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自体粘性骨在再生人类牙周骨内缺损方面优于自体富血小板纤维和生物活性玻璃的简单混合物吗?一项广泛的临床和 CBCT 研究。

Is Autologous Sticky Bone Better Than a Simple Mixture of Autologous PRF and Bioactive Glass in the Regeneration of Human Periodontal Intrabony Defects? An Extensive Clinical and CBCT Study.

出版信息

Int J Periodontics Restorative Dent. 2023 Oct 24(7):s264-s282. doi: 10.11607/prd.6152.

Abstract

Periodontal intrabony defects (IBDs) are commonly encountered in dental practice and are usually treated by open flap debridement (OFD) with or without bone grafts and/or guided tissue regeneration (GTR), platelet-rich fibrin (PRF), or other additives. A difficulty with these approaches is maintaining the space for bone growth at the determined location. In this report, autologous sticky bone (ASB) was used and compared to a simple mixture of PRF and bone graft (PRF-BG) using the identical graft material-bioactive glass morsels-to assess its regenerative potential in IBDs, as sticky bone is known to maintain the space, according to previous research. A total of 21 IBDs were treated by OFD, PRF-BG mixture, or ASB. Regenerative assessment was clinically and radiographically performed by CBCT at 1 year. All the treatment modalities (OFD, PRF-BG, and ASB) showed statistically significant improvements clinically and radiographically at 1 year in terms of probing pocket depth reduction (PPDR), clinical attachment level gain (CALG), CBCT defect fill (CBCT-DF), and CBCT defect resolution (CBCT-DR); P < .05. The ASB group depicted the most favorable results (P < .05) in terms of the parameters at 1 year followed by the PRF-BG group and then the OFD group. Treatment of periodontal IBDs with ASB resulted in significant improvements in clinical and CBCT parameters compared to baseline at 1 year, and intrasurgical graft handling was much better in the ASB group.

摘要

牙周内骨缺损(IBDs)在口腔临床中较为常见,通常采用翻瓣清创术(OFD)联合或不联合骨移植和/或引导组织再生(GTR)、富含血小板纤维蛋白(PRF)或其他添加剂进行治疗。这些方法的一个难点是在确定的位置保持骨生长的空间。在本报告中,使用了自体粘性骨(ASB),并与 PRF 和骨移植(PRF-BG)的简单混合物进行了比较,使用相同的移植物材料-生物活性玻璃颗粒来评估其在 IBD 中的再生潜力,因为粘性骨据以往研究显示,可维持空间。共有 21 例 IBD 采用 OFD、PRF-BG 混合物或 ASB 进行治疗。采用 CBCT 在 1 年时进行临床和影像学再生评估。所有治疗方式(OFD、PRF-BG 和 ASB)在 1 年时的临床和影像学探诊袋深度减少(PPDR)、临床附着水平增加(CALG)、CBCT 缺损填充(CBCT-DF)和 CBCT 缺损分辨率(CBCT-DR)方面均显示出统计学显著改善;P<.05。ASB 组在 1 年时的参数显示出最有利的结果(P<.05),其次是 PRF-BG 组,然后是 OFD 组。与基线相比,ASB 治疗牙周 IBD 在 1 年内可显著改善临床和 CBCT 参数,并且 ASB 组在术中移植物处理方面要好得多。

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