骨形态蛋白复合物联合引导组织再生技术治疗根分叉病变的研究

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

目的 评价骨形态蛋白复合物联合引导组织再生技术治疗根分叉病变的临床效果。方法 选择30颗Ⅱ～Ⅲ度根分叉病变患牙，其中骨形态蛋白复合物联合引导组织再生技术治疗10颗（BMP组），引导组织再生技术治疗10颗（GTR组），常规牙周翻瓣术治疗10颗（OFD组），作为对照组。术后12周、24周分别观察各组的牙周探诊深度（PPD）、根分叉水平探入深度（HPD）、临床牙周附着丧失（CAL）和龈沟出血指数（SBI）等临床指标变化。用SPSS10．0软件包对相关数据统计学分析。结果 三组术后PPD、HPD、CAL和SBI均有明显减少，BMP组、GTR组与OFD组相比较，减少更为明显，有显著性差异（P〈0．05），BMP组与GTR组相比，PPD和CAL减少更为明显，有显著性差异（P〈0．01），而SBI无显著性差异（P〉0．05）。术前与术后X线比较，BMP组可见阴影变小，牙槽骨密度增加更为明显。结论 骨形态蛋白复合物联合GTR技术与传统的GTR术和牙周翻瓣术相比，更能有效减轻牙周炎症、减少牙周袋深度、增加临床牙周附着水平和促进牙周骨组织再生修复的能力。骨形态蛋白复合物联合GTR技术治疗Ⅱ～Ⅲ度根分叉病变可以获得满意的临床效果。

Objective To evaluate the effects of combination of bone morphogenetic protein complex and collagen membrane in the treatment of Class Ⅱ -Ⅲ furcation involvement. Methods Thirty - furcation defects （forty - five periodontal tissues defects） were selected and distributed 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）, horizontal probing depth （ HPD）, clinical attchment loss （CAL） and sulcus bleeding index （SBI）. The effects were analyzed statistically by SPSS10.0. Results At 2th and 24th week after 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 OFD group（ P 〈 0.01, group BMP vsOFD group, P 〈 0.05 group GTR vs OFD group）. SBI in group BMP and group GTR were significantly lower than those in OFD group（ P 〈 0.01）. The reductions of PPD and CAL in group BMP was significantly more than that in group GTR（ P 〈 0.05 ）. No significant difference in SBI reduction was observed between group BMP and group GTR（ P 〉 0.05）. Conclusion The therapy of GTR and combination of RBX and GTR were more effective than the control group in reducing PPD and CAL and moderating periodontitis, and the curative effect in group BMP was the best. It was concluded that the class Ⅱ-Ⅲ furcation involvement can be treated by combination of RBX and GTR.