The purpose of the study was to compare the effects of guided tissue regeneration (GTR) with expanded polytetrafluoroethylene (ePTFE) non-resorbable barriers and polylactic acid bioabsorbable barriers in humans with intrabony defects due to periodontitis. Ten patients presented with 2 intrabony defects each. Mucoperiosteal flaps were performed. One of the defects was randomly assigned for placement of the ePTFE barrier over the roots and alveolar bone and the other defect with placement of the polylactic acid barrier. A minimum of 9 months after barrier placement, surgical reentry was performed. The data were evaluated by the Wilcoxon matched-pairs signed-ranks test and the Fisher exact test. Treatment with both types of barriers produced significant changes from baseline for all parameters, except in the ePTFE group for the amount of bony crest resorption (P = 0.055) and in the polylactic acid group for increased recession (P = 0.109). The results showed no significant differences between the barriers for any parameters: probing depth reduction (polylactic acid 2.60 +/- 1.90, ePTFE 2.80 +/- 1.40; P = 1.000); attachment gain (polylactic acid 1.40 +/- 1.43, ePTFE 1.90 +/- 1.29; P = 0.336); increased recession (polylactic acid 0.80 +/- 1.40, ePTFE 1.10 +/- 0.99; P = 0.531); amount of vertical bone fill (polylactic acid 1.60 +/- 1.84, ePTFE 2.00 +/- 2.49; P = 0.984); bony crest resorption (polylactic acid -1.30 +/- 1.06, ePTFE -1.30 +/- 1.63; P = 1.000); depth of bony defect reduction (polylactic acid 2.90 +/- 1.20, ePTFE 3.30 +/- 1.70; P = 0.750); width of bony defect reduction (polylactic acid 2.20 +/- 1.23, ePTFE 2.20 +/- 1.23; P = 0.875); or volumetric changes (polylactic acid 33.50 +/- 19.70 microl, ePTFE 34.00 +/- 18.40 microl; P = 0.750).

A total of 9 teeth were treated with a free gingival graft followed by a coronally positioned flap in conjunction with conditioning of the root surface with citric acid. The grafting procedure was done 2 weeks after the subjects could perform adequate plaque control. Thirty days after grafting, a mucoperiosteal flap was raised. The root surface was thoroughly planed and conditioned with citric acid at pH 1.0, and the flap was then positioned coronally. Clinical measurements of the amount of recession, sulcus depth, and keratinized gingiva were taken preoperatively, and at 30 and 60 days after surgery. Recession was reduced by a mean of 3.24 +/- 2.08 mm. Width of keratinized gingiva was increased to a mean of 4.99 +/- 1.23 mm. Both of these findings were highly significant. Sulcus depth was not significantly changed.

The objective of this study was to evaluate the effectiveness of microfibrillar collagen as a barrier to prevent epithelial migration and allow for guided tissue regeneration. Fourteen study teeth were selected. Mucoperiosteal flaps were elevated and roots were debrided and planed. Avitene was placed over teeth and alveolar bone. Flaps were then sutured over it. At control sites no Avitene was placed. At 90 days, block sections were obtained and processed for histologic and histometric evaluation. Results revealed that all specimens had a long junctional epithelial attachment. New attachment was present within the area of the root notch at the original level of the alveolar bone, and there was no significant difference in mean connective tissue attachment between the control and experimental specimens (P = 0.614). Avitene did not form an effective barrier to epithelial migration nor did it allow for guided tissue regeneration and significant new attachment formation in humans.

The purpose of this study was to determine how the treatment of human tooth roots with tetracycline-HCl and fibronectin during periodontal surgery influences the attachment of the gingiva to the root surface. Mucoperiosteal flap surgery was performed on 22 teeth with periodontal disease. Teeth were assigned to three groups. Group one received surgery with degranulation and root planing. Group two received surgery with treatment of roots with tetracycline-HCl. Group three received surgery with treatment of roots with tetracycline-HCl and fibronectin. At 90 days, block sections were taken and teeth, gingiva, alveolar bone, and periodontal ligament were evaluated histologically. Controls healed with a long junctional epithelial attachment. Tetracycline and tetracycline with fibronectin groups demonstrated some reattachment, but only within the notches placed in the root at the original level of the bone. There was a trend for greater connective tissue attachment following tetracycline-HCl treatment of roots. The additional application of fibronectin to tetracycline treated roots appeared to partially negate the enhanced connective tissue attachment observed with tetracycline treatment alone.

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