骨形成蛋白复合物联合胶原膜治疗牙周缺损的临床研究

Clinical study of combination of bone morphogenetic protein complex and collagen membrane in treatment of periodontal tissue defects

目的 评价骨形成蛋白复合物联合胶原膜治疗牙周组织缺损的临床效果。方法 将骨形成蛋白复合物即重组合异种骨应用于引导组织再生(GTR)技术中,与传统的GTR技术和牙周翻瓣术对照研究。选择经过牙周基础治疗的35例4 5处牙周组织缺损,分为3组,BMP组:牙周缺损处植入骨形成蛋白复合物和胶原膜;GTR组:牙周缺损处植入胶原膜;OFD组:做牙周翻瓣术,为对照组。术后12、2 4周分别观察各组的牙周探诊深度(PPD)、临床牙周附着丧失(CAL)和龈沟出血指数(SBI)等临床指标变化。结果 3组术后PPD、CAL和SBI均有明显减少和降低。BMP组、GTR组与OFD组相比较,PPD和CAL减少、SBI降低,差异均有显著性(术后12周时P <0 .0 5 ,术后2 4周时P <0 .0 1) ;BMP组与GTR组相比,PPD和CAL减少,差异有显著性(P<0 .0 1) ,而SBI降低,差异无显著性(P >0 .0 5 )。

Objective To evaluate the effects of combination of bone morphogenetic protein complex and collagen membrane in the treatment of periodontal tissue defects. Methods The application of combination of bone morphogenetic protein complex(reconstituted bone xenograft,RBX) and collagen membrane were tested by comparing with the conventional GTR and the open flap debridement. Thirty-five patients(forty-five periodontal tissue defects) were selected and divided randomly into three groups after an initial therapy: group GTR(guided tissue regeneration with collagen membrane ), group BMP (combination of RBX and GTR ) and group OFD(open flap debridement, control). The followings were recorded before the operation and repeated at the 12th and 24th week evaluations: pocket probing depth (PPD), clinical attachment loss(CAL)and sulcus bleeding index(SBI). The effects were analyzed statistically by SPSS10.0. Results At the 12th and 24th weeks after the operation, three groups showed significant reduction in PPD, CAL and SBI. PPD, CAL in group BMP and group GTR were significantly lower than those in group OFD(P<0.01, group BMP vs. group OFD, P<0.05, group GTR vs. group OFD). SBI in group BMP and group GTR were significantly lower than those in group OFD(P<0.01, at the 24th week, P<0.05, at the 12th week). The reductions of PPD and CAL in group BMP were significantly more than those in group GTR(P<0.05). No significant differences in SBI reduction was observed between group BMP and group GTR(P>0.05). Conclusion The therapy of GTR and combination of RBX is more effective than the conventional GTR and OFD in reducing PPD and CAL and moderating periodontitis. It is concluded that combination of RBX and GTR can be used to promote periodontal regeneration.