胶原膜治疗Ⅱ～Ⅲ度根分叉区病变的临床观察

Effects of collagen membrane in the treatment of class Ⅱ-Ⅲ furcation defects

目的 :对引导组织再生术 (GTR)治疗Ⅱ～Ⅲ度根分叉区病变的短期临床疗效进行评价 ,分析影响其疗效的因素。方法 :选取Ⅱ～Ⅲ度根分叉区病变的患牙 2 1颗 ,胶原膜治疗 11颗 ,翻瓣术治疗 10颗 ,术后 3月通过观察牙龈指数、附着水平、根分叉垂直与水平探诊深度的变化 ;实验室检测龈沟液量 (GCF)及龈沟液碱性磷酸酶 (GCF -ALP)活性水平的变化 ;计算机测量分析根尖片 ,对 2种手术方法的临床疗效进行比较。结果 :术后 3月①自身前后比较 ,2组的牙龈指数均无显著性差异 (P >0 .0 5 ) ,根分叉垂直与水平探诊深度与GTR组的牙周附着水平 ,均有明显改善 ,且有显著性差异 (P <0 .0 5 ) ,翻瓣组临床附着水平变化则无显著性差异 (P >0 .0 5 ) ;胶原膜组与翻瓣组相比较 ,除牙龈指数外各项临床指标均具有显著性差异 (P<0 .0 5 )。②实验室观察 :自身前后对照比较。 2组GCF量均无显著性差异 (P >0 .0 5 ) ,GCF -ALP浓度均减少 ,且有统计学意义 (P <0 .0 5 )。胶原膜组与翻瓣组相比较 ,GCF -ALP浓度减小幅度较大 ,有显著性差异 (P <0 .0 5 )。③根尖片的测量 :2组根分叉区骨密度均增高 ,GTR组与对照组相比较 ,垂直向骨高度增加明显 ,具有显著性差异 (P <0 .0 5 )。结论 :胶原膜治疗Ⅱ～Ⅲ度根分叉区病变 。

Objective: To evaluate the effects of guided tissue regeneration(GTR) in the treatment of degree Ⅱ-Ⅲ furcation defects with collagen membranes.Methods: 11 sites with Ⅱ-Ⅲ furcation defects were treated with collagen membranes(group of GTR); 10 sites received flap operation(group of FO). Clinical indexes, radiographs and gingival crevicular fluid(GCF) was collected before surgery and 3 months after treatment. Alkaline phosphatase(ALP) in GCF was measured. The data were analyzed statistically. Results: 3 months after surgery, the clinical parameters of PD, PFD and AL were decreased(P<0.05) except gingival index(GI, P>0.05). The decreace of the clinical parameters measured in group GTR was more than that in group FO(P<0.05) except that of GI. ALP in GCF were decreased in both groups after treatment (P<0.05). ALP decreased more in group GTR than that in group FO(P<0.05). In group GTR and group FO the height of alveolar bone in furcation area increased by (7.37±1.17)% and (2.47±1.3)% respectively(P<0.05). Conclusion: GTR with collagen membrane is effective in the treatment of class Ⅱ-Ⅲ furcation defects .