Примена бета трикалцијум-фосфата и говеђег коштаног матрикса у вођеној регенерацији дубоких инфракоштаних пародонталних оштећења

Abstract

Introduction The primary goal of bone regeneration procedures with application of various regenerative biologic agents and biomaterials is to facilitate the formation of periodontal tissues lost as a result of periodontitis.

Objective The aim of the study was to compare clinical outcome of the guided tissue regeneration (GTR) treatment with the use of β-tricalcium phosphate and with bovine bone matrix in human deep intra-osseous defects.

Methods Twenty-one systemically healthy subjects with moderate to advanced periodontitis, between 30 and 56 years of age, 11 females and 10 males, were selected. Patients having two similar inter-proximal defects with pocket probing depths following initial therapy greater than 5 mm were recruited for the study. Experimental sites were grafted with pure β-tricalcium phosphate biomaterial (Cerasorb®) and a biomembrane, while control sites were treated with bovine-bone hydroxiapatite xenograft (Bio-oss®) and a biomembrane. Immediately before surgery and 12 months after surgery, pocket probing depth (PPD), epithelial attachment level (EAL) and gingival recession (GR) were evaluated.

Results In the experimental group PPD amounted to 6.76±0.83 mm before surgery, and decreased significantly to 2.67±0.48 mm 12 months following surgery, while in the control group PPD significantly decreased from 7.14±0.65 mm presurgically to 2.85±0.57 mm postsurgically. After one year, EAL gain was 2.76±0.99 mm in the experimental group, and 3.24±0.16 mm in the control group. After twelve months postoperatively GR amounted to 1.33±0.79 mm in the experimental group and to 1.05±0.80 mm in the control group. No statistically significant differences for PPD reduction, EAL gain and GR increase were detected between the groups.

Conclusion Results from the present study indicate that GTR treatment of deep intra-osseous defects with Bio-oss® and Cerasorb® resulted in clinically and statistically significant improvement of EAL gain and PPD reduction. A GR was slightly increased, with no statistical significance.

Keywords: periodontal regeneration; guided tissue regeneration; intra-bony defects; β-tricalcium phosphate; bovine-bone hydroxiapatite xenograft; resorbable biomembrane