Eickholz P, Lenhard M, Benn D K, Staehle H J
Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University Heidelberg, Germany.
J Periodontol. 1998 Nov;69(11):1210-7. doi: 10.1902/jop.1998.69.11.1210.
The aim of the present study was to clinically and radiographically compare guided tissue regeneration (GTR) therapy with bioabsorbable polyglactin 910 barriers and conventional periodontal surgery in intrabony defects. In 26 patients with advanced periodontitis, 29 teeth exhibiting interproximal intrabony defects were treated; 15 by conventional periodontal surgery (control) and 14 by GTR (test). Before and 12 months after surgery, clinical parameters were assessed and standardized radiographs were taken. On the radiographs the distances from the cemento-enamel junction (CEJ) to the alveolar crest (AC), and the CEJ to the most apical extension of the bony defect (BD) were measured using a computer-assisted analyzing device (LMSRT). Twelve months after surgery, 24 patients with 27 lesions were available for examination. For both methods statistically significant (P < 0.001) probing depth (PD) reduction (mean +/- standard deviation) of -4.49 +/- 1.94 mm (n = 13, test) and -3.22 +/- 1.48 mm (n = 14, control), as well as clinical attachment gain (CAL-V) of 3.41 +/- 1.59 mm (test) and 2.07 +/- 1.10 mm (control), was observed. Radiographic changes of the distance CEJ to AC of -0.95 +/- 1.72 mm (n = 9, test), and -0.98 +/- 1.53 mm (n = 11, control) were not significant. A significant bony fill (distance CEJ-BD) of 1.05 +/- 1.22 mm was observed for the test group (P < 0.01); the 0.68 +/- 2.04 mm bony gain for the control group was not statistically significant. The PD reduction (P < 0.05) and attachment gain (P < 0.01) in the test group was statistically significantly more favorable than in the control group. Twelve months after surgery, statistically more favorable PD reduction and attachment gain was observed using polyglactin 910 barriers than compared to conventional flap surgery. Hence, the use of bioabsorbable barriers for therapy of intrabony defects may be recommended.
本研究的目的是在临床上和影像学上比较使用生物可吸收聚乙醇酸910屏障的引导组织再生(GTR)疗法与传统牙周手术治疗骨内缺损的效果。26例晚期牙周炎患者的29颗存在邻间骨内缺损的牙齿接受了治疗;15颗采用传统牙周手术(对照组),14颗采用GTR(试验组)。在手术前和术后12个月,评估临床参数并拍摄标准化X光片。在X光片上,使用计算机辅助分析设备(LMSRT)测量从牙骨质釉质界(CEJ)到牙槽嵴(AC)的距离,以及CEJ到骨缺损(BD)最根尖延伸处的距离。术后12个月,24例患者的27处病变可供检查。两种方法均观察到探诊深度(PD)显著降低(P < 0.001)(均值±标准差),试验组为-4.49±1.94 mm(n = 13),对照组为-3.22±1.48 mm(n = 14),以及临床附着获得(CAL-V),试验组为3.41±1.59 mm,对照组为2.07±1.10 mm。CEJ到AC距离的影像学变化,试验组为-0.95±1.72 mm(n = 9),对照组为-0.98±1.53 mm(n = 11),差异不显著。试验组观察到显著的骨填充(CEJ-BD距离)为1.05±1.22 mm(P < 0.01);对照组0.68±2.04 mm的骨增量无统计学意义。试验组的PD降低(P < 0.05)和附着获得(P < 0.01)在统计学上比对照组更有利。术后12个月,与传统翻瓣手术相比,使用聚乙醇酸910屏障观察到统计学上更有利的PD降低和附着获得。因此,推荐使用生物可吸收屏障治疗骨内缺损。