Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Frankfurt, Germany.
Private Practice, Hanau, Germany.
J Clin Periodontol. 2023 Jul;50(7):996-1009. doi: 10.1111/jcpe.13814. Epub 2023 Apr 12.
To assess the long-term stability of attachment gain in infrabony defects (IBDs) 10 years after regenerative treatment with an enamel matrix derivative (EMD) alone.
Two centres (Frankfurt [F] and Heidelberg [HD]) invited patients for re-examination 120 ± 12 months after regenerative therapy. Re-examination included clinical examination (periodontal probing depths (PPD), vertical clinical attachment level (CAL), plaque index (PlI), gingival index (GI), plaque control record, gingival bleeding index and periodontal risk assessment) and review of patient charts (number of supportive periodontal care [SPC] visits).
Both centres included 52 patients (29 female; median baseline age: 52.0 years; lower/upper quartile: 45.0/58.8 years; eight smokers), each contributing one IBD. Nine teeth were lost. For the remaining 43 teeth, regenerative therapy showed significant CAL gain after 1 year (3.0; 2.0/4.4 mm; p < .001) and 10 years (3.0; 1.5/4.1 mm; p < .001) during which CAL remained stable (-0.5; -1.0/1.0 mm; p = 1.000) after an average SPC of 9 years. Mixed-model regression analyses revealed a positive association of CAL gain from 1 to 10 years with CAL 12 months post operation (logistic: p = .01) as well as a higher probability for CAL loss with an increasing vertical extent of a three-walled defect component (linear: p = .008). Cox proportional hazard analysis showed a positive association between PlI after 12 months and tooth loss (p = .046).
Regenerative therapy of IBDs showed stable results over 9 years. CAL gain is associated with CAL after 12 months and decreasing initial defect depth in a three-walled defect morphology. Tooth loss is associated with PlI 12 months post operation.
DRKS00021148 (URL: https://drks.de).
评估单独使用釉基质衍生物（EMD）再生治疗后 10 年，在治疗骨下袋（IBD）方面附着体获得的长期稳定性。
两个中心（法兰克福 [F] 和海德堡 [HD]）在再生治疗后 120±12 个月时邀请患者进行复查。复查包括临床检查（牙周探诊深度（PPD）、垂直临床附着水平（CAL）、菌斑指数（PlI）、牙龈指数（GI）、菌斑控制记录、牙龈出血指数和牙周风险评估）和病历回顾（支持性牙周治疗 [SPC] 就诊次数）。
两个中心共纳入 52 名患者（29 名女性；中位基线年龄：52.0 岁；下四分位数/上四分位数：45.0/58.8 岁；8 名吸烟者），每位患者贡献一个 IBD。9 颗牙齿脱落。对于其余 43 颗牙齿，再生治疗在第 1 年（3.0；2.0/4.4mm；p<0.001）和第 10 年（3.0；1.5/4.1mm；p<0.001）显示出 CAL 显著获得，在此期间，在平均接受 SPC 9 年后，CAL 保持稳定（-0.5；-1.0/1.0mm；p=1.000）。混合模型回归分析显示，从第 1 年到第 10 年的 CAL 获得与术后 12 个月时的 CAL 呈正相关（逻辑：p=0.01），而三壁缺损成分的垂直范围越大，CAL 丢失的可能性越高（线性：p=0.008）。Cox 比例风险分析显示，第 12 个月后的 PlI 与牙齿脱落呈正相关（p=0.046）。
IBD 的再生治疗在 9 年内显示出稳定的结果。CAL 获得与术后 12 个月时的 CAL 和三壁缺损形态中初始缺损深度的减少有关。牙齿脱落与术后 12 个月时的 PlI 有关。
DRKS00021148（网址：https://drks.de）。
