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J Contemp Dent Pract. 2020 Sep 1;21(9):970-976.
The aim of this study is to investigate the effectiveness of a combination of an equine-derived, enzyme-treated bone graft and an equine collagen membrane to treat intrabony defects caused by periodontitis.
About 22 patients with a single 1-, 2-, or 3-wall intrabony defect and a probing pocket depth (PPD) of ≥5 mm, who were treated using an enzyme-deantigenated equine bone graft in addition to a collagen membrane and were followed up for at least 10 years, were retrospectively assessed. The plaque index (PI), the sulcus bleeding index (SBI), PPD, and the clinical attachment level (CAL) at each follow-up visit were compared to baseline.
The mean PI, SBI, PPD, and CAL were 0.22 ± 0.41, 1.86 ± 0.78, 7.86 ± 1.39 mm, and 8.84 ± 1.86 mm, respectively, at baseline, and 0.25 ± 0.44, 0.12 ± 0.32, 2.59 ± 0.50, and 4.04 ± 0.77 mm, respectively, at the last follow-up. The difference was significant for all parameters ( < 0.001) except PI ( = 0.83). The final CAL gain was 4.8 mm (49.8%). The SBI, PPD, and CAL still significantly improved at the 12-month follow-up visit but not at the 24-month follow-up visit. There were no correlations between either the number of defect walls or smoking and outcomes. In one case, a surgical re-entry at 5 years allowed a clinical evaluation, showing that intrabony defect was repaired with the newly formed bone of the patient.
Equine bone granules in addition to an equine collagen membrane effectively and safely treated intrabony defects caused by periodontitis providing long-term results.
Equine-derived bone grafts have been in the market for more than 20 years. However, to the author's knowledge, no studies have reported long-term results for the use of this type of bone graft in periodontal surgery. The equine-derived bone granules used in the present study appears a promising option for treating intrabony defects due to moderate to severe periodontitis.
本研究旨在探讨马源性、酶处理骨移植物与马胶原膜联合应用于治疗牙周炎引起的骨内缺损的疗效。
回顾性分析了 22 例接受酶去抗原马源性骨移植加胶原膜治疗的单壁、双壁或三壁骨内缺损患者，这些患者的牙周袋探诊深度（PPD）≥5mm，随访时间至少 10 年。比较每次随访时的菌斑指数（PI）、探诊出血指数（SBI）、PPD 和临床附着水平（CAL）与基线时的情况。
基线时，患者的平均 PI、SBI、PPD 和 CAL 分别为 0.22 ± 0.41、1.86 ± 0.78、7.86 ± 1.39mm 和 8.84 ± 1.86mm，末次随访时分别为 0.25 ± 0.44、0.12 ± 0.32、2.59 ± 0.50mm 和 4.04 ± 0.77mm，除 PI（=0.83）外，所有参数均有显著差异（<0.001）。最终 CAL 获得 4.8mm（49.8%）。SBI、PPD 和 CAL 在 12 个月随访时仍有显著改善，但在 24 个月随访时无显著改善。缺损壁数量和吸烟与结果均无相关性。1 例患者在 5 年时再次手术，进行临床评估，显示骨内缺损已被患者的新生骨修复。
马源性骨颗粒联合马胶原膜可有效、安全地治疗牙周炎引起的骨内缺损，可获得长期效果。
马源性骨移植物已上市 20 多年。然而，据作者所知，尚无研究报告过这种类型的骨移植物在牙周手术中的长期效果。本研究中使用的马源性骨颗粒似乎是治疗中重度牙周炎引起的骨内缺损的一种很有前途的选择。
