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Irradiated glutaraldehyde-crosslinked human collagen membrane was evaluated for its effects on new attachment formation in clinical trials, using the principle of guided tissue regeneration (GTR). 19 adult periodontitis patients with 52 matched bilateral periodontal defects received scaling and polishing with oral hygiene instruction. The bilateral periodontal defects were treated by reflecting a flap with collagen membrane (test) or flap reflection alone (control). Plaque (P1I) and gingival index (GI) scorings, probing pocket depth (PPD) and probing attachment level (PAL) along with classification of furcation involvement (FI) and bony defects were made at pre- and post surgery (6 weeks, 3 and 6 months). Improvement of P1I and GI scores was seen in both test and control sites following the surgical therapy. Reductions in PPD and PAL were significantly (p less than 0.001) more pronounced at 6 months in the test sites compared to the controls. The 2 Class I furcations in the graft-treated teeth showed complete resolution, while the corresponding furcations in the control teeth showed incomplete closure. The use of human collagen membrane based on the GTR technique for treatment of human periodontal defects provided greater gain of clinical attachment than when flap surgery alone was undertaken.

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HLA-A, B and DR antigen frequencies were determined in three groups of periodontally diagnosed subjects: 49 patients with rapidly progressive periodontitis, 40 elderly subjects with minimal disease (considered as a resistant group) and 30 young subjects with minimal disease. The relative risk for HLA-A9 (previously reported to be associated with periodontal disease) was 15.5. HLA-A9 was present in 36.7% of the patients and 2.5% of the resistant group. HLA-A10 showed a significantly increased incidence in the resistant group (30.0%) compared to a non-periodontally diagnosed control population (9.0%), and was absent from the patient group. These findings provide additional evidence for the involvement of HLA-A9 in susceptibility to periodontitis, and suggest that A10 may play a role in resistance to the disease.

This study was initiated to test the biocompatibility, resorption and penetration characteristics of human collagen graft material in vitro and in vivo using light (LM) and electron microscopy (EM). To study this relationship, pieces of glutaraldehyde cross-linked collagen sponges (1 x 1 x 0.5 cm), were: (1) cultured in sterile Petri dishes with human gingival fibroblasts and human periodontal ligament fibroblasts for 2 weeks; (2) implanted in subcutaneous pockets made in both thighs (total 20 sites) of 10 Sprague-Dawley rats for 7-56 days. The behaviour of the growth of the fibroblasts was studied by inverted light microscopy (LM), then tissue culture specimens were studied from without and within using low-temperature scanning electron microscopy (LTSEM). Blocks obtained from the graft sites of the rat were processed for LM and transmission EM. Long-term LM observations showed attachment and random orientation of cells on and around the collagen sponge in culture during the first 48 h. Between 7 and 14 days, the majority of the cells adjacent to the sponge were orientated at right angles to its margin with their long axes approximately parallel to each other. The LTSEM revealed that large numbers of HGF and HPLF grew onto the collagen sponges, but no cellular penetration to the middle of the sponge was seen. LM and TEM of the rat specimens showed a cellular reaction to the collagen graft, as well as slow resorption, and fibroblast invasion of the graft at 6-8 weeks. It was concluded that the human collagen graft was biocompatible with HGF and HPLF, with penetration first observed at 42 days post-implantation. In the in vivo study, the collagen underwent slow resorption over a period of 8 weeks.