Górski Bartłomiej, Jalowski Stanisław, Górska Renata, Zaremba Maciej
Department of Periodontology and Oral Diseases, Medical University of Warsaw, Miodowa St 18, 00-246, Warsaw, Poland.
Department of Dental and Maxillofacial Radiology, Medical University of Warsaw, Nowogrodzka St 59, 02-006, Warsaw, Poland.
Clin Oral Investig. 2018 Nov;22(8):2819-2828. doi: 10.1007/s00784-018-2368-3. Epub 2018 Feb 6.
The aim of this study was to compare the clinical and radiographic efficacy of guided tissue regeneration with a modified perforated collagen membrane (MPM) or standard collagen membrane (CM) in the treatment of intrabony defects in patients with aggressive periodontitis (AgP).
Fifteen AgP patients were included in the study. Two single intrabony defects of at least 3 mm depth with ≥ 6 mm probing pocket depth (PPD) from each patient were randomly assigned to either xenogenic graft plus MPM (test group) or xenogenic graft plus CM (control group). PPD, clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and at 12 months. The radiographic assessments included the measurements of defect depth (DD), change in alveolar crest position (ACP), linear defect fill (LDF), and percentage defect fill (%DF).
After treatment, PPD, CAL, DD, and ACP values improved significantly in both groups, without statistical differences between them. However, with respect to LDF and %DF, the 12-month radiographic analysis at MPM-treated sites showed a significant improvement compared to the 6-month outcomes, that was not observed at control sites (additional LDF of 0.4 ± 0.5 mm, p = 0.010 and %DF of 6.4 ± 7.6%, p = 0.025).
Both strategies proved effective in the treatment of intrabony defects in patients with AgP. Nonetheless, enhanced LDF and %DF 12 months postoperatively at MPM-treated sites may stem from cellular and molecular migration from the periosteum and overlying gingival connective tissue through barrier's pores.
Modification of CM may have positive ramifications on periodontal regeneration.
本研究旨在比较改良穿孔胶原膜（MPM）或标准胶原膜（CM）引导组织再生治疗侵袭性牙周炎（AgP）患者骨内缺损的临床和影像学疗效。
15例AgP患者纳入本研究。从每位患者中选取两个深度至少为3mm且探诊袋深度（PPD）≥6mm的单个骨内缺损，随机分为异种移植物联合MPM组（试验组）或异种移植物联合CM组（对照组）。在基线和12个月时记录PPD、临床附着水平（CAL）和牙龈退缩（GR）。影像学评估包括测量缺损深度（DD）、牙槽嵴位置变化（ACP）、线性缺损填充（LDF）和缺损填充百分比（%DF）。
治疗后，两组的PPD、CAL、DD和ACP值均显著改善，两组之间无统计学差异。然而，关于LDF和%DF，MPM治疗部位的12个月影像学分析显示与6个月时的结果相比有显著改善，而对照组未观察到这种改善（额外的LDF为0.4±0.5mm，p = 0.010；%DF为6.4±7.6%，p = 0.025）。
两种策略在治疗AgP患者的骨内缺损方面均被证明是有效的。尽管如此，MPM治疗部位术后12个月LDF和%DF的增加可能源于细胞和分子通过屏障孔隙从骨膜和覆盖的牙龈结缔组织迁移。
CM的改良可能对牙周再生有积极影响。
