Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.
J Periodontol. 2020 Sep;91(9):1148-1158. doi: 10.1002/JPER.19-0529. Epub 2020 Feb 26.
Identifying factors affecting the treatment outcomes of guided tissue regeneration (GTR) in furcation defects is imperative in order to obtain predictable regeneration outcomes. The aims of this study were to evaluate the clinical outcomes and survival of furcation-involved teeth treated with GTR, and potential factors affecting the results.
Furcation defects treated with GTR using an allogeneic cancellous bone graft and covered by an absorbable membrane with at least 1-year follow-up were selected. All data relative to the clinical outcomes were recorded. Analyses were conducted to evaluate the immediate (1-year post-op) clinical outcomes and the long-term (the last assessment time) survival of the treated teeth. The effect of variables on the 1-year post-op clinical attachment level (CAL) changes and the tooth survival were assessed via multi-level regression analyses and Cox Proportional-Hazards Models.
Ninety-eight treated defects were selected. The average follow-up was 5.3 ± 4.3 years. At the 1-year post-surgical recall, 1.23 ± 1.48 mm CAL gain was observed (P < 0.05). The 5- and 10-year survival rates of the treated teeth were 86.5% and 74.3%, respectively. The vertical component of the defect and the location of the furcation were significantly related to the post-surgical 1-year CAL gain, whereas membrane exposure significantly affected tooth survival.
Within the limitations of this study, data suggests GTR using allogeneic cancellous bone graft and absorbable collagen membrane to be a viable option for treating furcation-involved teeth if the defect morphology and the location of the defect are favorable.
为了获得可预测的再生结果,确定影响引导组织再生(GTR)治疗叉状缺损效果的因素至关重要。本研究旨在评估用 GTR 治疗叉状缺损的临床效果和存活率,并分析潜在的影响因素。
选择使用同种异体松质骨移植物进行 GTR 治疗,并使用可吸收膜覆盖的叉状缺损,随访时间至少为 1 年。记录所有与临床效果相关的数据。分析评估治疗后即刻(术后 1 年)的临床效果和治疗后牙齿的长期(最后评估时间)存活率。采用多水平回归分析和 Cox 比例风险模型评估变量对术后 1 年临床附着水平(CAL)变化和牙齿存活率的影响。
共选择 98 个治疗缺损。平均随访时间为 5.3 ± 4.3 年。在术后 1 年的随访中,观察到 1.23 ± 1.48mm 的 CAL 获得(P<0.05)。治疗后牙齿的 5 年和 10 年存活率分别为 86.5%和 74.3%。缺损的垂直成分和分叉位置与术后 1 年的 CAL 获得显著相关,而膜暴露则显著影响牙齿的存活率。
在本研究的限制范围内,如果缺损形态和位置有利,使用同种异体松质骨移植物和可吸收胶原膜的 GTR 治疗叉状缺损是一种可行的选择。