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牙髓-牙周联合病变再生性牙周治疗后生存率及临床和影像学变化的回顾性评估

Retrospective Gauging of Survival Rate and Clinical and Radiological Changes Following Regenerative Periodontal Therapy in Endodontic-Periodontal Lesions.

作者信息

Suresh Sneha, Kashyap Sandeep, Kabiraj Treena, Abhishek Kumar, Kumari Rosy, Hari Leena

机构信息

Department of Periodontics and Oral Implantology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India.

Department of Dental Surgery, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India.

出版信息

J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S748-S750. doi: 10.4103/jpbs.jpbs_29_25. Epub 2025 Apr 2.

Abstract

BACKGROUND

Endodontic-periodontal lesions present an open wound that might need surgical management using the GTR (guided tissue regeneration) to be managed using a combined approach.

AIM

To assess the survival rate and clinical and radiological changes following regenerative periodontal therapy in endodontic-periodontal lesions.

METHODS

The study assessed 104 cases in 82 subjects with a minimum 2-year follow-up. Following scaling and root planning with/without endodontic management, regenerative procedures using DBBM with 10% collagen (Group I) or DBBM with collagen membrane (Group II) were done. radiographic bone gain, mobility, relative clinical attachment levels, gingival recession, probing pocket depth, bleeding on probing, and plaque index changes were assessed.

RESULTS

In both groups, radiographic bone gains and improved clinical parameters were seen. Greater, but statistically nonsignificant probing depth reduction was seen in the DBBM + 10% collagen group compared to the DBBM + collagen membrane group with 4.54 ± 1.04 mm and 4.06 ± 0.80 mm respectively. Comparable radiographic bone gain was seen in Groups I and II with 5.13 ± 1.52 mm and 5.33 ± 1.82 mm. A 92.33% 5-year survival rate was reported following the regenerative surgery.

CONCLUSIONS

Improved radiographic bone and clinical attachment levels are seen following regenerative procedures with DBBM with 10% collagen in endodontic-periodontal lesions. Strict supportive periodontal therapy and oral hygiene can help maintain the successful results of regenerative medicine.

摘要

背景

牙髓牙周联合病变会形成开放性创口,可能需要采用引导组织再生术(GTR)进行手术治疗,以采用联合治疗方法进行处理。

目的

评估牙髓牙周联合病变再生性牙周治疗后的生存率以及临床和影像学变化。

方法

本研究评估了82名受试者中的104例病例,随访时间至少为2年。在进行或不进行牙髓治疗的洁治和根面平整后,采用含10%胶原蛋白的脱蛋白牛骨基质(DBBM)(第一组)或含胶原膜的DBBM(第二组)进行再生治疗。评估影像学骨增量、牙齿松动度、相对临床附着水平、牙龈退缩、探诊深度、探诊出血和菌斑指数变化。

结果

两组均观察到影像学骨增量和临床参数改善。与含胶原膜的DBBM组相比,含10%胶原蛋白的DBBM组探诊深度降低幅度更大,但无统计学意义,分别为4.54±1.04mm和4.06±0.80mm。第一组和第二组的影像学骨增量相当,分别为5.13±1.52mm和5.33±1.82mm。再生手术后报告的5年生存率为92.33%。

结论

在牙髓牙周联合病变中,采用含10%胶原蛋白的DBBM进行再生治疗后,影像学骨和临床附着水平得到改善。严格的支持性牙周治疗和口腔卫生有助于维持再生医学的成功效果。

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本文引用的文献

1
Clinical concepts for regenerative therapy in intrabony defects.
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Treatment of periodontal-endodontic lesions--a systematic review.
J Clin Periodontol. 2014 Aug;41(8):779-90. doi: 10.1111/jcpe.12265. Epub 2014 Jul 2.
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Periodontal regeneration of human infrabony defects. III. Diagnostic strategies to detect bone gain.
J Periodontol. 1993 Apr;64(4):269-77. doi: 10.1902/jop.1993.64.4.269.

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