Clinical and radiographic evaluation of human periodontal osseous defect (mandibular grade II furcation) treated with PepGen P‑15 and a bioresorbable membrane (Atrisorb)

Abstract

Background:The various treatment modalities available to treat furcation involvement either maintain the existing furcation or increases access to furcation or leads to elimination of furcation (root resection, bicuspidization etc). Newer treatment modalities include regenerative procedures like placement of bone graft and organic or synthetic membranes. In this study we have evaluated the use of a new xenograft based tissue engineered bone material which provides both the inorganic and organic component; individually and in conjunction with a synthetic bioresorbable material.Materials and Methods:6 patients with 18 mandibular grade 2 furcations were selected after the completion of initial phase in all the patients. Selected sites were divided into control and experimental groups randomly and were treated by split mouth design. The control sites were treated with flap debridement and placement of ABM graft, whereas the experimental site received flap debridement, ABM graft and a synthetic bioresorbable membrane.Results:All the parameters recorded showed significant reduction from baseline to 9 months in both the experimental and control group. When compared in between the control and experimental group, all the parameters showed marginally better results in the control group, although none of them were clinically significant.Conclusion:The results of this study suggest that the use of ABM along with a bioresorbable membrane and without membrane is both beneficial for the treatment of grade 2 furcation. On the cost benefit basis, the bone graft alone seems to be a better choice for regenerative treatment of furcation involvement.

Usage of Bone Replacement Grafts in Periodontics and Oral Implantology and Their Current Levels of Clinical Evidence — A Systematic Assessment

“…At the end, 189 articles were included. Overall, 55 studies were categorized at level I 12–66 . Twenty‐six were level II, 67–92 nine were level III, 93–101 46 were level IV S1‐S46 (see references in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp1.pdf and http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp2.pdf in online Journal of Periodontology ), and 53 were level V S47‐S99 (see references in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp1.pdf and http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp3.pdf in online Journal of Periodontology ).…”

“…Some of these studies used more than one type of xenograft and/or other types of grafts (see http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_suptab3.pdf in online Journal of Periodontology ). Twenty‐four 13,16,17,27,35‐50,54,64‐66 of 90 studies were considered level I of evidence. These level I studies are summarized in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_suptab4.pdf in online Journal of Periodontology .…”

“…Of the 55 level I studies, four studies did not have numerical statistical analysis 15,32,38,53 . Of the 51 level I studies that included numerical statistical analysis, 18 did not have statistical significance 12,13,19,21,23,29,31,36,37,40,44,51,54,59,60,62,63,65 …”

“…From the level I studies selected, xenografts were mainly used for treatment of supra‐ and infrabony defects 16,42‐46 and sinus augmentation 13,17,35,37,47,49,54,64,66 . There were also studies on postextraction grafting 27 , 38 , 41 and GBR 36,39,48,65 Furthermore, there were single studies involving furcation treatment 40 and peri‐implantitis treatment 50 . Similar to the studies on allografts, these articles report the efficacy of xenografts used in a variety of periodontal/implantology procedures.…”

Evaluation of Efficacy of Surgical Periodontal Therapy with the Use of Bone Graft in the Treatment of Periodontal Intrabony Defects

“…implementing the combined use of the bioresorptive Atrisorb membrane and bone graft did not show clinically better treatment results. The authors believe that long-term studies with a larger sample are needed, which would be aimed at comparing bone grafts and combination of GTR with bone graft, followed by histological evaluation of periodontal healing ( 16 , 17 ). We agree that further research in this area is needed.…”