Cortellini P, Bowers G M
Department of Periodontics, University of Siena, Italy.
Int J Periodontics Restorative Dent. 1995 Apr;15(2):128-45.
A task force of periodontists established clinical and histologic outcomes (goals) for the treatment of intrabony defects and researched the literature for techniques that would most predictably achieve these goals. The group also identified factors that could influence predictability. The treatment outcomes selected by the task force included regeneration of a true attachment apparatus; gain in bone and probing attachment levels; reduction in probing pocket depth; minimal gingival recession; increased patient comfort; esthetic appearance and state of wellness; and maintenance of health, comfort, and function over time. Based on evidence, it was concluded that guided tissue regeneration, guided tissue regeneration combined with the use of decalcified freeze dried bone allografts and freeze-dried bone allografts alone are the most predictable regenerative procedures for achieving selected treatment outcomes. Various factors, such as patient characteristics, the morphology of the defect, and the surgical technique can influence the healing response of intrabony defects. Patient factors, such as plaque control, compliance, and cigarette smoking, can directly affect predictability of periodontal regeneration. Defect selection is critical, and deep and narrow defects are the most predictable response to regenerative procedures. The number of remaining bony walls is important in grafting procedures, but their influence is questionable in guided tissue regeneration. Various technical procedures, such as flap design, defect debridement, and wound protection, may influence the predictability of regeneration.
一个牙周病专家特别工作组确定了骨内缺损治疗的临床和组织学结果（目标），并检索文献以寻找最有可能实现这些目标的技术。该小组还确定了可能影响可预测性的因素。特别工作组选择的治疗结果包括真正附着装置的再生；骨量增加和探诊附着水平提高；探诊袋深度减小；牙龈退缩最小化；患者舒适度提高；美观外观和健康状态；以及长期维持健康、舒适度和功能。基于证据，得出的结论是，引导组织再生、引导组织再生联合使用脱钙冻干异体骨以及单独使用冻干异体骨是实现选定治疗结果最可预测的再生程序。各种因素，如患者特征、缺损形态和手术技术，可影响骨内缺损的愈合反应。患者因素，如菌斑控制、依从性和吸烟，可直接影响牙周再生的可预测性。缺损的选择至关重要，深而窄的缺损对再生程序的反应最可预测。剩余骨壁的数量在植骨手术中很重要，但其在引导组织再生中的影响存在疑问。各种技术程序，如瓣设计、缺损清创和伤口保护，可能影响再生的可预测性。
