치주 골내 결손에서 인산옥타칼슘 기반 골이식재를 이용한 조직유도재생술의 임상적 및 방사선학적 분석

다국어 초록 (Multilingual Abstract)

Background
Guided Tissue Regeneration (GTR) in periodontal infrabony defects has long relied
on deproteinized bovine bone mineral (DBBM) as the standard graft material because
of its excellent biocompatibility and space-maintaining ability. However, its minimal
resorption and limited remodeling often restrict complete replacement by vital bone.
Octacalcium phosphate (OCP), a physiological precursor of hydroxyapatite, offers
distinct biological advantages—it actively participates in bone mineral formation
through lattice transformation, enhancing early osteoblastic differentiation and rapid
new bone deposition.
Recent developments have focused on the low-temperature synthesized OCP-HA
composite demonstrates both predictable resorption and dimensional stability. While
its efficacy has been reported in various bone regeneration settings, evidence in
periodontal GTR remains limited. This study therefore aimed to evaluate the clinical
and radiographic outcomes of GTR using OCP-HA composite compared with DBBM.
Methods
Patients with Stage III periodontitis and ≥3 mm two- or three-wall infrabony defects
were randomized into three groups: DBBM (BO), OCP-HA (BT), and 1:1 mixture of
DBBM + OCP-HA (CO). All defects were treated using the simplified papilla
preservation technique, tetracycline root conditioning, and a resorbable collagen
membrane.
Clinical parameters (probing pocket depth [PPD], clinical attachment level [CAL],
tooth mobility, plaque index [PI], gingival index [GI]) and radiographic parameters
(linear defect fill [LDF] and defect angle) were assessed at baseline, 3 months, and
6 months. Success measures (pocket closure [PC] and composite outcome measure
[COM]) were analyzed.
Statistical analysis was performed using Kruskal–Wallis and Wilcoxon signed-rank
tests for continuous variables, with Dunn–Bonferroni post hoc correction for
significant findings. Chi-squared and McNemar’s tests were used for categorical
variables.
Results
Thirty-two sites from 23 patients were followed up. All groups demonstrated
significant PPD reduction (mean Δ 2.0-3.9 mm, p < 0.05) and CAL gain (mean Δ 2.4
3.7 mm, p < 0.01). Radiographic linear defect fill (LDF) averaged 2.3–3.8 mm,
showing a significant improvement within all groups (p < 0.01) and a significant
intergroup difference favoring the BT group (p = 0.008). Pocket closure was
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achieved in 58% of sites, and COM success in 45%, with comparable distribution
across groups. No adverse events were recorded, and all cases showed uneventful
healing.
Conclusions
GTR with OCP yielded clinical and radiographic outcomes comparable to DBBM.
Given its synthetic origin and biologic conversion potential, OCP represents a viable
alternative graft material for infrabony defect regeneration.

목차 (Table of Contents)

• I. 서론 1
• II. 대상 및 방법 5
• III. 결과 11
• IV. 고찰 19
• V. 결론 25
• VI. 참고문헌 26