Cortellini P, Pini-Prato G, Tonetti M
Department of Periodontics, University of Siena, Italy.
J Clin Periodontol. 1994 Oct;21(9):606-10. doi: 10.1111/j.1600-051x.1994.tb00751.x.
The aim of this investigation was to assess the role of supportive periodontal care in the maintenance of clinical attachment gained, after surgical treatment according to the principles of GTR, in deep infrabony defects. Following GTR treatment, 40 deep infrabony defects in 23 patients gained 4.1 mm of probing attachment level (PAL) after 1 year of stringent plaque control. In the subsequent 3 years, 15 patients (22 sites, group A) were recalled every 3 months. In this group, the gained attachment level remained stable. Conversely, 8 patients (18 sites, group B), who received only sporadic care, lost at 4 years, 2.8 +/- 2.7 mm of the PAL gained at 1 year. Group A patients had significantly lower full mouth plaque and bleeding scores than group B at 4 years. Furthermore, detection of bleeding on probing, plaque, P. gingivalis and P. intermedia was significantly more frequent in regenerated sites of group B patients. Risk assessment analysis indicated that GTR sites in patients receiving only sporadic care had a 50-fold increase in risk of PAL loss between 1 and 4 years with respect to patients undergoing regular recall. It was concluded that stability of gained clinical attachment was dependent upon stringent oral hygiene.
本研究的目的是评估在根据引导性组织再生（GTR）原则对深骨下袋缺损进行手术治疗后，支持性牙周治疗在维持所获得的临床附着方面的作用。在GTR治疗后，23例患者的40个深骨下袋缺损在经过1年严格的菌斑控制后，探诊附着水平（PAL）增加了4.1毫米。在随后的3年中，15例患者（22个部位，A组）每3个月复诊一次。在该组中，所获得的附着水平保持稳定。相反，8例患者（18个部位，B组）仅接受了不定期的护理，在4年时，失去了1年时所获得的2.8±2.7毫米的PAL。在4年时，A组患者的全口菌斑和出血评分显著低于B组。此外，在B组患者的再生部位，探诊出血、菌斑、牙龈卟啉单胞菌和中间普氏菌的检出频率显著更高。风险评估分析表明，仅接受不定期护理的患者的GTR部位在1至4年期间PAL丧失的风险相对于接受定期复诊的患者增加了50倍。得出的结论是，所获得的临床附着的稳定性取决于严格的口腔卫生。
