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羊膜绒毛膜和脱矿骨基质糊剂异体移植治疗牙周骨内缺损的临床和影像学评估:一项随机临床试验

Clinical and radiographic evaluation of amnion chorion membrane and demineralized bone matrix putty allograft for management of periodontal intrabony defects: a randomized clinical trial.

作者信息

Temraz Amr, Ghallab Noha A, Hamdy Reham, El-Dahab Omnia Abu

机构信息

Faculty of Dentistry, Cairo University, Cairo, Egypt.

Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, 43 Zahraa Street, Dokki, Giza, Egypt.

出版信息

Cell Tissue Bank. 2019 Mar;20(1):117-128. doi: 10.1007/s10561-018-09743-6. Epub 2019 Jan 10.

Abstract

The aim of this trial was to compare the clinical and radiographic outcomes of amnion chorion membrane (ACM) with demineralized bone matrix (DBM) in a putty form in management of periodontal intrabony defects. Twenty-two participants with severe chronic periodontitis and intrabony defects, were randomly assigned in two equal parallel groups. Each group was treated with open flap debridement (OFD) and ACM or OFD and DBM putty. Plaque index, gingival index, pocket depth (PD), clinical attachment level (CAL) and radiographic measurement of bone defect area (BDA) were recorded at baseline, 3 and 6 months postoperatively. Both ACM and DBM putty demonstrated significant improvement in all clinical and radiographic outcomes at 6 months compared to baseline values. However, no significant difference was observed between the two treatment modalities when compared at different time intervals. Six months postoperatively, ACM showed 3.18 ± 0.85 mm, PD reduction and 2.25 ± 0.75 mm CAL gain, while DBM putty revealed 3.45 ± 1.08 mm PD reduction and 2.73 ± 0.85 mm CAL gain. Radiographic assessment showed that mean baseline BDA for ACM group was 10.39 ± 3.86 mm, which significantly reduced to 5.21 ± 2.38 after 6 months. Mean BDA mm in DBM putty group also significantly improved after 6 months, 5.35 ± 3.63 mm when compared to baseline values 9.80 ± 5.77 mm. Both ACM barrier and DBM putty allograft provided significant improvement in clinical and radiographic outcomes after 6 months, yet no significant differences were noticed between them. This trial implied that both biomaterials have a potential regenerative capacity in treating periodontal intrabony defects.

摘要

本试验的目的是比较羊膜绒毛膜(ACM)与油灰状脱矿骨基质(DBM)在治疗牙周骨内缺损方面的临床和影像学结果。22名患有重度慢性牙周炎和骨内缺损的参与者被随机分为两个相等的平行组。每组均接受开放性翻瓣清创术(OFD)并使用ACM或OFD并使用DBM油灰进行治疗。在基线、术后3个月和6个月时记录菌斑指数、牙龈指数、牙周袋深度(PD)、临床附着水平(CAL)以及骨缺损面积(BDA)的影像学测量值。与基线值相比,ACM和DBM油灰在6个月时所有临床和影像学结果均显示出显著改善。然而,在不同时间间隔进行比较时,两种治疗方式之间未观察到显著差异。术后6个月,ACM组的PD减少了3.18±0.85mm,CAL增加了2.25±0.75mm,而DBM油灰组的PD减少了3.45±1.08mm,CAL增加了2.73±0.85mm。影像学评估显示,ACM组的平均基线BDA为10.39±3.86mm,6个月后显著降至5.21±2.38mm。DBM油灰组6个月后的平均BDA也显著改善,与基线值9.80±5.77mm相比为5.35±3.63mm。6个月后,ACM屏障和DBM油灰同种异体移植物在临床和影像学结果方面均有显著改善,但两者之间未发现显著差异。本试验表明,两种生物材料在治疗牙周骨内缺损方面均具有潜在的再生能力。

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