引导组织再生术治疗牙周牙髓联合病变的观察

目的观察应用Bio-Oss骨胶原与Bio-Gide胶原膜联合进行引导组织再生术,对牙周牙髓联合病变治疗后3年疗效。方法对16例患者20颗牙周牙髓联合病变患牙,先行根管治疗,牙周基础治疗后4周,联合使用Bio-Oss骨胶原与Bio-Gide胶原膜进行引导组织再生术,术后定期维护。术前和术后6、12、18、24、30、36个月,观测记录临床牙周指标,包括探诊深度（probing depth,PD）、附着丧失（attachment loss,AL）、牙龈退缩（gingivalrecession,GR）,拍X线片,对所得数据进行统计学分析。结果患牙行引导组织再生术术前PD、AL、GR分别为（4.81±1.37）mm、（5.48±1.76）mm、（0.64±0.62）mm,术后36个月PD、AL、GR分别为（2.09±0.66）mm、（3.90±1.11）mm、（1.86±0.83）mm。术后6、12、18、24、30、36个月PD、AL均较术前减少,差异有统计学意义（P〈0.05）;术后6、12、18、24、30、36个月GR较术前有所增加,差异有统计学意义（P〈0.05）。X线片显示治疗后随时间的延长,患牙周围骨密度不断增高,骨形成量不断增加。结论 Bio-Oss骨胶原与Bio-Gide胶原膜联合进行引导组织再生术,治疗牙周牙髓联合病变可获得良好稳定的临床疗效。

Bone Graft and Guided Tissue Regeneration in Treatment for Combined Periodontic-Endodontic Lesion

Objective To observe the effect of bone graft and guided tissue regeneration(GTR) in treatment for combined periodontic-endodontic lesion.Methods Sixteen patients(20 teeth) were investigated.Four weeks after root canal therapy and initial periodontal therapy,Bio-Oss collagen for bone graft and Bio-Gide collagen membrane for GTR were used in these teeth.Clinical examinations were performed,6,12,18,24,30,36 months after the surgery.Results Probing depth(PD) and attachment loss(AL) reduced 6,12,18,24,30,36 months after the surgery.There was statistical significance.Gingival recession(GR) increased after the surgery,there was statistical significance.PD,AL,GR values at baseline were respectively(4.81±1.37) mm,(5.48±1.76) mm,(0.64±0.62) mm,and all indexes at 36 months after therapy were respectively(2.09±0.66) mm,(3.90±1.11) mm,(1.86±0.83) mm.X ray showed increased bone density.Conclusion Bio-Oss collagen for bone graft and Bio-Gide collagen membrane for GTR combined periodontic-endodontic lesion therapy can get good and steady clinical efficacy.