Nakayama Yohei, Tabe Shinichi, Igarashi Kazuma, Moriya Satoshi, Katsumata Tsuyoshi, Kobayashi Ryo, Nakagawa Shuta, Nishino Tomoko, Fukuoka Namiko, Hosono Kota, Yamasaki Mai, Yamazaki Yosuke, Ogihara-Takeda Moe, Ito Shoichi, Saito Yumi, Yamaguchi Arisa, Tsuruya Yuto, Yamazaki-Takai Mizuho, Yoshino Shoichi, Takai Hideki, Ogata Yorimasa
Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.
Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.
J Periodontal Implant Sci. 2024 Aug;54(4):236-252. doi: 10.5051/jpis.2303080154. Epub 2023 Nov 13.
Enamel matrix derivative (EMD) has demonstrated beneficial effects on wound healing following surgery. However, the effects of recombinant human fibroblast growth factor 2 (rhFGF-2) in periodontal regeneration therapy have not been extensively studied. This retrospective study was conducted to compare the wound healing outcomes of the modified papilla preservation technique (mPPT) between EMD and rhFGF-2 therapies.
A total of 79 sites were evaluated for early wound healing using the modified early wound healing index (mEHI), which included 6 items: incision, fibrin clotting, step, redness, swelling, and dehiscence. A numeric analog scale, along with postoperative images of the 6 mEHI items, was established and used for the evaluations. The inter-rater reliability of the mEHI was assessed via intraclass correlation coefficients (ICCs). After adjusting for factors influencing the mPPT, the differences in mEHI scores between the EMD and rhFGF-2 groups were statistically analyzed. Additionally, radiographic bone fill (RBF) was evaluated 6 months after surgery.
The ICC of the mEHI was 0.575. The mEHI, redness score, and dehiscence scores were significantly higher in the rhFGF-2 group (n=33) than in the EMD group (n=46). Similar results were observed in the subgroup of patients aged 50 years or older, but not in those younger than 50 years. In the subgroup with non-contained bone defects, related results were noted, but not in the subgroup with contained bone defects. However, early wound healing did not correlate with RBF at 6 months after surgery.
Within the limitations of this study, the findings suggest that early wound healing following the use of mPPT with rhFGF-2 is somewhat superior to that observed after mPPT with EMD. However, mEHI should be improved for use as a predictive tool for early wound healing and to reflect clinical outcomes after surgery.
釉基质衍生物（EMD）已被证明对手术后的伤口愈合有有益作用。然而，重组人成纤维细胞生长因子2（rhFGF-2）在牙周再生治疗中的效果尚未得到广泛研究。本回顾性研究旨在比较EMD和rhFGF-2治疗之间改良乳头保留技术（mPPT）的伤口愈合结果。
使用改良早期伤口愈合指数（mEHI）对总共79个部位的早期伤口愈合情况进行评估，该指数包括6项：切口、纤维蛋白凝块、台阶、发红、肿胀和裂开。建立了数字模拟量表以及6项mEHI项目的术后图像，并用于评估。通过组内相关系数（ICC）评估mEHI的评分者间信度。在调整影响mPPT的因素后，对EMD组和rhFGF-2组之间的mEHI评分差异进行统计学分析。此外，在手术后6个月评估影像学骨填充（RBF）情况。
mEHI的ICC为0.575。rhFGF-2组（n = 33）的mEHI、发红评分和裂开评分显著高于EMD组（n = 46）。在50岁及以上患者亚组中观察到类似结果，但在50岁以下患者亚组中未观察到。在非包容性骨缺损亚组中观察到相关结果，但在包容性骨缺损亚组中未观察到。然而，早期伤口愈合与术后6个月的RBF无关。
在本研究的局限性内，研究结果表明，使用rhFGF-2的mPPT后的早期伤口愈合在一定程度上优于使用EMD的mPPT后的早期伤口愈合。然而，mEHI应加以改进，以用作早期伤口愈合的预测工具并反映手术后的临床结果。
