Oral Health Sciences, Kristianstad University, Kristianstad, Sweden.
School of Dental Science, Trinity College, Dublin, Ireland.
J Clin Periodontol. 2018 Oct;45(10):1266-1274. doi: 10.1111/jcpe.12986. Epub 2018 Aug 21.
To assess whether the treatment outcome differed between surgical debridement, with or without a bone substitute.
Forty-one adults with three- or four-wall peri-implant bone defects were enrolled in a 1-year RCT. Surgical debridement (control group), or in combination with a bone substitute (Endobon®) (test group) was performed.
Radiographic evidence of defect fill (primary outcome) was only significant in the test group (P = 0.004). At year 1, no bleeding on probing (BOP) in the control and test groups were 7/20 (35%) and 10/21 (47.6%), respectively (χ = 0.67, P = 0.41). Plaque scores did not differ by study group at baseline (P = 0.31), or at year 1 (P = 0.08). Mid-buccal soft tissue recession changes did not differ by groups (P = 0.76). Successful treatment outcome (defect fill ≥1.0 mm, PPD values at implant ≤5 mm, no BOP, and no suppuration was identified in 1/20 (5.0%) control, and 9/21 (42.9%) test individuals (F = 7, 9, P < 0.01). Number needed to treat analysis identified an absolute risk reduction of 32.8% in benefit of the test procedure. (F = 7, 9, P < 0.01).
Successful treatment outcome using a bone substitute was more predictable when a composite therapeutic endpoint was considered.
评估在进行清创术时，是否存在骨替代物对治疗结果的影响。
41 名成年人患有三壁或四壁种植体周围骨缺损，参与了一项为期 1 年的 RCT。对患者进行清创术（对照组）或联合使用骨替代物（Endobon®）（实验组）。
仅在实验组中，影像学上的缺损填充证据（主要结局）具有显著差异（P=0.004）。在第 1 年，对照组和实验组中探诊出血（BOP）为 7/20（35%）和 10/21（47.6%）（χ=0.67，P=0.41）。在基线时（P=0.31）或第 1 年时（P=0.08），两组的菌斑评分无差异。颊侧软组织退缩变化在各组之间无差异（P=0.76）。成功的治疗结果（缺损填充≥1.0mm，PPD 值≤5mm，无 BOP，无化脓，在对照组中为 1/20（5.0%），实验组中为 9/21（42.9%）（F=7，9，P<0.01）。需要治疗的人数分析表明，实验组的绝对风险降低了 32.8%，具有明显的治疗效果。（F=7，9，P<0.01）。
当考虑综合治疗终点时，使用骨替代物的成功治疗结果更具可预测性。
