胶原膜联合双相磷酸钙引导组织再生治疗骨内牙周缺损的临床影像学评价

S. Lamichhane, M. Humagain, A. Dawadi, Prakriti Rupakhety
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摘要

背景:牙周治疗成功的理想结果是牙周再生。引导组织再生目前被认为是牙周再生的金标准。再生膜本身力学性能差,生物材料不稳定,缺乏生物相容性,导致缺损部位直接使用生物活性材料。因此,本研究旨在通过临床和影像学检查来评估含有双相磷酸钙的生物活性分子的可吸收膜的有效性。方法:选取16例骨内缺损患者共20例。本研究设计为准试验,即定量非随机试验。在牙周通道瓣术后使用丙烯酸支架、胶原膜及同种异体骨移植,分别记录基线及术后6个月牙菌斑指数、牙龈指数、牙袋探探深度、牙龈后退量及相对附着水平等临床参数。在基线和6个月后,使用骨断层照相仪测量x线片骨填充量。数据分析采用配对t检验和Wilcoxon符号秩检验。结果:术后各项指标均有统计学意义。临床发现附着增加2.1±1.25mm,骨袋复位3.35±1.39mm,而x线片骨填充为2.81±1.43mm。然而,术后发现牙龈萎缩增加。结论:骨同种异体与再生膜结合治疗人骨内牙周缺损效果良好。
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CLINICO-RADIOGRAPHIC EVALUATION OF GUIDED TISSUE REGENERATION USING COLLAGEN MEMBRANE AND BIPHASIC CALCIUM PHOSPHATE IN TREATMENT OF INTRABONY PERIODONTAL DEFECTS
Background: The ideal result of successful periodontal therapy is periodontal regeneration. Guided tissue regeneration is considered currently as gold standard for periodontal regeneration. Poor mechanical properties, biomaterials instability and lack of biocompatibility of regenerative membrane alone led to direct use of bioactive materials in defect area. So, this study was intended towards evaluation of effectiveness of resorbable membrane with bioactive molecule containing biphasic calcium phosphate determined by amount of bone fill both clinically and radiographically. Methods: A total of 20 intrabony defects from sixteen patients were selected. The study designed was Quasi experiment, a quantitative non randomized experimental trial. The clinical parameters like Plaque index, Gingival index, Pocket probing depth, Amount of Gingival recession and relative attachment level were recorded at baseline and after 6 months by using acrylic surgical stent following periodontal access flap surgery along with use of collagen membrane and alloplast bone graft. Radiographic parameters were taken using Orthopantomograph for measuring the radiographic bone fill at baseline and after 6 months. Data were analyzed using paired t-test and Wilcoxon sign rank test. Results: All the parameters post operatively were statistically significant. Clinically, gain in attachment was 2.1±1.25mm and pocket reduction was 3.35±1.39mm whereas linear radiographic bone fill was found to be 2.81±1.43mm. However, gingival recession was found to be increased post-operatively. Conclusions: The current study showed combination of bone alloplast and regenerative membrane yields promising results in treatment of human intrabony periodontal defects.
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