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使用两种不同生物可吸收膜治疗骨内缺损的引导性组织再生疗法:12个月的结果。

GTR therapy of intrabony defects using 2 different bioresorbable membranes: 12-month results.

作者信息

Christgau M, Bader N, Schmalz G, Hiller K A, Wenzel A

机构信息

Department of Operative Dentistry and Periodontology, University of Regensburg, Germany.

出版信息

J Clin Periodontol. 1998 Jun;25(6):499-509. doi: 10.1111/j.1600-051x.1998.tb02479.x.

Abstract

This prospective split-mouth study was designed to compare the clinical and radiographic healing results in intrabony periodontal defects 12 months after GTR therapy with 2 different bioresorbable barriers. The study comprised 25 healthy patients with one pair of contralaterally located intrabony defects with a probing pocket depth of > or = 6 mm and radiographic evidence of angular bone loss of > or = 4 mm. The 2 defects of each patient were randomized for treatment either with polylactic acid (PLA) membranes or with polyglactin-910 (PG-910) membranes. The patients received systemic doxycycline (100 mg/d) for 11 days postoperatively. One blinded examiner recorded the following clinical parameters using a pressure calibrated probe at baseline and after 12 months: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), and probing attachment level (PAL). The vertical relative attachment gain (V-rAG) was calculated as a % of the PAL gain related to the maximum possible attachment gain (expressed by the intraoperatively measured depth of the osseous defect). Geometrically standardized intraoral radiographs were quantitatively evaluated for bone changes (density, area) in the defect region using digital subtraction radiography (DSR). Clinical and radiographic data were statistically analyzed using the Wilcoxon-signed-rank test (alpha=0.05). Postoperative membrane exposures occurred in 9 PLA and 13 PG-910 treated sites. After 12 months of healing, both barrier types provided significant PPD reductions and PAL gain [median (25/75 percentile)]: deltaPPD [PLA: 3.0 (2.0/4.0) mm; PG-910: 3.0 (2.0/4.5) mm]; deltaPAL [PLA: 3.0 (2.5/4.0) mm; PG-910: 2.0 (1.0/4.0) mm]. V-rAG amounted to 60% in PLA sites and 54% in PG-910 sites. DSR revealed significant bone density gain after 12 months. 58.3% of the initial defect area in PLA sites and 54.0% of the initial defect area in PG-910 sites showed bone density gain. Neither clinical nor radiographic data revealed any significant difference between the 2 barrier types after 12 months. In conclusion, this 12-month study demonstrated that PLA and PG-910 membranes provided similar favorable regeneration results in deep intrabony periodontal defects.

摘要

这项前瞻性的半口对照研究旨在比较使用两种不同的生物可吸收屏障进行引导组织再生(GTR)治疗12个月后,骨内牙周缺损的临床和影像学愈合结果。该研究纳入了25名健康患者,每名患者均有一对位于对侧的骨内缺损,探诊袋深度≥6mm,且影像学显示角形骨吸收≥4mm。将每名患者的两个缺损随机分为两组,分别使用聚乳酸(PLA)膜或聚乙醇酸-910(PG-910)膜进行治疗。患者术后接受11天的全身强力霉素治疗(100mg/天)。一名盲法检查者在基线和12个月后使用压力校准探针记录以下临床参数:龈乳头出血指数(PBI)、牙龈退缩(REC)、探诊袋深度(PPD)和探诊附着水平(PAL)。垂直相对附着增加量(V-rAG)以PAL增加量占最大可能附着增加量的百分比来计算(通过术中测量的骨缺损深度表示)。使用数字减影放射成像(DSR)对几何标准化的口腔内X光片进行定量评估,以观察缺损区域的骨变化(密度、面积)。使用Wilcoxon符号秩检验(α=0.05)对临床和影像学数据进行统计分析。术后,9个接受PLA治疗的部位和13个接受PG-910治疗的部位出现了屏障暴露。愈合12个月后,两种屏障类型均使PPD显著降低,PAL增加[中位数(第25/75百分位数)]:ΔPPD[PLA:3.0(2.

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