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侵袭性牙周炎骨内缺损引导组织再生治疗后的影像学结果

Radiographic outcomes following treatment of intrabony defect with guided tissue regeneration in aggressive periodontitis.

作者信息

Rakmanee Thanasak, Griffiths Gareth S, Auplish Gita, Darbar Ulpee, Petrie Aviva, Olsen Irwin, Donos Nikolaos

机构信息

Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, UK.

Faculty of Dentistry, Thammasat University, Patumthani, Thailand.

出版信息

Clin Oral Investig. 2016 Jul;20(6):1227-35. doi: 10.1007/s00784-015-1609-y. Epub 2015 Oct 10.

Abstract

OBJECTIVES

This study reports the radiographic analysis of a split-mouth, single-blinded, randomised controlled clinical trial which was designed to compare the efficacy of simplified papilla preservation flap (SPPF) with or without guided tissue regeneration (GTR) in patients with aggressive periodontitis (AgP).

METHODS

Eighteen AgP patients who had similar bilateral intrabony defects were treated. In all patients, the defects presented with radiographic evidence of an intrabony defect ≥3 and ≥5 mm of periodontal pocket depths (PPD). The surgical procedures included access for root instrumentation using SPPF alone (control) or, after debridement, a placement of resorbable GTR membrane (test). The standardised radiographic assessments were carried out at pre-surgical baseline and at 6 and 12 month post-surgery. Radiographic linear measurements and subtraction radiography were used as the method of analysis.

RESULTS

Both treatments showed significant improvements in linear radiographic bone fill and defect resolution at 6 and 12 months, compared to baseline. The 12-month subtraction radiography at the GTR sites showed a significant improvement compared to the 6-month outcomes.

CONCLUSIONS

Both therapies were effective in the treatment of intrabony defects in AgP patients although no significant differences between them could be demonstrated. The finding that the bone fill and resolution of the defect at the GTR sites were significantly higher at 12 months than at 6 months after treatment indicates that bone regeneration is still an ongoing process at 6 months post-surgery.

CLINICAL RELEVANCE

Radiographic assessment of periodontal regeneration should be carried out at 12 months post-surgery in order to evaluate the complete healing of the bony defect.

摘要

目的

本研究报告了一项采用分口、单盲、随机对照临床试验的影像学分析,该试验旨在比较简化乳头保留瓣(SPPF)联合或不联合引导组织再生(GTR)治疗侵袭性牙周炎(AgP)患者的疗效。

方法

对18例双侧骨内缺损情况相似的AgP患者进行治疗。所有患者的缺损在影像学上均显示骨内缺损≥3mm且牙周袋深度(PPD)≥5mm。手术操作包括仅使用SPPF进行牙根器械操作(对照组),或在清创后放置可吸收GTR膜(试验组)。在术前基线以及术后6个月和12个月进行标准化的影像学评估。采用影像学线性测量和减影放射摄影作为分析方法。

结果

与基线相比,两种治疗方法在术后6个月和12个月时,影像学线性骨填充和缺损分辨率均有显著改善。GTR位点的12个月减影放射摄影结果与6个月时相比有显著改善。

结论

两种治疗方法对AgP患者骨内缺损均有效,尽管两者之间未显示出显著差异。治疗后12个月时GTR位点的骨填充和缺损分辨率显著高于6个月,这一发现表明术后6个月时骨再生仍在持续进行。

临床意义

为评估骨缺损的完全愈合情况,应在术后12个月进行牙周再生的影像学评估。

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