Clinical effects of combination anorganic bovine-derived hydroxyapatite matrix(ABM)/cell

치의학과/석사[한글] 치주 질환으로 인해 상실된 치주조직의 재생을 위해 이용되는 골이식재의 치료효과를 알아 보고자 ABM/P-15을 사용하여 술 후 6개월간 치료에 대한 임상적 효과를 34명의 만성치주염으로 진단된 환자의 34개의 골내낭을 대상으로 치은박리수술을 시행한 12개의 골내낭을 대조 1군으로, 탈회냉동건조골울 이식한 11개의 골내낭을 대조2군으로, ABM/P-15를 이식한 11개의 골내낭을 실험군으로 설정하였다. 술전과 술후 6개월 후의 치료효과를 치주낭 탐침깊이, 부착상실, 탐침골 깊이의 변화로 비교하여 다음과 같은 결론을 얻었다. 1. 치주낭 탐침깊이의 변화는 대조 1군(2.0 ±0.9mm), 대조 2군(3.0 ±0.9mm)과 실험군(3.4 ±1.5mm) 모두 술후 6개월에 유의성있는 감소를 보였다.(P<0.01). 대조 1군에 비해 실험군에서 유의성있는 더 많은 감소를 보였다(P<0.05). 2. 부착상실의 변화는 대조 1군(0.1 ±0.ㅣ7mm)에서는 유의차가 없었으나, 대조2군(2.0 ±0.6mm)과 실험군(2.2 ±1.0mm)에서는 술후 6개월에 유의성있는 감소를 보였다 (P<0.01) 대조 1군에 비해 대조 2군과 실험군에서 유의성잇는 더 많은 감소를 보였다(P<0.05). 3. 탐침골 깊이의 변화는 대조 1군(0.1 ±0.9mm)에서는 술후 6개월에 유의성있는 차이를 보이지 않았고, 대조 2군(2.7 ±1.0mm)과 실험군(3.4 ±1.3mm)에서는 술후 6개월에 유의성있는 감소를 보였다(P,0.01). 대조 1군에 비해 대조 2군과 실험군에서 유의성있는 더 많은 감소를 보였다(P<0.05). 이상의 결과로 치주골내낭의 치료시 AMB/P-15를 이식하는 경우 부착상실과 탐침골 깊이가 유의차있게 감소하는 결과를 나타내었으므로 ABM/P-15는 치주조직 재생에 효과적인 골이식재로 생각되어 진다. [영문] The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be categorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regenration, but ideal graft material has not been developed theat fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic periodontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the followed results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0(0.9mm), positive control(3.0(0.9mm), and experimental group(3.4(1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group(P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6month after treatment in positive control(2.0(0.6mm), and experimental group(2.2(1.0mm)except negative control group(0.1 (0.8mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6month after treatment in positive control(2.7(1.0mm), and experimental group(3.4(1.3mm)except negative control group(0.1(0.9mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P