Scott T A, Towle H J, Assad D A, Nicoll B K
Periodontics Department, Naval Dental School, National Naval Dental Center, Bethesda, MD, USA.
J Periodontol. 1997 Jul;68(7):679-86. doi: 10.1902/jop.1997.68.7.679.
The purpose of the study was to compare clinical parameter changes and osseous regeneration in 12 pairs of comparable Class II mandibular molar furcation invasion defects using either a bioabsorbable demineralized laminar bone allograft membrane or a non-resorbable expanded polytetrafluoroethylene (ePTFE) membrane as a barrier in guided tissue regeneration. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects within each pair were randomly selected for treatment with either bioabsorbable demineralized bone allograft membrane or ePTFE membrane. All defects were concurrently grafted with particulate demineralized freeze-dried bone allograft (DFDBA). Additional measurements were made at surgery to determine crestal resorption and the vertical and horizontal dimensions of the osseous defects. The temporal course and extent of membrane exposures were also recorded. The non-resorbable membrane was retrieved 6 weeks following placement. Six months following initial surgical treatment, each site was surgically re-entered and all soft and hard tissue measurements repeated. Descriptive statistical analysis revealed that both treatments resulted in significant within-group mean vertical and horizontal osseous fill, but no statistical difference emerged between the groups. As based on this pilot study, laminar bone membrane may be as effective as ePTFE when used in conjunction with DFDBA for treatment of Class II mandibular molar furcation bone defects. This pilot study of low power suggests that these two materials may be equivalent when used in conjunction with DFDBA. Further studies of much higher power and of the laminar bone alone as compared to positive and negative controls are required. Laminar bone does not require a secondary surgical procedure for removal and may undergo less frequent instances and degrees of exposure during healing.
本研究的目的是比较使用生物可吸收脱矿层状骨同种异体移植膜或不可吸收的膨体聚四氟乙烯（ePTFE）膜作为引导组织再生屏障时，12对具有可比性的II类下颌磨牙根分叉侵入性缺损的临床参数变化和骨再生情况。使用校准后的牙周探针进行测量，以确定软组织退缩、探诊深度和附着水平。每对缺损随机选择使用生物可吸收脱矿骨同种异体移植膜或ePTFE膜进行治疗。所有缺损均同时植入颗粒状脱矿冻干骨同种异体移植物（DFDBA）。在手术时进行额外测量，以确定牙槽嵴吸收以及骨缺损的垂直和水平尺寸。还记录了膜暴露的时间过程和程度。不可吸收膜在放置后6周取出。初次手术治疗6个月后，对每个部位再次进行手术切开，并重复所有软组织和硬组织测量。描述性统计分析显示，两种治疗方法均导致组内平均垂直和水平骨填充显著，但两组之间无统计学差异。基于这项初步研究，层状骨膜与DFDBA联合使用治疗II类下颌磨牙根分叉骨缺损时可能与ePTFE一样有效。这项低效能的初步研究表明，这两种材料与DFDBA联合使用时可能等效。需要进行更高效能的进一步研究，并将层状骨单独与阳性和阴性对照进行比较。层状骨不需要二次手术取出，并且在愈合過程中暴露的频率和程度可能较低。
