Hromčík Filip, Halusková Adéla, Hollá Lydie Izakovičová
Clinic of Stomatology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czechia.
Clin Exp Dent Res. 2025 Feb;11(1):e70094. doi: 10.1002/cre2.70094.
This case series evaluated the clinical efficacy of the novel "lateral approach" combined with an enamel matrix derivative (EMD) and bone grafting in the regenerative surgical treatment of intrabony defects associated with an edentulous ridge.
The innovative flap, called the "lateral approach," is explicitly designed for regeneration of unchallenged isolated intrabony defects associated with edentulous alveolar ridges. The flap is defined by a curved vertical incision on the buccal side opposite the treated defect and a sulcular incision on the buccal and defect-associated sides, promoting uneventful healing and regeneration while minimizing complications. Seven intrabony defects (one per patient) distal to the lower second molar were treated using the "lateral approach" combined with EMD and grafting with deproteinized bovine bone mineral. The primary outcome was clinical attachment level (CAL) change. As additional parameters, pocket probing depth (PPD) reduction and complication rate were analyzed. All the outcomes were assessed 6 months post-surgery and compared with the baseline values.
Primary wound healing occurred in 100% of cases, and no complications were reported. At the 6-month re-evaluation, the initial median CAL of 6 mm (interquartile range 5-8 mm) was reduced to 3 mm (3-5 mm). The corresponding median PPD was reduced from 6 mm (IQR 6-8 mm) to 4 mm (IQR 3-5 mm). These differences were statistically significant (p < 0.05).
The "lateral approach" is a technique for the surgical treatment of intrabony defects associated with the edentulous ridge. Within the limitations of the study, this method seems to be suitable for distal intrabony defects in the lower second molars, which frequently develop after third molar extraction.
本病例系列评估了新型“外侧入路”联合釉基质衍生物（EMD）和骨移植在与无牙嵴相关的骨内缺损再生手术治疗中的临床疗效。
这种创新的皮瓣，即“外侧入路”，是专门为与无牙牙槽嵴相关的未受挑战的孤立骨内缺损的再生而设计的。该皮瓣由与治疗缺损相对的颊侧的弯曲垂直切口以及颊侧和与缺损相关侧的龈沟切口界定，可促进顺利愈合和再生，同时将并发症降至最低。对7例下颌第二磨牙远中的骨内缺损（每位患者1例）采用“外侧入路”联合EMD并使用脱蛋白牛骨矿物质进行移植治疗。主要结局是临床附着水平（CAL）的变化。作为附加参数，分析了探诊深度（PPD）的降低和并发症发生率。所有结局均在术后6个月进行评估，并与基线值进行比较。
100%的病例实现了一期伤口愈合，未报告并发症。在6个月的重新评估时，初始中位CAL为6毫米（四分位间距5 - 8毫米）降至3毫米（3 - 5毫米）。相应的中位PPD从6毫米（IQR 6 - 8毫米）降至4毫米（IQR 3 - 5毫米）。这些差异具有统计学意义（p < 0.05）。
“外侧入路”是一种用于治疗与无牙嵴相关的骨内缺损的手术技术。在本研究的局限性范围内，该方法似乎适用于下颌第二磨牙远中的骨内缺损，这些缺损在第三磨牙拔除后经常出现。
