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用于牙周再生的天然胶原蛋白膜与核糖体交联胶原蛋白膜:一项随机临床试验。

Native vs. ribosome-crosslinked collagen membranes for periodontal regeneration: A randomized clinical trial.

作者信息

Wang Yiwei, Xia Yiru, Qian Jielei, Xie Yufeng, Shu Rong, Lin Zhikai

机构信息

Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.

出版信息

J Periodontal Res. 2025 Feb;60(2):154-165. doi: 10.1111/jre.13321. Epub 2024 Jul 4.

Abstract

AIM

To evaluate whether the ribosome-crosslinked collagen membrane (RCCM) is non-inferior to the natural collagen membrane (NCM) used in regeneration surgery in terms of clinical attachment level (CAL) gain at 6 months.

METHODS

Eighty patients diagnosed as generalized periodontitis presenting with isolated infrabony defect (≥4 mm deep) were enrolled and randomized to receive regenerative surgery, either with NCM or RCCM, both combined with deproteinized bovine bone mineral (DBBM). CAL, pocket probing depth (PPD), and gingival recession (GR) were recorded at baseline, 3, and 6 months postoperatively. Periapical radiographs were taken at baseline, immediately, and 6 months after surgery. Early wound healing index (EHI) and patients' responses were recorded at 2 weeks postoperatively.

RESULTS

At 6 months post-surgery, the mean CAL gain was 3.1 ± 1.5 mm in the NCM group and 2.9 ± 1.5 mm in the RCCM group, while the mean PPD was 4.3 ± 1.1 mm in the NCM group and 4.2 ± 1.0 mm in the RCCM group. Both groups demonstrated a statistically significant improvement from the baseline (p < .01). RCCM was non-inferior to NCM concerning the primary outcome (CAL gain at 6 months). The GR at 6 months postoperatively was 1.3 ± 1.2 and 1.2 ± 1.1 mm, which showed no difference compared with baseline. At 6 months follow-up, the radiographic linear bone fill (RLBF) was 6.5 ± 2.8 and 5.5 ± 2.6 mm (p > .05), while the bone fill percentage (BF%) was 102.3 ± 53.5% and 92.3 ± 40.1% (p > .05), in the NCM and RCCM groups, respectively. There was no significant difference in EHI and postoperative responses between two groups.

CONCLUSION

RCCM + DBBM resulted in no-inferior clinical and radiographic outcomes to NCM + DBBM for the treatment of isolated infrabony defect in 6 months.

摘要

目的

评估在6个月时,核糖体交联胶原膜(RCCM)在临床附着水平(CAL)增加方面是否不劣于再生手术中使用的天然胶原膜(NCM)。

方法

纳入80例诊断为广泛性牙周炎且伴有孤立性骨下袋缺损(≥4mm深)的患者,随机接受再生手术,分别使用NCM或RCCM,并均联合脱蛋白牛骨矿物质(DBBM)。在基线、术后3个月和6个月时记录CAL、牙周袋探诊深度(PPD)和牙龈退缩(GR)。在基线、术后即刻和术后6个月拍摄根尖片。在术后2周记录早期伤口愈合指数(EHI)和患者反应。

结果

术后6个月,NCM组的平均CAL增加为3.1±1.5mm,RCCM组为2.9±1.5mm,而NCM组的平均PPD为4.3±1.1mm,RCCM组为4.2±1.0mm。两组与基线相比均有统计学显著改善(p<0.01)。RCCM在主要结局(6个月时的CAL增加)方面不劣于NCM。术后6个月时的GR分别为1.3±1.2和1.2±1.1mm,与基线相比无差异。在6个月随访时,NCM组和RCCM组的影像学线性骨填充(RLBF)分别为6.5±2.8和5.5±2.6mm(p>0.05),而骨填充百分比(BF%)分别为102.3±53.5%和92.3±40.1%(p>0.05)。两组之间的EHI和术后反应无显著差异。

结论

对于治疗孤立性骨下袋缺损,在6个月时,RCCM+DBBM在临床和影像学结局方面不劣于NCM+DBBM。

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