Differences in effectiveness of membrane fixation using periosteal vertical mattress and simple sling suture techniques in infrabony pocket treatment

Beta Widya Oktiani, S. Lastianny, Ahmad Syaify
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Abstract

Guide tissue regeneration (GTR) is the treatment of infrabony pockets for soft and hard tissue regeneration. Membrane is used as a barrier and prevents apical migration of the cells in epithelial tissues. Membrane fixation is one of the procedures in GTR treatment because resorbed membrane is less stable. Simple sling suture technique for membrane fixation has 1 anchorage, located in coronal flap, while periosteal vertical mattress suture technique has 2 anchorages in periosteum, making it more stable. This study aimed to study the differences in the effectiveness of membrane fixation using periosteal vertical mattress suture and simple sling suture techniques in terms of probing depth, relative attachment loss, and alveolar bone height in the treatment of infrabony pockets. The samples were divided into 2 groups. The first group was open flap debridement (OFD) with demineralized freeze dried bone allograft (DFDBA) application and membrane fixation with simple sling suture, while the second group was OFD with DFDBA application and membrane fixation with periosteal vertical mattress suture, observed on day 0, 30th day, and 90th day. The results of the study showed significant differences in the probing depth and relative attachment loss (except from the 30th day to the 90th day), and there were no significant differences in the alveolar bone height from the baseline to the 90th day, between the group of membrane fixation using simple sling suture and that of periosteal vertical mattress suture techniques on flap surgery. This study concluded that membrane fixation in the treatment of infrabony pocket with periosteal vertical mattress suture technique is more effective in reducing the probing depth and relative attachment loss, but there is no difference in increasing the alveolar bone height when compared to simple sling suture technique.
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骨膜垂直垫膜固定与简单吊带缝合治疗下骨袋疗效的差异
引导组织再生(GTR)是一种治疗下骨袋的软硬组织再生方法。在上皮组织中,膜被用作屏障,防止细胞向顶端迁移。膜固定是治疗GTR的一种方法,因为被吸收的膜不太稳定。单纯的悬吊缝合法膜固定有1个锚点,位于冠状皮瓣内,而骨膜垂直床垫缝合法在骨膜内有2个锚点,更加稳定。本研究旨在研究骨膜垂直床垫缝合和简单吊带缝合在治疗下骨袋时,膜固定在探查深度、相对附着丧失和牙槽骨高度方面的差异。将样本分为两组。第一组采用开瓣清创(OFD)联合脱矿冻干同种异体骨移植(DFDBA)应用,单纯吊带缝合膜固定;第二组采用脱矿冻干同种异体骨移植(DFDBA)应用,骨膜垂直床垫缝合膜固定,分别于第0、30、90天进行观察。本研究结果显示,单纯悬吊缝合膜固定组与骨膜垂直垫式缝合瓣手术组的牙槽骨高度从基线到第90天无显著差异(30天至第90天除外),牙槽骨探测深度和相对附着损失均有显著差异。本研究认为膜固定治疗下骨袋与骨膜垂直床垫缝合技术在减少探探深度和相对附着损失方面更有效,但在增加牙槽骨高度方面与单纯吊带缝合技术没有差异。
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