{"title":"引导组织再生治疗牙周骨内及功能缺损。系统回顾","authors":"Kevin G. Murphy, John C. Gunsolley","doi":"10.1902/annals.2003.8.1.266","DOIUrl":null,"url":null,"abstract":"<p><b>Background:</b> Many clinical studies have demonstrated that guided tissue regeneration (GTR) is a successful treatment modality of periodontal reconstructive surgery and it has become an accepted procedure in most periodontal practices.</p><p><b>Rationale:</b> The purpose of this structured review was to assess the efficacy of guided tissue regeneration (GTR) procedures in patients with periodontal osseous defects compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes. It extends the scope of previous GTR systematic reviews, which were limited to randomized controlled studies, by the scope of outcome measures examined, and the duration of the study.</p><p><b>Focused Question:</b> In patients with periodontal osseous defects, what is the effect of physical barriers compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes?</p><p><b>Search Protocol:</b> An electronic search of the Cochrane Oral Health Group Trials Register and MEDLINE databases was performed. Manual searching of journals included <i>Journal of Clinical Periodontology, Journal of Periodontology</i>, and <i>Journal of Periodontal Research</i> up to January 2002. This manual search also included review of relevant bibliographies. Two manufacturers of GTR devices were contacted regarding unpublished data.</p><p><b>Selection Criteria</b></p><p><b>Inclusion criteria:</b> Studies were selected for review if the evidence level was 3B (cohort) or above, at least 6 months duration, and compared a test GTR intervention with a surgical control.</p><p><b>Exclusion criteria:</b> Studies with experimental design problems; histologic or microbiological investigations; or those with outcome measurements, study populations, or study duration not consistent with the inclusion criteria were excluded. Primary outcome measures for intrabony defects were: clinical attachment level (CAL) gain, probing depth reduction (PD), gingival recession (REC) reduction; for furcation defects: vertical probing attachment level (VPAL) gain, vertical probing depth reduction (VPD), horizontal probing depth reduction (HPD), horizontal open probing attachment level gain (HOPA), and vertical open probing attachment level gain (VOPA). Meta-analysis was performed to compare GTR procedures to other surgical treatments and to examine the resulting clinical outcomes.\n\n </p><p><b>Reviewer's Conclusions:</b> Overall, GTR is consistently more effective than OFD in the gain of clinical attachment and probing depth reduction in the treatment of intrabony and furcation defects.</p><p><i>Ann Periodontol 2003;8:266-302.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"8 1","pages":"266-302"},"PeriodicalIF":0.0000,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2003.8.1.266","citationCount":"353","resultStr":"{\"title\":\"Guided Tissue Regeneration for the Treatment of Periodontal Intrabony and Furcation Defects. A Systematic Review\",\"authors\":\"Kevin G. Murphy, John C. 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引用次数: 353
摘要
背景:许多临床研究表明,引导组织再生(GTR)是牙周重建手术的一种成功治疗方式,并已成为大多数牙周实践中公认的治疗方法。基本原理:本结构化综述的目的是评估引导组织再生(GTR)手术在牙周骨缺损患者中的临床、放射学、不良反应和以患者为中心的结果,并与手术对照进行比较。它扩大了以前GTR系统评价的范围,这些评价仅限于随机对照研究,通过检查结果测量的范围和研究的持续时间。重点问题:在牙周骨缺损患者中,与手术对照相比,物理屏障对临床、放射学、不良反应和以患者为中心的结果有什么影响?检索方案:对Cochrane口腔健康组试验注册和MEDLINE数据库进行电子检索。手工检索的期刊包括:Journal of Clinical periodonology, Journal of periodonology, and Journal of Periodontal Research,截止到2002年1月。这项手工搜索还包括对相关参考书目的审查。我们就未公布的数据联系了两家GTR设备制造商。入选标准:选择证据水平为3B(队列)或以上、持续时间至少6个月的研究进行综述,并将试验GTR干预与手术对照进行比较。排除标准:有实验设计问题的研究;组织学或微生物学调查;或者那些结果测量、研究人群或研究持续时间不符合纳入标准的被排除。骨内缺损的主要预后指标为:临床附着水平(CAL)增加、探探深度减少(PD)、牙龈后退(REC)减少;分形缺陷:垂直探测附着层增益(VPAL)、垂直探测深度减小(VPD)、水平探测深度减小(HPD)、水平打开探测附着层增益(HOPA)、垂直打开探测附着层增益(VOPA)。进行荟萃分析,比较GTR手术与其他手术治疗,并检查由此产生的临床结果。总的来说,GTR在治疗骨内和功能缺损时,在获得临床附着和减少探查深度方面始终比OFD更有效。中华牙周病杂志2003;8:391 - 391。
Guided Tissue Regeneration for the Treatment of Periodontal Intrabony and Furcation Defects. A Systematic Review
Background: Many clinical studies have demonstrated that guided tissue regeneration (GTR) is a successful treatment modality of periodontal reconstructive surgery and it has become an accepted procedure in most periodontal practices.
Rationale: The purpose of this structured review was to assess the efficacy of guided tissue regeneration (GTR) procedures in patients with periodontal osseous defects compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes. It extends the scope of previous GTR systematic reviews, which were limited to randomized controlled studies, by the scope of outcome measures examined, and the duration of the study.
Focused Question: In patients with periodontal osseous defects, what is the effect of physical barriers compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes?
Search Protocol: An electronic search of the Cochrane Oral Health Group Trials Register and MEDLINE databases was performed. Manual searching of journals included Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research up to January 2002. This manual search also included review of relevant bibliographies. Two manufacturers of GTR devices were contacted regarding unpublished data.
Selection Criteria
Inclusion criteria: Studies were selected for review if the evidence level was 3B (cohort) or above, at least 6 months duration, and compared a test GTR intervention with a surgical control.
Exclusion criteria: Studies with experimental design problems; histologic or microbiological investigations; or those with outcome measurements, study populations, or study duration not consistent with the inclusion criteria were excluded. Primary outcome measures for intrabony defects were: clinical attachment level (CAL) gain, probing depth reduction (PD), gingival recession (REC) reduction; for furcation defects: vertical probing attachment level (VPAL) gain, vertical probing depth reduction (VPD), horizontal probing depth reduction (HPD), horizontal open probing attachment level gain (HOPA), and vertical open probing attachment level gain (VOPA). Meta-analysis was performed to compare GTR procedures to other surgical treatments and to examine the resulting clinical outcomes.
Reviewer's Conclusions: Overall, GTR is consistently more effective than OFD in the gain of clinical attachment and probing depth reduction in the treatment of intrabony and furcation defects.