低速富血小板纤维蛋白膜联合脱矿冻干骨同种异体移植物(DFDBA)与胶原膜联合DFDBA治疗Ⅲ期牙周炎非包容性骨内缺损的随机对照临床试验。

Low-Speed Platelet-Rich Fibrin Membrane in Conjunction With Demineralized Freeze-Dried Bone Allograft (DFDBA) Compared to Collagen Membrane With DFDBA in Noncontained Intraosseous Defects of Stage III Periodontitis: A Randomized Controlled Clinical Trial.

作者信息

Almoliky Najeeb, Hosny Manal, Elbattawy Weam, Fawzy El-Sayed Karim

机构信息

Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany.

出版信息

Int J Dent. 2025 Feb 23;2025:6393105. doi: 10.1155/ijod/6393105. eCollection 2025.

Abstract

Noncontained (1- or combined 1- to 2-wall) periodontal intraosseous defects represent challenging clinical situations with unpredictable surgical therapeutic outcomes. This randomized clinical trial assessed demineralized freeze-dried bone allograft (DFDBA) with low speed-platelet-rich fibrin (PRF) membrane compared to DFDBA with collagen membrane (CM) in the surgical periodontal therapy of noncontained intraosseous defects of stage III periodontitis patients. Twenty-two stage III periodontitis patients with noncontained intraosseous defects measuring ≥3 mm and clinical attachment loss ≥5 mm were randomly allocated into two groups: test group (low-speed PRF membrane + DFDBA) and control group (CM + DFDBA), with 11 participants per group. Clinical and radiographic assessments were conducted at baseline, 3, 6, 9, and 12 months for clinical attachment level (CAL; primary outcome), gingival recession depth (GRD), probing depth (PD), full mouth bleeding score (FMBS) and full mouth plaque score (FMPS), radiographic bone fill and radiographic linear defect depth (RLDD; all secondary outcomes). The mean (±SD) CAL-gain for the test group was 2.45 (±1.51), 2.91 (±1.70), 2.91 (±1.87), and 2.82 (±1.83) mm, while for the control group 2.82 (±1.25), 3.27 (±1.27), 3.00 (±1.41), and 2.64 (±1.50) mm at 3, 6, 9, and 12 months, respectively, with no significant intergroup differences ( > 0.05). Despite the absence of significant intergroup differences, both groups demonstrated significant intragroup improvement in CAL- and PD-gain, and RLDD-reduction at 3, 6, 9, and 12 months as well as RLDD improvement at 12 months ( < 0.05). PRF membranes, in conjunction with DFDBA, show significant improvement of periodontal clinical and radiographic parameters, comparable to CMs with DFDBA. ClinicalTrials.gov identifier: NCT03922503.

摘要

非局限性(1壁或1至2壁联合)牙周骨内缺损代表了具有挑战性的临床情况,手术治疗结果难以预测。这项随机临床试验评估了在III期牙周炎患者非局限性骨内缺损的手术牙周治疗中,低速富血小板纤维蛋白(PRF)膜与脱矿冻干骨同种异体移植物(DFDBA)联合使用,与胶原膜(CM)与DFDBA联合使用的效果。22例III期牙周炎患者,其非局限性骨内缺损≥3mm且临床附着丧失≥5mm,被随机分为两组:试验组(低速PRF膜+DFDBA)和对照组(CM+DFDBA),每组11名参与者。在基线、3、6、9和12个月时进行临床和影像学评估,评估指标包括临床附着水平(CAL;主要结局)、牙龈退缩深度(GRD)、探诊深度(PD)、全口出血评分(FMBS)和全口菌斑评分(FMPS)、影像学骨填充和影像学线性缺损深度(RLDD;所有次要结局)。试验组的平均(±标准差)CAL增加量在3、6、9和12个月时分别为2.45(±1.51)、2.91(±1.70)、2.91(±1.87)和2.82(±1.83)mm,而对照组在相应时间分别为2.82(±1.25)、3.27(±1.27)、3.00(±1.41)和2.64(±1.50)mm,组间差异无统计学意义(>0.05)。尽管组间差异无统计学意义,但两组在3、6、9和12个月时CAL增加量、PD减少量以及RLDD减少量均有显著的组内改善,且在12个月时RLDD也有改善(<0.05)。PRF膜与DFDBA联合使用,在牙周临床和影像学参数方面显示出显著改善,与CM和DFDBA联合使用相当。ClinicalTrials.gov标识符:NCT03922503。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f93/11872290/77d5600c26e4/IJD2025-6393105.001.jpg

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