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非切口乳头法治疗牙周深袋伴根分叉病变的疗效观察

Supra-alveolar attachment gain in the treatment of combined intra-suprabony periodontal defects by non-incised papillae surgical approach.

机构信息

Private Practice, Murcia, Spain.

Department of Stomatology, Faculty of Medicine, University of Murcia, Murcia, Spain.

出版信息

J Clin Periodontol. 2019 Sep;46(9):927-936. doi: 10.1111/jcpe.13158. Epub 2019 Jul 22.

Abstract

AIM

To assess the effectiveness of non-incised papillae surgical approach (NIPSA) in periodontal reconstructive surgery of combined intra-suprabony defects.

MATERIALS AND METHODS

Patients with deep periodontal defects treated with NIPSA (n = 20) were analysed. Defects were treated with enamel matrix derivative plus xenograft. Clinical outcomes were assessed before surgery and at 12 months. Wound closure was assessed one week post-surgery. Supra-alveolar attachment gain (SUPRA-AG) was recorded at 12 months post-surgery.

RESULTS

Non-incised papillae surgical approach showed significant improvements in clinical attachment gain (5.9 ± 2.38 mm; p < 0.001), recession reduction (0.25 ± 0.44; p < 0.05) and tip of the papillae coronal displacement (0.4 ± 0.5; p < 0.05). It also showed complete wound closure of the apical mucosal incision in the 85% of the cases, with no interproximal tissue necrosis. SUPRA-AG (1.9 ± 1.74) showed a positive tendency, associated with complete intrabony defect resolution.

CONCLUSIONS

Non-incised papillae surgical approach promoted primary intention healing, wound stability and space provision for optimal periodontal reconstruction, preserving supra-alveolar soft tissue integrity.

摘要

目的

评估非切开乳头外科手术(NIPSA)在联合内牙槽嵴骨缺损牙周重建术中的效果。

材料和方法

分析了接受 NIPSA(n=20)治疗的深度牙周缺损患者。使用釉基质衍生物加异种移植物治疗缺损。在手术前和 12 个月时评估临床结果。术后一周评估伤口闭合情况。在术后 12 个月记录牙槽嵴顶附着增加(SUPRA-AG)。

结果

非切开乳头外科手术在临床附着增加(5.9±2.38mm;p<0.001)、退缩减少(0.25±0.44;p<0.05)和乳头尖端冠向移位(0.4±0.5;p<0.05)方面均有显著改善。它还显示 85%的病例根尖黏膜切口完全闭合,无近中组织坏死。SUPRA-AG(1.9±1.74)显示出积极的趋势,与完全的牙槽骨内缺损解决相关。

结论

非切开乳头外科手术促进了一期愈合、伤口稳定性和为最佳牙周重建提供空间,保持了牙槽嵴顶软组织的完整性。

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