生物活性玻璃治疗牙周骨下袋的临床研究

Clinical evaluation of bioactive glass in the treatment of periodontal intrabony defects

目的 评价生物活性玻璃 (bioactiveglass ,BAG)治疗牙周骨下袋的临床疗效。方法 随机选择经过牙周基础治疗的 2 0处牙周骨缺损 ,其中 13处进行翻瓣术加BAG移植 ,另外 7处只做翻瓣术加以对照。通过术后 3、6个月的复查 ,比较两组的临床疗效。结果 BAG组术前的探诊深度、附着丧失和出血指数分别为 6 19mm、6 31mm和 2 77,术后 6个月时分别为 3 2 3mm、3 6 5mm和 0 6 5 ;翻瓣组术前的探诊深度、附着丧失和出血指数分别为 6 86mm、7 71mm和 2 93,术后 6个月时分别为4 5 0mm、5 35mm和 1 93。术后BAG组和翻瓣组的探诊深度、附着丧失及BAG组的出血指数均比术前明显减少。BAG组的上述指标均明显低于翻瓣组 ,BAG组的出血指数减少值显著大于翻瓣组。结论 翻瓣术加BAG植入和单纯翻瓣术均能明显改善骨下袋患牙的临床指标 ,而前者的临床疗效优于后者 。

Objective To evaluate the effect of a new product of bioactive glass, Perioglas  on human periodontal intrabony defects. Methods Twenty periodontal intrabony defects in 10 healthy adults were selected. Four weeks after an initial therapy, they were randomly assigned to either a BAG experimental (open flap debridement with BAG, totally 13 defects) or a control OFD (simple open flap debridement, totally 7 defects) group. For both groups, routine flap procedure was performed, but the Perioglas  was implanted only in the BAG group. The followings were recorded before the operation and repeated at the 3rd and 6th month evaluations: plaque index (PLI), bleeding index (BI), gingival recession (REC), probing depth (PD) and clinical attachment loss (CAL). Results At the 3rd and 6th months after operation, both groups showed significant reduction in PD and CAL. PD and CAL in BAG group at baseline were 6 19 mm and 6 31 mm, which were 3 23 mm and 3 65 mm at 6th after surgery, respectively PD and CAL in OFD group at baseline were 6 86 mm and 7 71 mm, which were 4 50 mm and 5 35 mm at 6 th after surgery, respectively And the BAG group showed significant reduction in BI, which from 2 77 at baseline to 0 65 at 6th month post operation. BI, PD and CAL in BAG group were significantly lower than those in OFD group. The reduction of BI in BAG group was significantly more than that in OFD group. Conclusions The bioactive glass is effective as an adjunct to conventional surgery in the treatment of intrabony defects.