Froum S J, Weinberg M A, Tarnow D
New York University, Department of Implant Dentistry, New York, USA.
J Periodontol. 1998 Jun;69(6):698-709. doi: 10.1902/jop.1998.69.6.698.
The purpose of this study was to compare the repair response of bioactive glass synthetic bone graft particles and open debridement in the treatment of human periodontal osseous defects. Fifty-nine defects in 16 healthy adults were selected. Each patient had at least 2 sites with attachment loss of at least 6 mm with clinical and radiographic evidence of intrabony or furcation defects. One to 3 months after cause-related therapy (oral hygiene instructions, scaling and root planing), the following measurements were recorded prior to surgery: probing depths, clinical attachment level, and gingival recession. Each defect was surgically exposed and measurements made of the alveolar crest height and base of osseous defect. The test defects were implanted with bioactive glass. The other sites served as unimplanted controls. Flaps were sutured at or close to the presurgical level. Radiographs and soft tissue presurgical measurements were repeated at 6, 9, and 12 months. At 12 months all sites were surgically re-entered to record osseous measurements. At the 12-month evaluation, significantly greater mean probing depth reduction was noted in the bioactive glass group compared to the controls (4.26 mm versus 3.44 mm; P = 0.028). Clinical attachment level gain was significantly improved (P = 0.0004) in the bioactive glass sites (2.96 mm) compared to the control sites (1.54 mm). There was significantly less gingival recession in the bioactive glass sites (1.29 mm) compared to the control sites (1.87 mm). Defect fill was significantly greater in the bioactive glass sites (3.28 mm) compared to the control sites (1.45 mm). Defect depth reduction was significantly greater in the bioactive glass sites (4.36 mm) compared to the control sites (3.15 mm). In conclusion, bioactive glass showed significant improvement in clinical parameters compared to open flap debridement.
本研究的目的是比较生物活性玻璃人工骨移植颗粒与开放性清创术在治疗人类牙周骨缺损中的修复反应。选取了16名健康成年人的59处缺损。每位患者至少有2个部位附着丧失至少6 mm，并有骨内或根分叉缺损的临床和影像学证据。在进行与病因相关的治疗（口腔卫生指导、龈下刮治和根面平整）1至3个月后，在手术前记录以下测量值：探诊深度、临床附着水平和牙龈退缩。每个缺损均通过手术暴露，并测量牙槽嵴高度和骨缺损底部。试验缺损植入生物活性玻璃。其他部位作为未植入的对照。将瓣缝合至术前水平或接近术前水平。在6、9和12个月时重复进行影像学检查和软组织术前测量。在12个月时，所有部位均再次进行手术以记录骨测量值。在12个月的评估中，与对照组相比，生物活性玻璃组的平均探诊深度降低显著更大（4.26 mm对3.44 mm；P = 0.028）。与对照部位（1.54 mm）相比，生物活性玻璃部位的临床附着水平增加显著改善（P = 0.0004）（2.96 mm）。与对照部位（1.87 mm）相比，生物活性玻璃部位的牙龈退缩显著更少（1.29 mm）。与对照部位（1.45 mm）相比，生物活性玻璃部位的缺损填充显著更大（3.28 mm）。与对照部位（3.15 mm）相比，生物活性玻璃部位的缺损深度降低显著更大（4.36 mm）。总之，与开放性瓣清创术相比，生物活性玻璃在临床参数方面显示出显著改善。
