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上颌第二磨牙Ⅱ度根分叉病变的引导组织再生:8例半口对照研究。

Guided tissue regeneration in Class II furcation involved maxillary molars: a controlled study of 8 split-mouth cases.

作者信息

Avera J B, Camargo P M, Klokkevold P R, Kenney E B, Lekovic V

机构信息

University of California, Los Angeles, School of Dentistry, Section of Periodontics, 90095, USA.

出版信息

J Periodontol. 1998 Sep;69(9):1020-6. doi: 10.1902/jop.1998.69.9.1020.

Abstract

The purpose of this study was to clinically evaluate the effectiveness of polytetrafluoroethylene membranes in the healing of interproximal Class II furcation defects in maxillary molars using a surgical treatment technique based on the principles of guided tissue regeneration. Eight subjects with similar bilateral Class II furcation lesions on the mesial aspect of maxillary first molars participated in this study. Patients received initial therapy consisting of oral hygiene instructions, scaling and root planing, and occlusal adjustment if necessary. Clinical parameters evaluated included plaque index, sulcular bleeding index, probing depth, attachment level, gingival recession, and open horizontal and vertical furcation fill. An acrylic occlusal stent was used to assure reproducibility of measurements. Experimental sites received a polytetrafluoroethylene membrane following surgical exposure of the furcation. Control sites were treated in the exact same manner but without a membrane. Membranes were removed at 6 weeks after the first surgery. Reentry surgeries were performed at 9 months. Postsurgical results showed a significant improvement in probing depth, attachment level, and open horizontal furcation fill for both groups when compared to baseline values, with experimental sites performing significantly better than controls. Control sites showed a slight loss in open vertical furcation fill while experimental sites remained unchanged. This study suggests that guided tissue regeneration using polytetrafluoroethylene membranes is of some but limited value in the treatment of maxillary molar interpoximal Class II furcation lesions.

摘要

本研究的目的是采用基于引导组织再生原理的外科治疗技术,临床评估聚四氟乙烯膜对上颌磨牙Ⅱ类根分叉病变愈合的有效性。8名上颌第一磨牙近中面有类似双侧Ⅱ类根分叉病变的受试者参与了本研究。患者接受了包括口腔卫生指导、洁治和根面平整以及必要时的咬合调整在内的初始治疗。评估的临床参数包括菌斑指数、龈沟出血指数、探诊深度、附着水平、牙龈退缩以及水平和垂直向根分叉开放区的填充情况。使用丙烯酸咬合支架以确保测量的可重复性。在手术暴露根分叉后,试验部位放置聚四氟乙烯膜。对照部位采用完全相同的方式治疗,但不放置膜。在首次手术后6周取出膜。在9个月时进行再次手术。术后结果显示,与基线值相比,两组的探诊深度、附着水平和水平向根分叉开放区填充情况均有显著改善,试验部位的表现明显优于对照部位。对照部位的垂直向根分叉开放区填充略有减少,而试验部位保持不变。本研究表明,使用聚四氟乙烯膜进行引导组织再生在上颌磨牙近中Ⅱ类根分叉病变的治疗中具有一定但有限的价值。

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