Çankaya Zeynep Turgut, Ünsal Berrin, Gürbüz Sühan, Bakirarar Batuhan, Tamam Evşen
Int J Periodontics Restorative Dent. 2020 Mar/Apr;40(2):e73-e83. doi: 10.11607/prd.4359.
This study aimed to create papilla with concentrated growth factor (CGF) in cases in which the interdental papilla was not able to fill the interproximal space (IPS) due to physiologic factors. A three-dimensional digital model of this space with the digital impression obtained from direct intraoral scanning of IPS was created. This study aimed to evaluate the efficacy of CGF in the regeneration of multiple adjacent papillary losses (MAPL), with the change in the IPS area calculated on intraorally scanned images obtained with digital impressions. This study included 160 teeth from 40 patients with 120 papillary losses. Patients were randomly allocated to the test group (TG) (n = 20), with 60 MAPL (three adjacent, lost interdental papillae per patient) receiving minimally invasive surgery with CGF, or the control group (CG) (n = 20), with 60 MAPL without surgery. A total of 480 images were uploaded to a software. The patients' age, gender, Plaque Index, bleeding on probing, and mean probing pocket depth values were evaluated. Papillary area (PA) were calculated between the two central, lateral-central, and lateral-canine teeth at baseline and posttreatment periods of 3, 6, and 12 months in both groups. Papillary filling percentage, keratinized-gingiva width, papillary thickness, thrombocyte, count and mean platelet volume were recorded in TG. Considering the variables in TG and CG, there was no difference in terms of age, gender, and periodontal parameters (P > .05). PA at 3, 6, and 12 months showed statistically significant differences from baseline values in TG (P < .001) but not in CG (P > .05). In TG, a moderate positive correlation was found between the midline papillary thickness and the 3-, 6-, and 12-month filling percentages (r: 0.506, P = .023; r: 0.509, P = .022; and r: 0.515, P = .02, respectively), and a high positive correlation was determined between thrombocyte count and the 6- and 12-month filling percentages (r: 0.733, P < .001; and r: 0.744, P < .001, respectively). CGF provided papillary regeneration in the treatment of MAPL and supported three-dimensional structure of the regenerated interdental papilla throughout 1 year.
本研究旨在针对因生理因素导致牙间乳头无法充满牙间隙（IPS）的病例，使用浓缩生长因子（CGF）来形成乳头。通过对IPS进行直接口内扫描获得数字印模，创建了该空间的三维数字模型。本研究旨在评估CGF在多个相邻乳头缺失（MAPL）再生中的疗效，并根据通过数字印模获得的口内扫描图像计算IPS面积的变化。本研究纳入了40例患者的160颗牙齿，其中存在120处乳头缺失。患者被随机分配至试验组（TG）（n = 20），60处MAPL（每位患者三个相邻的缺失牙间乳头）接受含CGF的微创手术，或对照组（CG）（n = 20），60处MAPL未接受手术。总共480张图像被上传至一款软件。对患者的年龄、性别、菌斑指数、探诊出血以及平均探诊袋深度值进行了评估。在两组中，分别于基线以及治疗后3个月、6个月和12个月时计算两颗中切牙、侧切牙与中切牙之间以及侧切牙与尖牙之间的乳头面积（PA）。记录了试验组的乳头充盈百分比、角化龈宽度、乳头厚度、血小板计数和平均血小板体积。考虑试验组和对照组中的变量，在年龄、性别和牙周参数方面无差异（P > .05）。试验组在3个月、6个月和12个月时的PA与基线值相比有统计学显著差异（P < .001），而对照组无差异（P > .05）。在试验组中，中线乳头厚度与3个月、6个月和12个月时的充盈百分比之间存在中度正相关（r分别为0.506，P = .023；r为0.509，P = .022；r为0.515，P = .02），血小板计数与6个月和12个月时的充盈百分比之间存在高度正相关（r分别为0.733，P < .001；r为0.744，P < .001）。CGF在MAPL治疗中实现了乳头再生，并在一整年中维持了再生牙间乳头的三维结构。
