Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.
Private Practice, Soest, Germany.
J Clin Periodontol. 2019 May;46(5):552-563. doi: 10.1111/jcpe.13110.
Evaluation of 20-year results after open flap debridement (OFD) and guided tissue regeneration (GTR) of infrabony defects in a randomized controlled trial.
In originally 16 periodontitis patients (baseline examination), periodontal surgery was performed in 44 infrabony defects. Polylactide acetyltributyl citrate barriers were randomly assigned to 23 out of these 44 defects (parallel). Ten of these patients (GTR) exhibited a second, contra-lateral defect (OFD) each (split-mouth). At baseline, 12, 120 and 240 ± 12 months after surgery probing depths, attachment level, bleeding on probing as well was Plaque Index, Gingival Bleeding Index and plaque control record were obtained.
Twelve patients contributing 38 defects were available at 240 months. At 12, 120 and 240 ± 12 months, both groups showed significant (p < 0.01) attachment gain (split-mouth: OFD: 12 months: 4.15 ± 2.93 mm; 120 months: 3.35 ± 2.37 mm, 240 months: 3.60 ± 2.55 mm; GTR: 12 months: 3.50 ± 2.47 mm; 120 months: 3.90 ± 2.76 mm, 240 months: 3.80 ± 2.69 mm; parallel: OFD: 12 months: 3.53 ± 2.04 mm; 120 months: 3.59 ± 2.54 mm, 240 months: 3.53 ± 2.50 mm; GTR: 12 months: 4.07 ± 2.88 mm; 120 months: 3.13 ± 2.22 mm, 240 months: 3.13 ± 2.22 mm). Seven teeth (3 OFD, 4 GTR) were lost. Only 1 patient out of 12 was kept in regular supportive periodontal therapy (SPT) over 20 years. The study failed to show significant attachment gain differences between both groups after 240 months.
Twenty years after OFD and GTR in infrabony defects in a population with lack of regular SPT attachment gains at 12 months after surgery were stable. About 82% of the initially included teeth were still in place.
在一项随机对照试验中，评估牙周翻瓣清创术（OFD）和引导组织再生术（GTR）治疗骨下缺损 20 年的结果。
在最初的 16 名牙周炎患者（基线检查）中，对 44 个骨下缺损进行了牙周手术。聚乳酸乙酰柠檬酸三丁酯屏障被随机分配到这些 44 个缺损中的 23 个（平行）。其中 10 名患者（GTR）各有一个第二、对侧缺损（OFD）（分口）。在基线、12、120 和 240±12 个月后，测量了探诊深度、附着水平、探诊出血以及菌斑指数、牙龈出血指数和菌斑控制记录。
在 240 个月时，12 名患者（38 个缺损）可供使用。在 12、120 和 240±12 个月时，两组均显示出显著的（p<0.01）附着体获得（分口：OFD：12 个月：4.15±2.93mm；120 个月：3.35±2.37mm，240 个月：3.60±2.55mm；GTR：12 个月：3.50±2.47mm；120 个月：3.90±2.76mm，240 个月：3.80±2.69mm；平行：OFD：12 个月：3.53±2.04mm；120 个月：3.59±2.54mm，240 个月：3.53±2.50mm；GTR：12 个月：4.07±2.88mm；120 个月：3.13±2.22mm，240 个月：3.13±2.22mm）。7 颗牙（3 颗 OFD，4 颗 GTR）脱落。在 20 年的时间里，只有 12 名患者中的 1 名接受了定期的牙周支持治疗（SPT）。研究未能显示出 240 个月后两组之间附着体获得的显著差异。
在缺乏定期 SPT 的人群中，骨下缺损接受牙周翻瓣清创术和引导组织再生术治疗 20 年后，附着体获得在术后 12 个月时稳定。最初纳入的牙齿中约有 82%仍在原位。
