Nakayama Yohei, Ogihara-Takeda Moe, Saito Yumi, Yamaguchi Arisa, Ogata Yorimasa
Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
J Periodontal Implant Sci. 2024 Dec;54(6):405-418. doi: 10.5051/jpis.2400740037. Epub 2024 May 27.
Recombinant human fibroblast growth factor-2 (rhFGF-2) has demonstrated positive effects on wound healing at 2 weeks after periodontal surgery relative to enamel matrix derivative (EMD). However, the effects at earlier postoperative stages have not been reported. This retrospective study compared the early wound healing outcomes 1 week after surgery using the modified papilla preservation technique (mPPT) with either EMD or rhFGF-2 therapy.
We compiled a list of all mPPT sites treated with EMD or rhFGF-2 during the survey period (September 2011 to March 2022). Early wound healing was assessed using the early wound healing score (EHS) and the modified early wound healing index (mEHI). Inter-rater reliability for the EHS and mEHI was established using intraclass correlation coefficients. Factors influencing mPPT were identified by analyzing the correlation coefficients between the EHS items, mEHI items, and potential influencing factors. After adjusting for factors impacting EHS, mEHI, and mPPT, we compared the EHS and mEHI between EMD and rhFGF-2 groups.
In total, 72 sites were evaluated. The scores for incision line, step, and dehiscence were significantly higher in those receiving rhFGF-2 (n=42) compared to those treated with EMD (n=30). The EHS item scores did not differ significantly between groups. Among patients aged ≥50 years, but not those <50 years, significantly higher step and dehiscence scores were found in the rhFGF-2 group than the EMD group (<0.01). Additionally, for patients exhibiting a clinical attachment level (CAL) ≥8 mm, the step score was significantly higher in the rhFGF-2 group than in the EMD group (<0.05), but this trend was not reflected in those with a CAL <8 mm.
In this study, early wound closure at mPPT sites was more effectively achieved with rhFGF-2 than with EMD. Nevertheless, biochemical assessments are required to compare the re-epithelialization effects of these therapies.
与釉基质衍生物(EMD)相比,重组人成纤维细胞生长因子-2(rhFGF-2)在牙周手术后2周对伤口愈合具有积极作用。然而,术后早期阶段的效果尚未见报道。这项回顾性研究比较了采用改良乳头保留技术(mPPT)并接受EMD或rhFGF-2治疗的患者术后1周的早期伤口愈合结果。
我们整理了在调查期间(2011年9月至2022年3月)所有接受EMD或rhFGF-2治疗的mPPT部位列表。使用早期伤口愈合评分(EHS)和改良早期伤口愈合指数(mEHI)评估早期伤口愈合情况。使用组内相关系数确定EHS和mEHI的评分者间信度。通过分析EHS项目、mEHI项目与潜在影响因素之间的相关系数,确定影响mPPT的因素。在对影响EHS、mEHI和mPPT的因素进行调整后,我们比较了EMD组和rhFGF-2组之间的EHS和mEHI。
总共评估了72个部位。与接受EMD治疗的患者(n=30)相比,接受rhFGF-2治疗的患者(n=42)的切口线、台阶和裂开评分显著更高。两组之间的EHS项目评分无显著差异。在年龄≥50岁的患者中,rhFGF-2组的台阶和裂开评分显著高于EMD组(<0.01),但在年龄<50岁的患者中并非如此。此外,对于临床附着水平(CAL)≥8 mm的患者,rhFGF-2组的台阶评分显著高于EMD组(<0.05),但在CAL<8 mm的患者中未体现出这种趋势。
在本研究中,rhFGF-2比EMD更有效地实现了mPPT部位的早期伤口闭合。然而,需要进行生化评估以比较这些疗法的再上皮化效果。