GUIDED TISSUE REGENERATION IN THE TREATMENT OF FURCATION DEFECTS IN MANDIBULAR MOLARS - A CLINICAL-STUDY OF DEGREE III INVOLVEMENTS
GUIDED TISSUE REGENERATION IN THE TREATMENT OF FURCATION DEFECTS IN MANDIBULAR MOLARS - A CLINICAL-STUDY OF DEGREE III INVOLVEMENTS
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DOI：
10.1111/j.1600-051x.1989.tb01635.x
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发表时间：
1989-03-01
影响因子：
6.7
通讯作者：
SANAVI, F
中科院分区：
文献类型：
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作者：
PONTORIERO, R;LINDHE, J;SANAVI, F
本研究旨在利用引导组织再生的原理，评估下颌磨牙III度分叉缺损患者牙周组织的再生能力。患者样本包括21名年龄在26-65岁之间的患者，他们在右侧和左侧磨牙区域出现牙周病变，包括“穿透性”分叉缺陷。检查后，每个患者都接受了一系列的全口洁治和根面平整。2-3个月后，召回患者进行基线检查。在每个患者中，涉及分叉的磨牙被随机分配到测试或对照治疗程序中。测试程序包括在磨牙的口腔和舌侧抬高粘液骨膜瓣。去除肉芽组织，对暴露的根面进行清创和平整。对分叉缺陷入口的宽度和高度进行了评估。调整特氟龙膜以覆盖缺损的入口(口腔和舌部)，并以Pontoriero等人描述的方式保持。(1988)。将皮瓣重新放置在膜的外表面，并用缝线固定，10天后取出。术后指导患者每日两次用葡萄糖酸氯己定冲洗口腔，疗程4周。在1-2个月的愈合期后拔除胎膜。除了放置膜外，在对照牙区进行了与测试程序相同的手术程序。在手术后6个月的时间里，患者接受菌斑控制计划，包括每隔一周进行一次专业的牙齿清洁。在这段时间结束时，所有患者都被重新检查。复查结果显示，21个“贯通”分叉缺损中，有8个完全愈合，完全闭合。另有10个部分愈合，只有3个在愈合6个月后仍然开放。对照组以前的“穿透”创面均未愈合，完全闭合。10个对照缺损区部分充填，11个保持开放。讨论了牙周组织在不同大小的分叉缺损中再生的可能性。
The present investigation was designed to evaluate the regenerative potential of the periodontal tissues in degree III furcation defects at mandibular molars using a treatment procedure based on the principle of guided tissue regeneration. The patient sample included 21 patients, 26-65 years of age, who presented periodontal lesions in the right and left molar regions including "through and through" furcation defects. After an examination, each patient was subjected to a series of full-mouth scaling and root planing. 2-3 months later, they were recalled for a baseline examination. The furcation-involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of muco-periosteal flaps at the buccal and lingual aspects of the molars. Granulation tissue was removed and the exposed root surfaces were debrided and planed. The width and the height of the entrance openings to the furcation defects were assessed. A teflon membrane was adjusted to cover the entrances to the defects (buccal and lingual) and was retained in the manner described by Pontoriero et al. (1988). The flaps were repositioned on the outer surface of the membrane and secured by sutures which were removed after 10 days. Following surgery, the patients were instructed to rinse the mouth twice daily for 4 weeks with chlorhexidine gluconate. The membranes were removed after a healing period of 1-2 months. A surgical procedure identical to the test procedure was performed in the control tooth regions with the exception of the placement of membranes. During a 6-month period after surgery, the patients were maintained in a plaque control program including professional tooth cleaning every second week. At the end of this period, all patients were re-examined. The results of this re-examination demonstrated that out of 21 "through and through" furcation defects treated with the GTR therapy, 8 healed with complete closure of the defect. An additional 10 defects had become partially healed and only 3 defects were after a healing period of 6 months still open. In the control group, none of the previous "through and through" defects had healed with complete closure. 10 control defects were partially filled and 11 remained open. The potential for regeneration of periodontal tissues in furcation defects of varying dimensions is discussed.