Cortellini P, Paolo G, Prato P, Tonetti M S
Department of Periodontology, University of Siena, Italy.
J Clin Periodontol. 1996 Feb;23(2):106-11. doi: 10.1111/j.1600-051x.1996.tb00542.x.
44 patients (34% smokers) presenting with severe periodontitis were treated with full mouth root planing (RPL). In each patient, 1 intrabony defect was treated with guided tissue regeneration (GTR). After 1 year of monthly prophylaxis, full mouth plaque (FMPS) and bleeding (FMBS) scores were 8.3 +/- 4.1% and 5.6 +/- 3.8%. At 1 year, the GTR treated sites were matched, in each patient, with 1 RPL site, in terms of probing attachment level (PAL 6.8 +/- 2.4 mm GTR, and 6.5 +/- 2.3 mm RPL). At this point, 24 patients took part in a supportive periodontal care program. 20 patients did not participate, and received only sporadic care by general dentists. At 5 years, all patients were reexamined. FMPS was 10.5 +/- 6.8% and FMBS 7.7 +/- 6.4%. A significant PAL loss was observed in both sites (1.2 +/- 1.4 mm GTR, 1.3 +/- 1.3 mm RPL, p < 0.0001) between 1 and 5 years. Differences in PAL loss between GTR and RPL sites were not statistically significant. Only a minority of sites (34%), however, lost PAL, while 66% remained stable. 75% of the matched sites (GTR and RPL) within the same patients were concordant in terms of PAL stability. The 23 patients in which both sites remained stable, had good oral hygiene, complied with the recall system, and did not smoke. The 10 patients in which both sites lost PAL showed deteriorating oral hygiene, did not comply with the recall system, and smoked. PAL loss in the GTR and/or RPL sites was consistently observed in patients (losers) showing PAL loss in other teeth. Losers had, in general, negative subjects characteristics, and showed a higher prevalence of tooth loss.
(i) GTR and RPL sites showed comparable susceptibility to periodontal breakdown; (ii) stability of outcomes was consistently associated with good oral hygiene, compliance with a supportive periodontal care program, and no cigarette smoking.
44例患有重度牙周炎的患者（34%为吸烟者）接受了全口根面平整术（RPL）治疗。对每位患者的1个骨内缺损采用引导组织再生术（GTR）进行治疗。经过1年每月1次的预防性治疗后，全口菌斑（FMPS）和出血（FMBS）评分分别为8.3±4.1%和5.6±3.8%。1年后，在每位患者中，将接受GTR治疗的部位与1个接受RPL治疗的部位在探诊附着水平方面进行匹配（GTR为6.8±2.4mm，RPL为6.5±2.3mm）。此时，24例患者参加了牙周支持治疗项目。20例患者未参加，仅接受普通牙医的偶尔治疗。5年后，对所有患者进行复查。FMPS为10.5±6.8%，FMBS为7.7±6.4%。在1至5年期间，两个部位均观察到明显的探诊附着水平丧失（GTR为1.2±1.4mm，RPL为1.3±1.3mm，p<0.0001）。GTR部位和RPL部位之间的探诊附着水平丧失差异无统计学意义。然而，只有少数部位（34%）出现探诊附着水平丧失，而66%保持稳定。同一患者内75%的匹配部位（GTR和RPL）在探诊附着水平稳定性方面是一致的。两个部位均保持稳定的23例患者口腔卫生良好，遵守复诊制度，且不吸烟。两个部位均出现探诊附着水平丧失的10例患者口腔卫生恶化，不遵守复诊制度，且吸烟。在其他牙齿出现探诊附着水平丧失的患者（失败者）中，始终观察到GTR和/或RPL部位的探诊附着水平丧失。一般来说，失败者具有负面的个体特征，且牙齿丧失的患病率较高。
（i）GTR部位和RPL部位对牙周破坏的易感性相当；（ii）治疗效果的稳定性始终与良好的口腔卫生、遵守牙周支持治疗项目以及不吸烟相关。
