引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响

doi:10.19723/j.issn.1671-167X.2020.02.024

北京大学学报（医学版） ›› 2020, Vol. 52 ›› Issue (2): 346-352. doi: 10.19723/j.issn.1671-167X.2020.02.024

引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响

李菲,乔静,段晋瑜,张勇,王秀婧()

北京大学口腔医学院·口腔医院,门诊部国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室, 北京 100034

收稿日期:2018-08-08 出版日期:2020-04-18 发布日期:2020-04-18
通讯作者: 王秀婧 E-mail:wang_xiu_jing@163.com
基金资助:
北京大学口腔医院新技术新疗法重点项目;国家自然科学基金(81600868);曹采方牙周耕耘科研基金(2016)

Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classⅡ furcation involvements of mandibular molars

Fei LI,Jing QIAO,Jin-yu DUAN,Yong ZHANG,Xiu-jing WANG()

First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China

Received:2018-08-08 Online:2020-04-18 Published:2020-04-18
Contact: Xiu-jing WANG E-mail:wang_xiu_jing@163.com
Supported by:
Supported by the New Technology and New Treatment Foundation of Peking University School;Hospital of Stomatology, the National Natural Science Foundation of China(81600868);the Cao Caifang Periodontal Gengyun Foundation of Peking University School and Hospital of Stomatology(2016)

摘要/Abstract

摘要：

目的评价引导性组织再生术(guided tissue regeneration, GTR)是否能够增进浓缩生长因子(concentrated growth factors, CGF)联合植骨术治疗下颌磨牙Ⅱ度根分叉病变的临床效果,以期为根分叉病变的再生寻求更好的治疗方法.方法: 纳入需进行牙周手术的35例下颌磨牙Ⅱ度根分叉病变患者,随机分为两组,试验组采用GTR+CGF+植骨术进行治疗,对照组采用CGF+植骨术进行治疗.在术前和术后1年时分别对患牙进行临床检查,并拍摄锥形束CT(cone beam computed tomography, CBCT).比较试验组和对照组手术前后临床和CBCT数据的变化.结果: 基线时两组的探诊深度,垂直附着丧失和水平附着丧失差异均无统计学意义(P>0.05).术后1年时,两组的临床指标较基线时均有显著改善(P<0.001),其中试验组的垂直附着获得和水平附着获得分别为(4.11±1.98) mm和(3.84±1.68) mm,改善程度显著高于对照组(P<0.001).基线时两组的CBCT显示的垂直骨丧失和水平骨丧失差异均无统计学意义(P>0.05).术后1年时,试验组的垂直骨缺损和水平骨缺损较基线时和对照组均有显著改善(P<0.001),分别减少(3.84±1.68) mm和(3.88±2.12) mm.结论: 下颌磨牙Ⅱ度根分叉病变患者观察1年的结果显示,GTR可以促进CGF+植骨术在下颌磨牙Ⅱ度根分叉病变中的治疗效果.

关键词: 浓缩生长因子, 根分叉病变, 骨移植, 引导组织再生术

Abstract:

Objective: Tissues loss due to periodontal disease is typically treated by a variety of rege-nerative treatment modalities, including bone grafts, guided tissue regeneration (GTR) and growth factors, to reform the supporting tissues of teeth. Concentrated growth factors (CGF) are produced by centrifuging blood samples at alternating and controlled speeds using a special centrifuge. The purpose of this study was to evaluate whether GTR could improve the effect of CGF combined with bone graft in the treatment of classⅡ furcations of mandibular molars.Methods: In the present study, thirty-five classⅡ furcation involvements were included and randomly divided into two groups. The experimental group (n=17) accepted GTR combined with CGF and bone graft therapy, and the controlled group (n=18) accepted CGF combined with bone graft therapy. The clinical examinations and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery. Comparisons of clinical and CBCT data before and after operation between the experimental group and the control group were made.Results: The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, the clinical parameters of both groups were significantly improved (P<0.001). The probing depths of the experimental group were (4.81±1.95) mm and (3.56±1.94) mm, respectively, significantly higher than the changes of the control group (P<0.001). The vertical and horizontal attachment gains of the experimental group were (4.11±1.98) mm and (3.84±1.68) mm, respectively, significantly higher than the changes of the control group (P<0.001). At the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with those of the control group: (3.84±1.68) and (3.88±2.12) mm, respectively (P<0.001).Conclusion: Within the limitation of the present study, GTR showed positive role in the effect of CGF combined with bone graft in the treatment of classⅡ furcation involvements of mandibular molars.

Key words: Concentrated growth factors, Furcation involvement, Bone grafting, Guided tissue regeneration

中图分类号:

R781.3

李菲,乔静,段晋瑜,张勇,王秀婧. 引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响[J]. 北京大学学报（医学版）, 2020, 52(2): 346-352.

Fei LI,Jing QIAO,Jin-yu DUAN,Yong ZHANG,Xiu-jing WANG. Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classⅡ furcation involvements of mandibular molars[J]. Journal of Peking University (Health Sciences), 2020, 52(2): 346-352.

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参考文献 24

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Group	Number of teeth	Furcation location		Total
Group	Number of teeth	Buccal	Lingual	Total
Experimental group	11	9	8	17
Controlled group	11	9	9	18

Items	Experimental group	Controlled group
PPD/mm, $\bar{x}±s$
Baseline	7.86±2.47	7.73±2.15
1 year post-surgery	3.05±1.33^*	4.17±2.09^*
PPD reduction	4.81±1.95^#	3.56±1.94
REC/mm, $\bar{x}±s$
Baseline	1.42±0.87	1.48±0.69
1 year post-surgery	2.12±1.05^*	2.14±1.03^*
REC increase	0.70±0.63	0.66±0.62
CAL-V/mm, $\bar{x}±s$
Baseline	9.28±2.65	9.21±2.51
1 year post-surgery	5.17±1.48^*	6.31±2.45^*
Vertical attachment gain	4.11±1.98^#	2.90±2.01
CAL-H/mm, $\bar{x}±s$
Baseline	6.08±2.31	6.05±2.44
1 year post-surgery	2.24±1.29^*	3.35±1.67^*
Horizontal attachment gain	3.84±1.68^#	2.70±1.47

Items	Experimental group	Controlled group
BL-V/mm, $\bar{x}±s$
Baseline	6.01±2.34	6.04±2.58
1 year post-surgery	2.17±1.49^*	3.15±1.37^*
Vertical radiograph bone gain	3.84±1.68^#	2.89±2.03
BL-H/mm, $\bar{x}±s$
Baseline	6.75±2.44	6.73±2.57
1 year post-surgery	2.87±2.02^*	4.21±2.07^*
Horizontal radiograph bone gain	3.88±2.12^#	2.52±2.26

引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响

Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classⅡ furcation involvements of mandibular molars

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