The osteogenic potential of decalcified freeze-dried bone allografts in the treatment of human periodontal osseous defects was evaluated over a 6 month period. Cortical bone, obtained under sterile conditions from a human donor within 24 hours after death, was decalcified, freeze-dried and ground to a particle size of 250 to 500 microns. Twenty-seven osseous defects with one-, two- and wide three-wall morphology were treated. Clinical measurements were made with a stent and a calibrated periodontal probe before surgery, at the time of surgery, and at re-entry. The combined mean osseous regeneration for all defects was 2.4 mm. This represented a 65% mean bone-fill of the original defect. The findings demonstrate that decalcified freeze-dried bone allograft has potential as an osseous grafting material in periodontal therapy.

Freeze-dried bone allografts (FDBAs) were evaluated alone and in combination with various types of autogenous bone in the treatment of periodontal osseous defects. A total of 381 defects were evaluated by surgical reentry approximately 1 year after grafting. Reentry data were compared with similar data obtained when the grafts were placed. Osseous regeneration and pocket reduction were rated as complete, greater than 50%, less than 50%, or failed. Complete or greater than 50% regeneration was considered successful. When compared with FDBAs, composite freeze-dried bone allografts/autogenous bone grafts (FDBA/ABGs) appear to offer significantly improved results in both osseous regeneration and pocket reduction. Use of composite FDBA/ABGs resulted in significant improvement in the treatment of combination one/two-wall defects and furcation involvements. A trend of improvement was seen with two-wall defects. The surgical data indicated that complete wound closure and the use of antibiotics enhanced graft success. The results also indicated that the presence of endodontically obturated teeth may be a consideration in the success or failure of the graft.

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Bacterial cells dehydrated beyond a critical point no longer react uniformly to ethylene oxide sterilization. The percentage of cells resistant to the lethal effect of ethylene oxide after desiccation is often as small as 0.1 to 0.001%. However, 5% resistant cells were observed with one type of microorganism dried in broth. The presence of organic matter increases the percentage of cells that become resistant to ethylene oxide after dehydration. The phenomenon is produced by exposing cells to a vacuum or a chemically desiccated atmosphere. It is not a permanent change, because the resistant cells rapidly become susceptible if wetted with water. On the other hand, mere exposure to a high relative humidity (RH), i.e., 75 to 98%, after desiccation requires 6 and 4 days, respectively, to overcome this resistance. Moisture studies showed that there is less water in bacterial cells that have been desiccated and then equilibrated to successively high RH values up to 100% RH, than in cells that have not been desiccated, but allowed to dry naturally until equilibrated to the same RH values.

Effect of moisture on ethylene oxide sterilization. Appl. Microbiol. 12:496-503. 1964.-Bacterial cells dehydrated beyond a critical point no longer react uniformly to ethylene oxide sterilization. The percentage of cells resistant to the lethal effect of ethylene oxide after desiccation is often as small as 0.1 to 0.001%. However, 5% resistant cells were observed with one type of microorganism dried in broth. The presence of organic matter increases the percentage of cells that become resistant to ethylene oxide after dehydration. The phenomenon is produced by exposing cells to a vacuum or a chemically desiccated atmosphere. It is not a permanent change, because the resistant cells rapidly become susceptible if wetted with water. On the other hand, mere exposure to a high relative humidity (RH), i.e., 75 to 98%, after desiccation requires 6 and 4 days, respectively, to overcome this resistance. Moisture studies showed that there is less water in bacterial cells that have been desiccated and then equilibrated to successively high RH values up to 100% RH, than in cells that have not been desiccated, but allowed to dry naturally until equilibrated to the same RH values.