Gupta Abhaya, Govila Vivek, Pant Vandana A, Gupta Rajiv, Verma Umesh P, Ahmad Hafsa, Mohan Sumedha
Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Periodontology, Babu Banarasi Das College of Dental Sciences, Babu Banarasi Das University, Lucknow, Uttar Pradesh, India.
Natl J Maxillofac Surg. 2018 Jan-Jun;9(1):22-32. doi: 10.4103/njms.NJMS_12_18.
This study aimed to evaluate the efficacy of local drug delivery system of zoledronate (ZLN) gel as an adjunct to scaling and root planing (SRP) for the treatment of human periodontal intrabony defects clinically and radiographically.
Forty intrabony defects (three walled and combined defects without involving furcation) in moderate to severely affected forty chronic periodontitis patients (range, 30-50 years) were randomly divided into two groups and treated either with 0.05% ZLN gel (ZLN = 20; 1 dropout) or placebo gel (control group [CG] = 20) after SRP. Clinical parameters such as plaque index (PI), gingival index (GI), tooth-specific pocket probing depth (T PPD), and clinical attachment levels (TsCAL) were assessed at baseline and at 3 and 6 months using occlusal acrylic stent. Radiographic parameters were assessed at baseline and 6 months, utilizing "ONIS 2.5 PROFESSIONAL" and "SYNGO" software compatible with DentaScan to measure the volumetric bone changes in intrabony defects.
In intragroup comparisons, both groups showed significant PI and GI reduction ( < 0.001) after treatment at 3 and 6 months. In intergroup comparisons, T PPD reduction and T CAL gain were significant only in ZLN at 6 months from both baseline and 3 months. Radiographically, significant reduction in defect depth and buccolingual width with volumetric defect gain of 40.24% ± 7.44% in ZLN compared to insignificant gain of 1.60% ± 4.06% in CG was observed at 6 months.
ZLN gel applied subgingivally in intrabony defects resulted in significant improvements both clinically and radiographically.
本研究旨在通过临床和影像学方法评估唑来膦酸(ZLN)凝胶局部给药系统作为龈下刮治术和根面平整术(SRP)辅助手段治疗人类牙周骨内缺损的疗效。
将40例中重度慢性牙周炎患者(年龄范围30 - 50岁)的40个骨内缺损(三壁及混合性缺损,未累及根分叉)随机分为两组,在SRP术后分别用0.05% ZLN凝胶(ZLN组 = 20例;1例退出)或安慰剂凝胶(对照组[CG] = 20例)进行治疗。使用咬合丙烯酸支架在基线、3个月和6个月时评估临床参数,如菌斑指数(PI)、牙龈指数(GI)、特定牙位的牙周袋探诊深度(T PPD)和临床附着水平(TsCAL)。在基线和6个月时,利用与DentaScan兼容的“ONIS 2.5 PROFESSIONAL”和“SYNGO”软件评估影像学参数,以测量骨内缺损的体积性骨变化。
组内比较,两组在3个月和6个月治疗后PI和GI均显著降低(<0.001)。组间比较,仅ZLN组在6个月时,与基线和3个月相比,T PPD降低和T CAL增加具有显著性。影像学上,6个月时观察到ZLN组缺损深度和颊舌宽度显著减小,体积性缺损增加40.24%±7.44%,而CG组仅增加1.60%±4.06%,无显著性差异。
在骨内缺损处龈下应用ZLN凝胶在临床和影像学上均有显著改善。