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自体牙移植与脱矿冻干骨同种异体移植治疗牙周骨下袋缺损的相对疗效比较评估——一项为期6个月的临床影像学和生化研究。

Comparative evaluation of the relative efficacy of autogenous tooth graft and demineralized freeze-dried bone allograft in the treatment of periodontal infrabony defects - A 6-month clinico-radiographic and biochemical study.

作者信息

Singh Anamika, Blaggana Vikram, Upadhyay Preeti, Tripathi Pragya, Blaggana Anshu

机构信息

Department of Periodontology, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India.

出版信息

J Indian Soc Periodontol. 2024 Sep-Oct;28(5):537-543. doi: 10.4103/jisp.jisp_43_24. Epub 2025 Feb 26.

Abstract

CONTEXT

Demineralized freeze-dried bone allograft (DFDBA) is a commonly used biomaterial in periodontal regeneration, while autogenous tooth graft (ATG) is a newer, nearly ideal biomaterial. In the literature, studies on ATG for managing periodontal infrabony defects are rare.

AIMS

The aim of this study was to comparatively evaluate the efficacy of DFDBA and ATG in the management of periodontal infrabony defects clinically, radiologically, and biochemically.

SETTINGS AND DESIGN

In this randomized controlled clinical trial, 30 sites were selected based on the study criteria and randomly assigned to Group A (DFDBA) and Group B (ATG) by toss of a coin.

MATERIALS AND METHODS

Selected patients were evaluated 3-4 weeks after phase I therapy. Both the groups underwent open flap debridement: Group A sites were grafted with DFDBA and Group B with ATG. Clinico-radiological evaluation was performed at baseline, 3 months, and 6 months for pocket probing depth (PPD), clinical attachment level (CAL), and linear defect depth (LDD). Biochemical assessment was done using enzyme-linked immunosorbent assay for gingival crevicular fluid-alkaline phosphatase (GCF-ALP) at baseline and at 6 months.

STATISTICAL ANALYSIS

Data obtained were subjected to parametric tests of significance (paired and unpaired -test).

RESULTS

In intragroup comparison, highly significant differences ( < 0.01) were observed in PPD reduction, CAL gain, LDD reduction, and GCF-ALP levels statistically from baseline to 6 months in both the groups. However, Group B showed greater PPD reduction, CAL gain, and LDD reduction as compared to Group A (3.667 > 2.933, 2.600 > 2.000, and 2.400 > 1.533 mm, respectively). Biochemically, Group B demonstrated higher GCF-ALP levels than Group A.

CONCLUSIONS

Within the limitations of the present study, highly significant changes were noticed in all the parameters statistically in both the groups, with ATG showing higher bone fill and ongoing bone healing at 6 months postoperatively in the management of periodontal infrabony defects.

摘要

背景

脱矿冻干骨同种异体移植物(DFDBA)是牙周再生中常用的生物材料,而自体牙移植(ATG)是一种较新的、近乎理想的生物材料。在文献中,关于ATG治疗牙周骨下袋缺损的研究很少。

目的

本研究旨在从临床、影像学和生物化学方面比较评估DFDBA和ATG治疗牙周骨下袋缺损的疗效。

设置与设计

在这项随机对照临床试验中,根据研究标准选择了30个部位,并通过抛硬币随机分为A组(DFDBA)和B组(ATG)。

材料与方法

在I期治疗后3至4周对入选患者进行评估。两组均接受开放性翻瓣清创术:A组部位植入DFDBA,B组植入ATG。在基线、3个月和6个月时对探诊深度(PPD)、临床附着水平(CAL)和线性缺损深度(LDD)进行临床影像学评估。在基线和6个月时使用酶联免疫吸附测定法对龈沟液碱性磷酸酶(GCF-ALP)进行生化评估。

统计分析

对获得的数据进行参数显著性检验(配对和非配对t检验)。

结果

在组内比较中,两组从基线到6个月时在PPD降低、CAL增加、LDD降低和GCF-ALP水平方面均观察到高度显著差异(P<0.01)。然而,与A组相比,B组的PPD降低、CAL增加和LDD降低更明显(分别为3.667>2.933、2.600>2.000和2.400>1.533mm)。在生化方面,B组的GCF-ALP水平高于A组。

结论

在本研究的局限性范围内,两组在所有参数上均观察到高度显著的统计学变化,在牙周骨下袋缺损的治疗中,ATG在术后6个月显示出更高的骨填充和持续的骨愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be55/11932557/8c531294d874/JISP-28-537-g001.jpg

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