歯周骨欠損の治療における誘導骨再生に対する自己象牙質粒子とBio-Ossの埋入の効果の比較分析

[Comparative analysis of the effect of autologous dentin particles and implantation of Bio-Oss on guided bone regeneration in the treatment of periodontal bone defects].

抄録

目的:

歯周骨欠損治療における誘導骨再生に対する自己象牙質粒子とBio-Oss骨粉埋入の効果を分析すること。

PURPOSE: To analyze the effect of autologous dentin particles and Bio-Oss bone powder implantation on guided bone regeneration in the treatment of periodontal bone defects.

方法:

2018年5月から2020年5月までに張掖人民病院で治療した歯周骨欠損患者で、誘導骨再生治療を受けた82例を選択し、乱数表法に従って実験群と対照群に分け、各群41例とした。対照群には術中にバイオオスを、実験群には術中に自己象牙質粒子を移植した。歯周ポケットの深さとアタッチメントロス、頬側軟組織のプロファイル、頬側軟組織の厚さ、レッドエステティックスコア、成功率、合併症を2群間で比較した。統計解析にはSPSS 22.0ソフトウェアを使用した。

METHODS: Eighty-two patients with periodontal bone defect treated in Zhangye People's Hospital from May 2018 to May 2020 who underwent guided bone regeneration treatment were selected and divided into experimental group and control group according to random number table method, with 41 cases in each group. The control group was implanted with Bio-Oss during the operation, and the experimental group was implanted with autologous dentin particles during operation. Periodontal pocket depth and attachment loss, buccal soft tissue profile, buccal soft tissue thickness, red aesthetic score, success rate, and complications were compared between the two groups of patients. SPSS 22.0 software package was used for statistical analysis.

結果:

グループ内の比較では、術後1ヶ月と1年後では、2つのグループの歯周ポケットの深さとアタッチメントロスが有意に減少した(P<0.05)、術後1年後では、2つのグループの歯周ポケットの深さとアタッチメントロスが術後1ヶ月よりも有意に減少した(P<0.05)。群間比較では、術後1ヶ月および1年後において、実験群の歯周ポケットの深さおよびアタッチメントロスは対照群のそれよりも有意に低かった(P<0.05)。群間比較では、術後1ヵ月および1年後において、両群の頬側軟組織プロフィールは術前と比較して有意に高く（P＜0.05）、術後1年後において、両群の頬側軟組織プロフィールは術後1ヵ月と比較して有意に低かった。群間比較では、術後1年後、実験群の頬軟部組織プロフィールは対照群のそれよりも有意に高かった（P<0.05）。群内比較では、術後1ヶ月および1年後、両群の頬軟部組織の厚さは、術前に比べて有意に高かった。群間比較では、各時点での頬軟部組織の厚さに両群間で有意差はなかった(P>0.05)。群内比較では、術後1ヶ月および1年後の両群の患者の赤色審美スコアは、術前と比較して有意に高かった(P<0.05)。さらに、術後1年後の両群の赤色審美スコアは、術後1ヶ月後のスコアと比較して有意に高かった(P<0.05)。グループ間の比較では、手術1ヶ月後と1年後に、実験グループの赤色美的スコアは対照グループのものより有意に高かった（P<0.05）。手術1年後の成功率は、実験群が90.24％（37/41）、対照群が85.37％（35/41）で、両群間に有意差はなかった（P>0.05）。合併症の発生率は両群間に有意差はなかった(P>0.05)。

RESULTS: Comparison within the group showed that 1 month and 1 year after operation, the periodontal pocket depth and attachment loss of the two groups were significantly reduced(P<0.05); and 1 year after operation, the periodontal pocket depth and attachment loss of the two groups were significantly lower than 1 month after surgery(P<0.05). Comparison between groups showed that 1 month and 1 year after operation, the periodontal pocket depth and attachment loss of the experimental group were significantly lower than those of the control group (P<0.05). Comparison within groups showed that 1 month and 1 year after operation, the buccal soft tissue profile of the two groups were significantly higher than that before operation (P<0.05); and 1 year after operation, the buccal soft tissue profile of the two groups were significantly lower than 1 month after operation. Comparison between groups showed that 1 year after operation, the buccal soft tissue profile of the experimental group was significantly higher than that of the control group (P<0.05). Comparison within groups showed that 1 month and 1 year after surgery, the thickness of the buccal soft tissue of the two groups were significantly higher than that before surgery. Comparison between groups showed that there was no significant difference in the thickness of the buccal soft tissue at each time point between the two groups(P>0.05). Comparison within groups showed that 1 month and 1 year after operation, the red aesthetic scores of patients in the two groups were significantly higher than those before operation (P<0.05); in addition, the red aesthetic scores of the two groups 1 year after surgery were significantly higher than those 1 month after surgery (P<0.05). Comparison between groups showed that 1 month and 1 year after surgery, the red aesthetic scores of the experimental group were significantly higher than those of the control group (P<0.05). One year after operation, the success rate of the experimental group and the control group were 90.24% (37/41) and 85.37% (35/41), respectively, and there was no significant difference between the two groups(P>0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).

結論:

自己象牙質粒子を歯周骨欠損患者の骨再生誘導に使用することで、歯周ポケットの深さとアタッチメントの喪失を減少させ、頬側軟組織のプロファイルと赤色審美スコアを改善することができ、成功率はBio-Ossの移植と同等である。したがって、安全で確実な治療法である。

CONCLUSIONS: Autologous dentin particles can be used to guide bone regeneration to treat patients with periodontal bone defects, which can reduce the depth of periodontal pockets and loss of attachment, improve the buccal soft tissue profile and red aesthetic score, and the success rate is equivalent to implantation of Bio-Oss. Therefore, it is a safe and reliable treatment method.