Sullivan H C, Dragoo M R
Dent Clin North Am. 1976 Jan;20(1):131-53.
The remarkable ability of the periodontium to repair once the long-term etiologic factors have been eliminated is now belatedly being recognized as a key consideration in periodontal therapy. This will force many practitioners interested in comprehensive periodontal treatment to reconsider the classic resective approach to pocket elimination. Resective techniques have been and will probably remain the foundation of periodontal therapy for some time to come. However, the knowledge that is now available concerning the reparative potential of the periodontium opens new treatment avenues for selected patients. In addition, as more research and clinical information becomes available, we can anticipate that the philosophy of repair will play an ever-increasing role in the therapeutic approach to periodontal treatment. This fact should not make the practitioner who is secure with his present treatment philosophy uncomfortable, since the required therapeutic modifications can easily be incorporated into the office routine without confusion. If the clinician then completes each step of the treatment plan with close attention to detail, regeneration will occur in many cases. It should be reiterated that many of the concepts introduced in this paper are based on the authors' clinical observations and are applicable only to select patients. Admittedly, basic research on this subject is sparse, however, the efficacy of this treatment modality has been well substantiated clinically by many therapists. The authors estimate that regenerative therapy is utilized in 10 to 20 per cent of their patients. They believe it is the therapeutic program of choice in many cases showing extensive periodontal destruction, since an innovative and skilled therapist treating a well motivated patient can utilize regenerative periodontal therapy in conjunction with sophisticated restorative dentistry in order to avoid complete dentures.
一旦长期病因被消除，牙周组织具有显著的修复能力，这一点目前才被人们认识到，它是牙周治疗中的一个关键考量因素。这将迫使许多对全面牙周治疗感兴趣的从业者重新审视传统的切除性方法来消除牙周袋。切除性技术一直是且在未来一段时间内可能仍将是牙周治疗的基础。然而，目前有关牙周组织修复潜力的知识为特定患者开辟了新的治疗途径。此外，随着更多研究和临床信息的出现，我们可以预期修复理念在牙周治疗的方法中将发挥越来越重要的作用。这一事实不应让那些对其现有治疗理念感到安心的从业者感到不安，因为所需的治疗调整可以轻松融入日常工作流程而不会造成混乱。如果临床医生在密切关注细节的情况下完成治疗计划的每一步，那么在许多情况下都会发生组织再生。应当重申的是，本文介绍的许多概念是基于作者的临床观察，仅适用于特定患者。诚然，关于这一主题的基础研究较少，然而，许多治疗师在临床上已经充分证实了这种治疗方式的有效性。作者估计，他们10%至20%的患者采用了再生治疗。他们认为，在许多显示广泛牙周破坏的病例中，再生治疗是首选的治疗方案，因为一位有创新精神且技术娴熟的治疗师治疗一位积极性高的患者时，可以将牙周再生治疗与复杂的修复牙科结合起来，以避免使用全口假牙。
