引导性组织再生术对浓缩生长因子联合植骨术治疗下颌磨牙Ⅱ度根分叉病变临床效果的影响

Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classⅡfurcation involvements of mandibular molars

目的:评价引导性组织再生术(guided tissue regeneration,GTR)是否能够增进浓缩生长因子(concentrated growth factors,CGF)联合植骨术治疗下颌磨牙Ⅱ度根分叉病变的临床效果,以期为根分叉病变的再生寻求更好的治疗方法。方法:纳入需进行牙周手术的35例下颌磨牙Ⅱ度根分叉病变患者,随机分为两组,试验组采用GTR+CGF+植骨术进行治疗,对照组采用CGF+植骨术进行治疗。在术前和术后1年时分别对患牙进行临床检查,并拍摄锥形束CT(cone beam computed tomography,CBCT)。比较试验组和对照组手术前后临床和CBCT数据的变化。结果:基线时两组的探诊深度、垂直附着丧失和水平附着丧失差异均无统计学意义(P>0.05)。术后1年时,两组的临床指标较基线时均有显著改善(P<0.001),其中试验组的垂直附着获得和水平附着获得分别为(4.11±1.98)mm和(3.84±1.68)mm,改善程度显著高于对照组(P<0.001)。基线时两组的CBCT显示的垂直骨丧失和水平骨丧失差异均无统计学意义(P>0.05)。术后1年时,试验组的垂直骨缺损和水平骨缺损较基线时和对照组均有显著改善(P<0.001),分别减少(3.84±1.68)mm和(3.88±2.12)mm。结论:下颌磨牙Ⅱ度根分叉病变患者观察1年的结果显示,GTR可以促进CGF+植骨术在下颌磨牙Ⅱ度根分叉病变中的治疗效果。

Objective:Tissues loss due to periodontal disease is typically treated by a variety of rege-nerative treatment modalities,including bone grafts,guided tissue regeneration(GTR)and growth factors,to reform the supporting tissues of teeth.Concentrated growth factors(CGF)are produced by centrifuging blood samples at alternating and controlled speeds using a special centrifuge.The purpose of this study was to evaluate whether GTR could improve the effect of CGF combined with bone graft in the treatment of classⅡfurcations of mandibular molars.Methods:In the present study,thirty-five classⅡfurcation involvements were included and randomly divided into two groups.The experimental group(n=17)accepted GTR combined with CGF and bone graft therapy,and the controlled group(n=18)accepted CGF combined with bone graft therapy.The clinical examinations and cone beam computed tomography(CBCT)were performed at baseline and 1 year post-surgery.Comparisons of clinical and CBCT data before and after operation between the experimental group and the control group were made.Results:The clinical and CBCT data of both groups were not statistically different at baseline(P>0.05).At the end of 1 year post-surgery,the clinical parameters of both groups were significantly improved(P<0.001).The probing depths of the experimental group were(4.81±1.95)mm and(3.56±1.94)mm,respectively,significantly higher than the changes of the control group(P<0.001).The vertical and horizontal attachment gains of the experimental group were(4.11±1.98)mm and(3.84±1.68)mm,respectively,significantly higher than the changes of the control group(P<0.001).At the end of 1 year post-surgery,the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with those of the control group:(3.84±1.68)and(3.88±2.12)mm,respectively(P<0.001).Conclusion:Within the limitation of the present study,GTR showed positive role in the effect of CGF combined with bone graft in the treatment of classⅡfurcation involvements of mandibular molars.