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比较 Er,Cr:YSGG 激光与微创外科技术治疗骨内缺损的疗效:一项多中心、随机、对照研究的 6 个月结果。

Comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Six-month results of a multicenter, randomized, controlled study.

机构信息

Private practice, Fullerton, CA.

A McGuire Institute Study, Private Practice-Based Clinical Research Network, Houston, TX.

出版信息

J Periodontol. 2021 Apr;92(4):496-506. doi: 10.1002/JPER.20-0028. Epub 2020 Jul 30.

DOI:10.1002/JPER.20-0028
PMID:32613664
Abstract

BACKGROUND

The purpose of this publication is to report on the six-month clinical results and patient-reported outcomes (PROs) comparing the surgical use of the erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B.

METHODS

Fifty-three adults (29 females and 24 males; aged 19 to 73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Recession, probing depth (PD), clinical attachment level (CAL), treatment time, and PROs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4 to 6 weeks following SRP, and 6 months following surgical therapy.

RESULTS

The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.6 mm (p = 0.05), PD with a non-inferiority margin of 0.5 mm (p = 0.05). Recession with a non-inferiority margin of 0.4 mm (p = 0.05). Faster procedure times were found for ERL (16.39 ± 6.21 minutes) versus MIST (20.17 ± 5.62 minutes), p = 0.0002. In the first 2 to 3 days of post-therapeutic diary outcomes, subjects reported less bruising, facial swelling, and use of ice pack for the ERL group.

CONCLUSIONS

This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST in terms of clinical outcomes but is superior in PROs for the surgical treatment of intrabony defects.

摘要

背景

本出版物旨在报告一项为期六个月的临床结果和患者报告的结果(PROs),比较使用铒,铬掺杂:钇,钪,镓和石榴石(Er,Cr:YSGG)激光(ERL)和微创外科技术(MIST)治疗患有 III 期,B 级广泛牙周炎的受试者的骨内缺损。

方法

53 名成年人(29 名女性和 24 名男性;年龄 19 至 73 岁),79 个骨内缺损,在接受牙周刮治和根面平整(SRP)后随机分为 ERL 单药治疗组(n = 27)或 MIST 治疗组(n = 26)。比较两组的退缩、探诊深度(PD)、临床附着水平(CAL)、治疗时间和 PROs。临床测量记录于基线、SRP 后 4 至 6 周和手术治疗后 6 个月。

结果

以下主要和次要结果变量与以下边界具有非劣效性:CAL 具有 0.6mm 的非劣效性边界(p = 0.05),PD 具有 0.5mm 的非劣效性边界(p = 0.05)。退缩具有 0.4mm 的非劣效性边界(p = 0.05)。发现 ERL 的手术时间更快(16.39 ± 6.21 分钟),而 MIST 为 20.17 ± 5.62 分钟,p = 0.0002。在治疗后 2 至 3 天的日记结果中,与 MIST 组相比,受试者报告 ERL 组的瘀伤、面部肿胀和冰敷使用较少。

结论

这是第一项多中心、随机、盲法、对照研究,证明 ERL 在临床结果方面不劣于 MIST,但在骨内缺损的手术治疗方面,PROs 更优。

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