Simonelli Anna, Farina Roberto, Minenna Luigi, Scapoli Chiara, Trombelli Leonardo
Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, Ferrara, 44121, Italy.
Operative Unit of Dentistry, AUSL of Ferrara, Ferrara, Italy.
Clin Oral Investig. 2025 May 28;29(6):316. doi: 10.1007/s00784-025-06396-0.
to evaluate the association between patient- and local- factors and pocket closure (i.e., probing depth, PD, ≤4 mm) following surgical treatment of intraosseous defects with the Single Flap Approach (SFA).
MATERIALS & METHODS: a retrospective analysis of data from previous studies was conducted on 101 defects treated with SFA alone or in combination with enamel matrix derivative with/without a bovine-derived xenograft. Pocket closure at 12 months was the primary outcome. Age, sex, smoking status, baseline PD, tooth type, depth of the supraosseous component, radiographic depth of the intraosseous component, defect angle, defect morphology, treatment modality were considered as candidate determinants in a bivariate logistic regression analysis. Backward stepwise regression was used to identify the optimal set of factors significantly associated with pocket closure.
12-month pocket closure occurred in 74.3% of cases. The probability of pocket closure was significantly associated with baseline PD (OR = 0.741, 95%CI: 0.565-0.973; p = 0.031) and defect morphology, with defects classified as "mainly 1-wall" and "mainly 3-wall" showing greater odds for pocket closure compared to "mainly 2-wall" defects (OR = 7.125, p = 0.006; and OR = 5.225, p = 0.006, respectively).
When performed according to the SFA, regenerative surgical procedures are associated with high probability of pocket closure at 12 months. Intraosseous lesions with deeper pre-surgery PD and/or prevalent 2-wall morphology have lower probability to be closed.
Data from the present study may be of use to the clinician who wants to optimize the odds for pocket closure at a deep intraosseous lesion that is being approached according to the SFA.
评估采用单瓣法（SFA）手术治疗骨内缺损后患者因素和局部因素与牙周袋闭合（即探诊深度，PD，≤4mm）之间的关联。
对先前研究的数据进行回顾性分析，研究对象为101例单独采用SFA或联合应用釉基质衍生物及有无牛源性异种移植物治疗的缺损。12个月时的牙周袋闭合情况为主要观察指标。在二元逻辑回归分析中，将年龄、性别、吸烟状况、基线PD、牙位、骨上部分深度、骨内部分的影像学深度、缺损角度、缺损形态、治疗方式作为候选决定因素。采用向后逐步回归法确定与牙周袋闭合显著相关的最佳因素组合。
74.3%的病例在12个月时实现了牙周袋闭合。牙周袋闭合的概率与基线PD（OR = 0.741，95%CI：0.565 - 0.973；p = 0.031）和缺损形态显著相关，与“主要为1壁”和“主要为3壁”的缺损相比，“主要为2壁”的缺损实现牙周袋闭合的几率更高（OR分别为7.125，p = 0.006；以及OR = 5.225，p = 0.006）。
按照SFA进行操作时，再生性手术在12个月时实现牙周袋闭合的概率较高。术前PD较深和/或普遍存在2壁形态的骨内病变实现闭合的概率较低。
本研究数据可能对希望优化采用SFA治疗的深部骨内病变实现牙周袋闭合几率的临床医生有所帮助。
