Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover, Germany.
Institute of Biostatistics, Hannover Medical School, Hannover, Germany.
Clin Exp Dent Res. 2022 Feb;8(1):9-19. doi: 10.1002/cre2.532. Epub 2022 Jan 11.
To investigate if the application of the granulation tissue preservation technique (GTPT) in regenerative therapy of infrabony periodontal defects results in more clinical attachment level (CAL) gain and more radiographic bone gain (RBG) than the conventional resective approach 12 months after surgery.
Forty patients exhibiting at least one infrabony defect with a probing pocket depth (PPD) ≥6 mm and a radiographic infrabony component (INFRA ) ≥3 mm were randomly treated with the GTPT (test group) or the double-flap approach with resection of the defect-filling granulation tissue (control group). Enamel matrix derivatives were applied in both groups. Clinical and radiographic parameters were recorded at baseline (t0), 6 months (t1), and 12 months (t2) after surgery. The primary outcome variable was CAL gain between t0 and t2.
When all patients were considered, ΔCAL did not differ significantly between the two groups (p = .160). Significant PPD reduction (test group: 4.38 ± 1.36 mm; control group: 4.06 ± 2.38 mm), CAL gain (test group: 3.75 ± 1.24 mm; control group: 2.88 ± 2.09 mm), and RBG (test group: 3.06 ± 1.74 mm; control group: 3.27 ± 2.19 mm) were achieved at t2 in both groups. Using multivariate linear regression, PPD and group were identified as variables with the greatest influence on ΔCAL . PPD and INFRA were identified as variables with the greatest influence on RBG . Patients with a defect angle >22° showed significantly more CAL gain in the test group (t0-t1: 3.08 ± 1.38 mm; t0-t2: 3.62 ± 0.96 mm) than in the control group (t0-t1: 1.77 ± 1.54 mm; t0-t2: 2.18 ± 1.83 mm).
Regarding all patients, the study failed to show significant differences between the test and control groups. However, the GTPT appears to lead to more CAL gain in noncontaining infrabony defects.
研究在再生治疗中应用肉芽组织保存技术（GTPT）是否比常规切除方法在手术后 12 个月时获得更多的临床附着水平（CAL）增加和更多的放射影像学骨增加（RBG）。
40 名患者至少有一个牙周袋深度（PPD）≥6mm 和放射影像学骨内成分（INFRA）≥3mm 的骨内缺损，随机接受 GTPT（实验组）或切除缺损填充肉芽组织的双瓣法（对照组）治疗。两组均应用釉基质衍生物。在基线（t0）、6 个月（t1）和 12 个月（t2）后记录临床和放射影像学参数。主要观察指标是 t0 至 t2 期间的 CAL 增加。
当考虑所有患者时，两组间 ΔCAL 无显著差异（p=0.160）。两组均有显著的 PPD 减少（实验组：4.38±1.36mm；对照组：4.06±2.38mm）、CAL 增加（实验组：3.75±1.24mm；对照组：2.88±2.09mm）和 RBG 增加（实验组：3.06±1.74mm；对照组：3.27±2.19mm）。多元线性回归显示，PPD 和组是对 ΔCAL 影响最大的变量。PPD 和 INFRA 是对 RBG 影响最大的变量。缺损角度>22°的患者在实验组中获得的 CAL 增加明显更多（t0-t1：3.08±1.38mm；t0-t2：3.62±0.96mm），而在对照组中则更少（t0-t1：1.77±1.54mm；t0-t2：2.18±1.83mm）。
就所有患者而言，该研究未能显示实验组和对照组之间有显著差异。然而，GTPT 似乎会导致非包含性骨内缺损的 CAL 增加更多。
