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引导组织再生术治疗上颌磨牙Ⅲ度根分叉病变

Guided tissue regeneration in the treatment of degree III furcation defects in maxillary molars.

作者信息

Pontoriero R, Lindhe J

机构信息

Department of Periodontology, Faculty of Odontology, Gothenburg University, Sweden.

出版信息

J Clin Periodontol. 1995 Oct;22(10):810-2. doi: 10.1111/j.1600-051x.1995.tb00265.x.

Abstract

11 subjects with generalized periodontitis and advanced lesions in the maxillary molar regions, including bilateral mesial-distal, but not buccal, degree III furcation defects in the 1st and/or 2nd molars, were recruited for the present clinical trial. The patients were given oral hygiene instruction and full-mouth scaling and root planing. A re-examination was performed after 3 months of healing, after which the furcation involved molars were randomly selected for a GTR or conservative treatment modality. An informed consent form was signed by each participating patient. The GTR procedure involved the elevation of mucoperiostal flaps, root surface debridement, and the placement of an e-PFTE membrane at the 2 entrances of the furcation defect. The flaps were repositioned and secured. The contralateral molar was treated in an identical manner but without the placement of the teflon membrane. The patients received amoxicillin (1g x 2/day for 8 days), were placed on chlorhexidine mouth rinsing and were recalled for prophylaxis 1x every 2 weeks. The teflon membranes were removed at a 2nd stage procedure after 6 weeks. All subjects were re-examined 6 months after the regenerative procedure, and in addition, all sites were evaluated following a reentry procedure. The final examination and measurements made during the reentry procedure documented that, although some reduction in probing pocket depth and some gain in probing attachment had occurred at both test and control sites, none of the furcation defects had closed, but retained the characteristics of a degree-III furcation involvement.

摘要

11名患有广泛性牙周炎且上颌磨牙区有晚期病变的受试者被纳入本临床试验,这些病变包括第一和/或第二磨牙双侧近远中,但不包括颊侧的III度根分叉病变。患者接受了口腔卫生指导以及全口洁治和根面平整。在愈合3个月后进行复查,之后随机选择根分叉受累的磨牙进行引导组织再生术(GTR)或保守治疗方式。每位参与的患者都签署了知情同意书。GTR手术包括掀起黏骨膜瓣、根面清创,并在根分叉缺损的两个入口处放置e-PFTE膜。将瓣重新定位并固定。对侧磨牙以相同方式治疗,但不放置聚四氟乙烯膜。患者服用阿莫西林(1g×2/天,共8天),使用氯己定漱口,并每2周召回进行一次预防治疗。6周后在第二阶段手术中取出聚四氟乙烯膜。在再生手术后6个月对所有受试者进行复查,此外,在再次进入手术(翻瓣手术)后对所有部位进行评估。再次进入手术期间进行的最终检查和测量记录显示,尽管在试验组和对照组部位的探诊深度均有一定程度降低,探诊附着有一定程度增加,但没有一个根分叉缺损闭合,而是保留了III度根分叉病变的特征。

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