Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects
Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects
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DOI：
10.1111/j.1600-051x.2008.01352.x
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发表时间：
2009-02-01
影响因子：
6.7
通讯作者：
Tonetti, Maurizio S.
中科院分区：
文献类型：
--
作者：
Cortellini, Pierpaolo;Tonetti, Maurizio S.
改良的微创外科技术在孤立牙间骨内缺损再生治疗中改善伤口稳定性。临床牙周病杂志2009；36: 157 - 163。doi: 10.1111 / j.1600 - 051 x.2008.01352。本文介绍了一种微创手术技术（modified微创外科技术，M-MIST）的改良手术入路，并初步评价了其联合淀粉原蛋白治疗孤立性深部骨内缺损的适用性和临床性能。对20例深部骨内分离缺损进行了研究。15例手术中使用M-MIST，而在5例出现舌骨内成分的部位，必须应用传统的MIST。根据乳头保存技术的原则，M-MIST由缺损相关乳头的颊部切口组成。只有一个颊瓣被提起，而牙间乳头保留原位。填补缺损的肉芽组织被解剖和移除，留下牙间和腭组织不变。在缝合前进行根内固定和再生材料的应用。皮瓣的初步关闭是通过一个单一的内部改良床垫缝合实现的。手术在手术显微镜和显微外科器械的帮助下进行。m - mist治疗部位（N=15）的手术椅时间为56±8.64 min。早期创面愈合是平稳的：所有部位的创面都得到了初步的闭合。未见水肿或血肿。患者没有报告疼痛或不适。1年的临床附着水平（CAL）增加为4.5 +/- 1.4 mm，缺损深度为6 +/- 1.5 mm。残余探测深度（pd）为3.1 +/- 0.6 mm。在基线和1年之间，观察到牙龈萎缩最小增加0.1 +/- 0.3 mm。M-MIST适用于20个选定的15个孤立的近端间缺陷。它导致非常有限的病人发病率和良好的临床改善。这些结果应该在更大的研究中得到证实。
Cortellini P, Tonetti MS. Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects. J Clin Periodontol 2009; 36: 157-163. doi: 10.1111/j.1600-051X.2008.01352.This paper describes a modified surgical approach of the minimally invasive surgical technique (modified minimally invasive surgical technique, M-MIST) and preliminarily evaluates its applicability and clinical performances in the treatment of isolated deep intrabony defects in combination with amelogenins.Twenty deep isolated intrabony defects in 20 patients were studied. Fifteen were surgically accessed with the M-MIST, while in five sites, which presented a lingual intrabony component, the conventional MIST had to be applied. The M-MIST consisted of a buccal incision of the defect-associated papilla, according to the principles of the papilla preservation techniques. Only a buccal flap was raised while the interdental papilla was left in situ. The granulation tissue filling the defect was dissected and removed, leaving the interdental and palatal tissues untouched. Root instrumentation and application of the regenerative material were performed before suturing. Primary closure of the flaps was attained with a single internal modified mattress suture. Surgery was performed with the aid of an operating microscope and microsurgical instruments.The surgical chair-time of the M-MIST-treated sites (N=15) was 56 +/- 8.64 min. Early wound healing was uneventful: primary wound closure was attained and maintained in all sites. No oedema or haematoma was noted. Patients did not report pain or discomfort. The 1-year clinical attachment level (CAL) gain was 4.5 +/- 1.4 mm in defects 6 +/- 1.5 mm deep. Residual probing depths (PDs) were 3.1 +/- 0.6 mm. A minimal increase of 0.1 +/- 0.3 mm in gingival recession between baseline and 1 year was observed.M-MIST was applicable on 15 isolated interproximal defects out of 20 selected ones. It resulted in very limited patient morbidity and excellent clinical improvements. These outcomes should be confirmed in a larger study.