Huang Hsiang-Ling, Ma Yun-Han, Tu Che-Chang, Chang Po-Chun
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei 10048, Taiwan.
Department of Dentistry, National Taiwan University Hospital, Taipei 10048, Taiwan.
Membranes (Basel). 2022 Feb 14;12(2):219. doi: 10.3390/membranes12020219.
Teeth with furcation involvement (FI) present a higher risk of loss and are difficult to maintain. This study evaluated the efficacy of furcation defect regeneration (FDR) as a regeneration strategy. Pre-operative and 6-month postoperative radiographs were collected from patients receiving regeneration therapy for mandibular teeth with degree II and early degree III FI. The linear furcation involvement (LFI), ratio of LFI (RLI), LFI and RLI adjusted bythe alveolar bone crest (ABC), and radiographic intensity were assessed. The effects of demographic characteristics, regeneration treatment strategies, the relationship between furcation and ABC, and adjacent intrabony defect regeneration (AIDR) were evaluated using a generalized linear model and logistic regression. The results demonstrated that 1.5 mm adjusted LFI and 40% adjusted RLI were achieved in both pure furcation defects and combined furcation-angular defects by the combination of bone replacement grafts (BRG) and enamel matrix derivatives (EMD) or collagen membrane (CM); deproteinized bovine bone matrix (DBBM) showed a superior outcome among BRG. In combined furcation-angular defects, EMD appeared more beneficial than CM, and AIDR significantly promoted adjusted LFI and RLI. In conclusion, DBBM with EMD or CM was effective for FDR, and AIDR had a positive effect on FDR in the combined furcation-angular defect.
存在根分叉病变(FI)的牙齿丧失风险更高且难以维持。本研究评估了根分叉缺损再生(FDR)作为一种再生策略的疗效。收集了接受下颌牙齿Ⅱ度和早期Ⅲ度FI再生治疗患者的术前和术后6个月的X线片。评估了线性根分叉病变(LFI)、LFI比值(RLI)、经牙槽嵴顶(ABC)调整后的LFI和RLI以及X线片密度。使用广义线性模型和逻辑回归评估人口统计学特征、再生治疗策略、根分叉与ABC的关系以及相邻骨内缺损再生(AIDR)的影响。结果表明,通过骨替代移植物(BRG)与釉基质衍生物(EMD)或胶原膜(CM)联合应用,在单纯根分叉缺损和根分叉-角形联合缺损中均实现了1.5mm的调整后LFI和40%的调整后RLI;在BRG中,脱蛋白牛骨基质(DBBM)显示出更好的效果。在根分叉-角形联合缺损中,EMD似乎比CM更有益,且AIDR显著促进了调整后的LFI和RLI。总之,DBBM与EMD或CM联合应用对FDR有效,且AIDR在根分叉-角形联合缺损中对FDR有积极作用。