Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Hiroshima University Hospital, Medical Informatics & Systems Management, Hiroshima, Japan.
J Periodontal Res. 2024 Aug;59(4):679-688. doi: 10.1111/jre.13259. Epub 2024 Mar 25.
This study aimed to investigate the factors influencing the clinical outcomes of regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2).
rhFGF-2 promotes periodontal regeneration, and identifying the factors influencing this regeneration is important for optimizing the effectiveness of rhFGF-2.
This study used a hospital information-integrated database to identify patients who underwent periodontal regenerative therapy with rhFGF-2. Factors included age, smoking status, diabetes mellitus (DM), periodontal inflamed surface area (PISA) at the initial visit, whether the most posterior tooth was involved or not, and preoperative radiological bone defect angle. Periodontal regenerative therapy outcomes were defined as good if radiographic bone fill ≥35% or periodontal pocket closure at 9-15 months after surgery. Bone fill rate (%) and periodontal pocket depth (mm) were also used as outcome measures. Factors were evaluated by simple regression analysis, and then the association between factors and the outcomes was determined by multivariate analysis.
PISA and age at the first visit did not significantly influence the success or failure of bone fill rate byrhFGF-2. However, DM, radiographic bone defect angle, and the most posterior tooth significantly influenced the regenerative effect (success/failure in bone fill) of rhFGF-2. The most posterior tooth was significantly associated with bone fill rate by rhFGF-2. Examination of the association between pocket closure and factors shows that the most posterior tooth significantly influenced. The most posterior tooth and preoperative PPD were significantly associated with pocket reduction depth. For the most posterior tooth, a significantly higher bone regeneration rate (p < .05) was observed with a combination of autologous bone graft and rhFGF-2 than with rhFGF-2 alone, and the effect was significant in multivariate analysis.
The radiographic bone defect angle, the involvement of most posterior teeth, and the presence of DM influenced the effectiveness of rhFGF-2 in periodontal regeneration. However, PISA values and age at the initial visit had no significant effect.
本研究旨在探讨影响重组人成纤维细胞生长因子-2（rhFGF-2）再生治疗临床效果的因素。
rhFGF-2 可促进牙周组织再生，确定影响这种再生的因素对于优化 rhFGF-2 的效果至关重要。
本研究使用医院信息综合数据库，确定接受 rhFGF-2 牙周再生治疗的患者。相关因素包括年龄、吸烟状况、糖尿病（DM）、初诊时的牙周炎炎症表面面积（PISA）、是否涉及最末牙以及术前放射状骨缺损角度。如果术后 9-15 个月的放射学骨填充≥35%或牙周袋闭合，则将牙周再生治疗结果定义为良好。骨填充率（%）和牙周袋深度（mm）也用作结果指标。通过简单回归分析评估因素，然后通过多变量分析确定因素与结果之间的关联。
PISA 和初诊时的年龄并没有显著影响 rhFGF-2 的骨填充成功率。然而，DM、放射状骨缺损角度和最末牙显著影响 rhFGF-2 的再生效果（骨填充成功/失败）。最末牙与 rhFGF-2 的骨填充率显著相关。检查与口袋闭合相关的因素表明，最末牙有显著影响。最末牙和术前 PPD 与袋减少深度显著相关。对于最末牙，与单独使用 rhFGF-2 相比，rhFGF-2 联合自体骨移植的骨再生率显著更高（p<0.05），且在多变量分析中效果显著。
放射状骨缺损角度、最末牙的受累以及 DM 的存在影响了 rhFGF-2 在牙周再生中的效果。然而，PISA 值和初诊时的年龄没有显著影响。
