치주판막술에 의해 치료된 골연하 결손부의 장기적 방사선학적 변화 양상의 관찰
Long-term radiographic evaluation of infrabony defect treated by flap operation
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Purpose: The goal of periodontal regenerative therapy is to replace bone, cementum, and periodontal ligament on a previously diseased root surface, which has suffered the loss of these supporting structures. To accomplish the regeneration, a number of surgical procedures have been advocated throughout the years. There seems to be a potential for some spontaneous periodontal tissue regeneration in the bottom of periodontal defect following open flap debridement alone. The aim of this study was to analyse the radiographic bone changes over 2-year after flap operation. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of infrabony defect(s). forty two sites of 33 patients aged 26 to 65 (mean age 45.5) were treated by flap operation with or without osseous surgery. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, gender, defect depth, defect angle) using the paired t-test were examined. Result: We observed 0.74mm of bone fill, 0.66mm of crestal resorption, 1.40mm of defect resolution, and 27% of percentage of defect resolution. Mandible, women, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. Conclusion: The results of this study suggest that the use of flap operation did enhance the outcome in terms of radiographically detectable bone fill. Both treatment resulted in some loss of crestal bone height. (J Korean Acad Periodontol 2008;38:429-436)
Abstract
Purpose: The goal of periodontal regenerative therapy is to replace bone, cementum, and periodontal ligament on a previously diseased root surface, which has suffered the loss of these supporting structures. To accomplish the regeneration, a number of surgical procedures have been advocated throughout the years. There seems to be a potential for some spontaneous periodontal tissue regeneration in the bottom of periodontal defect following open flap debridement alone. The aim of this study was to analyse the radiographic bone changes over 2-year after flap operation. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of infrabony defect(s). forty two sites of 33 patients aged 26 to 65 (mean age 45.5) were treated by flap operation with or without osseous surgery. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, gender, defect depth, defect angle) using the paired t-test were examined. Result: We observed 0.74mm of bone fill, 0.66mm of crestal resorption, 1.40mm of defect resolution, and 27% of percentage of defect resolution. Mandible, women, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. Conclusion: The results of this study suggest that the use of flap operation did enhance the outcome in terms of radiographically detectable bone fill. Both treatment resulted in some loss of crestal bone height. (J Korean Acad Periodontol 2008;38:429-436)
참고문헌 (29)
- Goldman HM, "A rationale for the treatment of the intrabony pocket; one method of treatment, subgingival curettage", J Periodontol, 20, pp.83~ (1949)
- Carranza FA, "A technique for reattachment", J Periodontol, 25, pp.272~ (1954)
- Ellegaard B, "New attachment of periodontal tissue after treatment of infrabony lesions", J Periodontol, 42, pp.648~652 (1971)
- Gottlow J, "Guided tissue regeneration following treatment of recession-type defects in the monkey", J Periodontol, 61, pp.680~685 (1990)
- Froum SJ, "Periodontal healing following open debridement flap procedures. I. Clinical assessment of soft tissue and osseous repair", J Periodontol, 53, pp.8~14 (1982)
- Polson AM, "Osseous repair in infrabony periodontal defects", J Clin Periodontol, 5, pp.13~23 (1978)
- Becker W, "Repair of intrabony defects as a result of open debridement procedures. Report of 36 treated cases", Int J Periodontics Restorative Dent, 6, pp.8~21 (1986)
- Garrett S, "Periodontal regeneration around natural teeth", Ann Periodontol, 1, pp.621~666 (1996)
- Listgarten MA, "Periodontal probing: what does it mean?", J Clin Periodontol, 7, pp.165~176 (1980)
- van der Velden U, "The influence of probing force on the reproducibility of pocket depth measurements", J Clin Periodontol, 7, pp.414~420 (1980)
- Benn DK, "A review of the reliability of radiographic measurements in estimating alveolar bone changes", J Clin Periodontol, 17, pp.14~21 (1990)
- Hausmann E, "Computerized methodology for detection of alveolar crestal bone loss from serial intraoral radiographs", J Periodontol, 63, pp.657~662 (1992)
- Falk H, "Persson R. Guided tissue regeneration therapy of 203 consecutively treated intrabony defects using a bioabsorbable matrix barrier. Clinical and radiographic findings", J Periodontol, 68, pp.571~581 (1997)
- Mellonig JT, "Decalcified freeze-dried bone allograft as an implant material in human periodontal defects", Int J Periodontics Restorative Dent, 4, pp.40~55 (1984)
- Tonetti MS, "Periodontal regeneration of human intrabony defects. Ⅳ. Determinants of healing response", J Periodontol, 64, pp.934~940 (1993)
- Steffensen B, "Relationship between the radiographic periodontal defect angle and healing after treatment", J Periodontol, 60, pp.248~254 (1989)
- Selvig KA, "Surgical treatment of intrabony periodontal defects using expanded polytetrafluoroethylene barrier membranes: influence of defect configuration on healing response", J Periodontol, 64, pp.730~733 (1993)
- Bjorn H, "Radiographic assessment of marginal bone loss", Odontologisk Revy, 20, pp.165~179 (1969)
- Schei O, "Alveolar bone loss as related to oral hygiene and age", J Periodontol, 30, pp.7~16 (1959)
- Tonetti MS, "Periodontal regeneration of human infrabony defects. Ⅲ. Diagnostic strategies to detect bone gain", J Periodontol, 64, pp.269~277 (1993)
- Steffensen B, "Relationship between the radiographic periodontal defect angle and healing after treatment", J Periodontol, 62, pp.248~254 (1989)
- Cortellini P, "Radiographic defect angle influences the outcomes of GTR therapy in intrabony defects 77th General Session of the IADR, Vancouver, Canada, March 1999;10-13", ~ (1999)
- Laurell L, "Treatment of intrabony defects by different surgical procedures. A literature review", J Periodontol, 69, pp.303~313 (1998)
- Mellonig J, "Clinical evaluation of guided tissue regeneration in the treatment of grade Ⅱ molar furcation invasions", Int J Periodontics Restorative Dent, 14, pp.255~271 (1994)
- Nyman S, "Effect of professional tooth cleaning on healing after periodontal surgery", J Clin Periodontol, 2, pp.80~86 (1975)
- Rosling B, "The effect of systematic plaque control on bone regeneration in infrabony pockets", J Clin Periodontol, 3, pp.38~53 (1976)
- Pihlstrom BL, "Comparison of surgical and nonsurgical treatment of periodontal disease. A review of current studies and additional results after 61", 2 years, 1983, pp.10, 524~541
- Kaldahl WB, "Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities", J Periodontol, 67, pp.93~102 (1996)
- Bragger U, "Remodelling of periodontal tissues adjacent to sites treated according to the principles of guided tissue regeneration (GTR)", J Clin Periodontol, 19, pp.615~624 (1992)