Joly Julio Cesar, Palioto Daniela Bazan, de Lima Antonio Fernando Martorelli, Mota Luis Fernando, Caffesse Raul
Department of Prosthodontics and Periodontics, School of Dentistry of Piracicaba, University of Campinas, São Paulo, Brazil.
Department of Periodontics, University of Pittsburgh, PA.
J Periodontol. 2002 Apr;73(4):353-359. doi: 10.1902/jop.2002.73.4.353.
The aim of this clinical and radiographic study was to evaluate the effect of guided tissue regeneration using a bioabsorbable barrier in the treatment of intrabony defects in humans.
Intrabony osseous defects (2 or 3 walls) around mandibular canines and premolars were treated in 10 systemically healthy patients with ages ranging from 35 to 56 years. Prior to the surgical phase, patients were enrolled in a strict maintenance program including oral hygiene instructions and scaling and root planing (presurgical PI and GI <10%). Patients were seen for professional prophylaxis during the duration of the study. Clinical measurements were performed with an electronic probe at baseline and at reentry 8 months following surgical therapy. Measurements included clinical attachment levels (CAL), gingival margin levels (GML), probing depths (PD), bone defect levels (BDL), and alveolar crest level (ACL). A split mouth design was used. Quadrants were randomly assigned for treatment by GTR (experimental) or open flap debridement alone control). Standardized radiographs were taken at baseline and at reentry. Digital images were analyzed by subtraction to assess changes in area (A) and optical density (OD). Data were evaluated using paired t test.
Statistically significant differences were found in both groups when comparing baseline and post-treatment values for CAL, GML, PD, and BDL (P <0.01). Greater reductions in BDL and gain in A and OD were observed in the GTR group when compared to control (P <0.01). Both therapies were effective in improving the clinical parameters assessed.
Clinical and radiographic findings from this study demonstrated more bone fill in sites treated with GTR. J Periodontol 2002;73:353-359.
本临床和影像学研究的目的是评估使用生物可吸收屏障引导组织再生治疗人类骨内缺损的效果。
对10名年龄在35至56岁之间、全身健康的患者下颌尖牙和前磨牙周围的骨内骨缺损(2壁或3壁)进行治疗。在手术阶段之前,患者参加了严格的维护计划,包括口腔卫生指导以及龈上洁治和根面平整(术前菌斑指数和牙龈指数<10%)。在研究期间对患者进行专业预防治疗。在基线时以及手术治疗后8个月复诊时使用电子探针进行临床测量。测量包括临床附着水平(CAL)、牙龈边缘水平(GML)、探诊深度(PD)、骨缺损水平(BDL)和牙槽嵴水平(ACL)。采用双侧对照设计。象限随机分配接受引导组织再生治疗(试验组)或仅接受开放瓣清创术(对照组)。在基线时和复诊时拍摄标准化X线片。通过图像相减分析数字图像以评估面积(A)和光密度(OD)的变化。使用配对t检验评估数据。
比较两组基线和治疗后CAL、GML、PD和BDL的值时,均发现有统计学意义的差异(P<0.01)。与对照组相比,引导组织再生组BDL减少更多,A和OD增加更多(P<0.01)。两种治疗方法在改善所评估的临床参数方面均有效。
本研究的临床和影像学结果表明,引导组织再生治疗的部位骨填充更多。《牙周病学杂志》2002年;73:353 - 359。