引导性组织再生联合植骨术对Ⅰ型牙周-牙髓联合病变的临床疗效分析

Clinical effect evaluation of guided tissue regeneration in combination with bone grafts for combined periodontal-endodontic lesions

目的:分析引导性组织再生(GTR)联合植骨术治疗Ⅰ型牙周-牙髓联合病变的临床疗效。方法:纳入因牙髓及根尖周病变引起的牙周-牙髓联合病变患者28例,共38个患牙。所有患牙经完善的根管治疗及牙周基础治疗后,根据患者的意愿分为两组:实验组(n=20),翻瓣置Bio-gene骨材料并覆盖Bioguide生物膜;对照组(n=18),仅行单纯牙周翻瓣术。分别记录患者术前、术后6个月牙周探诊深度(PD)、牙龈退缩(GR)、临床附着丧失(CAL)、牙齿松动度(TM)以及牙槽骨高度(AH),并进行统计分析。结果:术后6个月,两组PD、CAL、TM、GR较术前均有显著改善(P<0.05);与对照组相比,实验组PD和CAL明显降低(P<0.05),TM和GR两组间相比则无统计学差异(P> 0.05);X线片示,实验组有15个(75.00%)患牙有新骨形成,AH增加;而对照组有1个患牙(5.56%)AH略有增加。结论:GTR联合植骨术治疗牙髓及根尖周病变引起的牙周-牙髓联合病变的临床疗效优于单纯牙周翻瓣术。

AIM:To evaluate the clinical effects of guided tissue regeneration(GTR)in combination with bone grafting in the treatment of combined periodontal-endodontic lesions.METHODS:28 patients(38 teeth with primary endodontic lesion and secondary periodontal involvement) after perfect root canal and periodontal initial therapy still with periodontal surgery indications,were divided into 2 groups according to the will of patients.20 teeth in experimental group were treated with flap and Bio-gene bone material,then covered by Bio-guide biofilm.18 teeth in control group were treated by simple flap surgery.Before and 6 months after operation periodontal probing depth(PD),gingival recession(GR),clinical attachment loss(CAL),tooth mobility(TM) and alveolar bone height(AH) were measured.The data were statistically analyzed.RESLULTS:6 months after operation,PD,CAL and TM in the 2 groups were significantly improved than those on the baseline(P<0.05),whereas GR was increased(P<0.05).Compared with control group,PD and CAL of experimental group were significantly decreased(P<0.05).No significant difference in TM and GR variation was observed between the 2 groups(P>0.05).X-ray showed there was new bone formation in 15 teeth(75%) of experimental group and AH was increased significantly compared with pre-operation.CONCLUSION:In treatment of teeth suffering from primary endodontic lesion with secondary periodontal involvement,the application of GTR combined with bone grafts may gain better clinical effects than flap surgery.