善。在第1组中,所有三项菌斑指数测量值(PI)均无统计学显著变化,而第2组术后PI有显著降低。对于PBI指数,确定第1组在手术操作后及六个月后的值以及第2组的值均有统计学显著变化。对牙周袋探诊深度结果的统计分析表明,术后一个月以及六个月后牙周袋深度测量有显著变化,这意味着两组在术后一个月以及六个月后牙周袋深度均有显著降低。然而,我们未确定这两组之间牙周袋探诊深度的统计学显著差异。
手术治疗六个月后,两个受试组的临床参数均显示牙周袋探诊深度降低。与标准翻瓣手术相比,使用骨替代材料在减少探诊深度方面并未产生明显更好的效果。我们认为未来的研究应侧重于测试新的再生方法和材料(具有各种特性的骨替代材料、膜和手术方法)的有效性,这些方法将带来更好的治疗效果和可预测的结果。