三种骨移植治疗牙周骨内缺损的临床疗效比较

Jian Kang, Jinrong Zhao, Jing Li, Ying Zhang, Rui-dan Su, Yongqiang Ma, Zhi-Tao Wang
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摘要

目的比较引导组织再生(GTR)联合Bio-Gene、Bone3和Bio-Oss等不同骨移植材料治疗牙周骨内缺损的临床效果。方法将18例伴有牙周骨内缺损的慢性牙周炎患者随机分为Bio-Gene组、Bone3组和Bio-Oss组。所有患者在牙周清创术后进行牙周骨移植联合GTR手术。在手术前、拆线前(手术后2周)和手术后6个月收集患者的临床和放射学参数,包括牙周探查深度(PD)、临床附着丧失(CAL)、牙龈退缩(GR)和残余牙槽骨高度(RBH)。结果所有患者的伤口在拆线后均愈合良好。第一阶段的愈合没有感染或伤口裂开,术后的不适是可以接受的。牙周骨移植联合GTR治疗6个月后,三组的PD和CAL指标均较术前有显著改善(均P<0.05),骨密度与周围骨组织相似。结论Bio-Gene、Bone3和Bio-Oss均为治疗牙周炎引起的牙槽骨缺损的可靠骨移植材料,可显著提高成骨效果。关键词:牙周炎;骨内缺损;牙周骨移植;引导组织再生;骨替代品
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Comparison of clinical effects of three kinds of bone graft in the treatment of periodontal intra-bony defects
Objective To compare the clinical effects of guided tissue regeneration (GTR) combined with different bone graft materials, including Bio-Gene, Bone3 and Bio-Oss, in the treatment of periodontal intra-bony defects. Methods Eighteen patients with chronic periodontitis with periodontal intra-bony defects were randomly divided into the Bio-Gene group, the Bone3 group and Bio-Oss group. After periodontal debridement, periodontal bone grafting combined with GTR surgery was performed in all patients. The clinical and radiographic parameters of patients were collected before surgery, suture removal (2 weeks after surgery), and 6 months after surgery, including periodontal exploration depth (PD), clinical attachment loss (CAL), gingival recession (GR), and residual alveolar bone height (RBH). Results The wounds healed well in all patients when the suture was removed. The stage I healing was obtained without infection or wound dehiscence, and the postoperative discomfort was acceptable. At 6 months after periodontal bone grafting combined with GTR treatment, the PD and CAL indexes in the three groups were significantly improved compared with those before surgery (all P 0.05). Imaging results showed that new bone formation was observed in the original bone defect area in all three groups after 6 months of the treatment, the bone density was similar to the surrounding bone tissue. Besides, the RBH% increased significantly compared with that before the treatment (all P 0.05). Conclusions Bio-Gene, Bone3 and Bio-Oss are all reliable bone graft materials for the treatment of alveolar bone defects caused by periodontitis, which can significantly improve the osteogenesis effect. Key words: Periodontitis; Intra-bony defects; Periodontal bone grafting; Guided tissue regeneration; Bone substitute
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