内镜辅助下无切口不翻瓣再生技术治疗牙槽骨角型吸收的效果评价

A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique:a case series study

目的:探讨内镜辅助下无切口不翻瓣再生技术(non-incisional technique,NIT)治疗牙槽骨角型吸收的效果。方法:选择13例重度牙周炎患者的13颗患牙,均存在邻面牙槽骨角型吸收,在经过牙周基础治疗后6周接受NIT治疗。NIT治疗过程为在内镜下完成清创后填入骨再生材料,记录NIT治疗前及术后2年术区探诊深度(probing depth,PD)、临床附着水平(clinical attachment level,CAL)、牙龈退缩(gingival recession,GR)及影像学指标变化。采用SPSS22.0软件包对数据进行统计学分析。结果:NIT术后2年随访结果与术前相比,CAL降低(3.65±2.10) mm(P<0.001),PD降低(4.42±1.66) mm(P<0.001),GR为(0.38±0.87)mm (P=0.25),影像学骨下袋深度降低显著(P<0.001)。结论 :对于牙槽骨角型吸收位点,NIT治疗可以在不翻瓣情况下获得良好的牙周再生效果。

PURPOSE:To investigate the effect of endoscopy-aided non-incisional periodontal regeneration technique(NIT)in the treatment of alveolar bone angular resorption.METHODS:Thirteen patients with severe periodontitis(13 diseased teeth)were selected.All patients had alveolar bone angular resorption on adjacent surface.The patients received NIT treatment 6 weeks after periodontal primary therapy.The visualization of subgingival environment was acquired by the periodontal endoscopy.Following the removal of the subgingival plaque,calculus and intra-bony granulation tissue,bone grafting materials were placed into the intra-bony defects with the assistance of a delicate gingival protector.No flap was elevated and no sutures were applied.Probing depth(PD),gingival recession(GR),clinical attachment level(CAL),as well as radiographic parameters were evaluated at baseline and 2 years after treatment.SPSS 22.0 software package was used for data analysis.RESULTS:At 2-years follow-up,an average CAL gain of(3.65±2.10)mm(P<0.001),PD reduction of(4.42±1.66)mm(P<0.001),and minimal increase in GR of(0.38±0.87)mm(P=0.25)were observed.Alveolar bone was significantly improved at 2-years follow-up on radiographs(P<0.001).CONCLUSIONS:For angular resorption site of alveolar bone,NIT treatment can obtain good periodontal regeneration results without flap inversion.