Okada Munehiro, Fukuba Shunsuke, Yamaki Daichi, Iwata Takanori
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
Regen Ther. 2024 Sep 9;26:767-774. doi: 10.1016/j.reth.2024.08.017. eCollection 2024 Jun.
For deep intrabony defects or Class II furcation involvements (FI), periodontal tissue regenerative therapy combined with bone graft materials and a barrier membrane is recommended. The objective of this study was to assess the safety and efficacy of using carbonate apatite (COAp) granules and absorbable poly(lactic acid/caprolactone) (PLCL) membranes for periodontal regeneration in the treatment of intrabony defects and mandibular Class II FI.
This prospective pilot clinical study, conducted at a single center with a single-arm design, aimed to assess the safety and efficacy of COAp and PLCL membranes in patients with periodontitis. A total of 9 patients with 10 teeth, including seven deep intrabony defects and three Class II FI, were treated with COAp granules and PLCL membranes. Clinical parameters such as probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque Index (PI), and Gingival Index (GI) were assessed at baseline, 6 and 12 months post-surgery. Radiographic analysis was performed using dental X-rays and cone beam computed tomography (CBCT) images taken at baseline, 6, and 12 months post-surgery.
Postoperative healing was uneventful in most of the cases. In some cases, membrane exposures were observed. However, there were no signs of inflammation, such as abnormal bleeding, pain, swelling, or pus. These exposures eventually healed well in the end. The mean reductions in PPD at 6 and 12 months were 4.5 ± 1.6 mm and 4.9 ± 1.4 mm, respectively, while the mean gains in CAL were 4.4 ± 1.7 mm at 6 months and 4.6 ± 1.2 mm at 12 months. Radiographic analysis showed improvements in linear bone height within intrabony defects and in the vertical subclassification of FI in Class II FI.
Despite the limitations of this study, periodontal regenerative therapy using COAp granules and a PLCL membrane demonstrated promising clinical safety and efficacy for treating intrabony defects and mandibular Class II furcation involvement.
对于深骨内缺损或II度根分叉病变,推荐采用牙周组织再生治疗联合骨移植材料和屏障膜。本研究的目的是评估使用碳酸磷灰石(COAp)颗粒和可吸收聚(乳酸/己内酯)(PLCL)膜进行牙周再生治疗骨内缺损和下颌II度根分叉病变的安全性和有效性。
本前瞻性试点临床研究在单一中心采用单臂设计,旨在评估COAp和PLCL膜在牙周炎患者中的安全性和有效性。共有9例患者的10颗牙齿,包括7个深骨内缺损和3个II度根分叉病变,接受了COAp颗粒和PLCL膜治疗。在基线、术后6个月和12个月评估临床参数,如探诊深度(PPD)、临床附着水平(CAL)、探诊出血(BOP)、牙齿松动度(Mo)、菌斑指数(PI)和牙龈指数(GI)。使用牙科X线片和术后基线、6个月和12个月拍摄的锥形束计算机断层扫描(CBCT)图像进行影像学分析。
大多数病例术后愈合顺利。在某些病例中,观察到膜暴露。然而,没有炎症迹象,如异常出血、疼痛、肿胀或脓液。这些暴露最终愈合良好。6个月和12个月时PPD的平均降低分别为4.5±1.6mm和4.9±1.4mm,而6个月时CAL的平均增加为4.4±1.7mm,12个月时为4.6±1.2mm。影像学分析显示骨内缺损处的线性骨高度以及II度根分叉病变中根分叉的垂直亚分类有所改善。
尽管本研究存在局限性,但使用COAp颗粒和PLCL膜的牙周再生治疗在治疗骨内缺损和下颌II度根分叉病变方面显示出有前景的临床安全性和有效性。