Clinical Evaluation of the Use of Decalcified Freeze‐Dried Bone Allograft With Guided Tissue Regeneration in the Treatment of Molar Furcation Invasions

Abstract

The purpose of this study is to evaluate the potential of decalcified freeze-dried bone allograft (DFDBA) combined with a barrier material in the treatment of human molar furcation defects (experimental) as compared to the barrier technique alone (control). Fifteen pairs of Class II or III furcation invasion defects comprised the study group. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects from each pair were randomly selected to be treated with an expanded polytetrafluoroethylene membrane (e-PTFE) and DFDBA or the membrane alone. Additional measurements were made during surgery to determine crestal resorption, and vertical and horizontal open probing attachment. The membrane was removed 4 to 6 weeks post-insertion. Six months post-treatment, each site was surgically reentered and measurements repeated. Following either treatment, recession was minimal with statistically significant improvement in probing depth reduction and clinical attachment level gain favoring the combined technique. Hard tissue changes were comparable for alveolar crestal resorption, however, there was a distinct difference, statistically, for both horizontal and vertical bone repair favoring the use of the demineralized bone graft in combination with the e-PTFE membrane.

Periodontitis vs. Peri-Implantitis: The Same Disease? The Same Treatment?

“…GTR with either decalcified freeze-dried bone allograft (Anderegg et al, 1991) or composite grafts of autografts and tricalcium phosphate and/or demineralized freeze-dried bone allografts (Schallhorn and McClain, 1988) showed substantially more bone fill on re-entry in comparison with other studies (Wallace et al, 1994;Becker et al, 1995) which have shown no real benefit of the combination of GTR and grafting material. Caffesse et al (1993) reported results of treatment of furcation defects in beagle dogs, with and without demineralized freeze-dried cortical bone grafts, in a GTR procedure and found that the use of the guided tissue regeneration procedure resulted in an increase in connective tissue and alveolar bone regeneration, but that adjunctive bone grafting in itself did not appear to enhance regeneration.…”

An evaluation of bovine derived xenograft with and without a bioabsorbable collagen membrane in the treatment of mandibular Class II furcation defects

“…The result is consistent with similar studies. 12,34,35 However, it should be pointed out that none of the treatment modalities resulted in complete closure of the Class II furcation defects. Some other studies have reported a similar result while using the GTR technique for the treatment of furcation defects.…”

Regeneration of class II furcation defects: determinants of increased success

“…However, Cortellini et al (37) reported that the depth of the infraosseous component of the defect is one of the most important factors in achieving the maximum regenerative potential. Anderegg et al (38) also reported that the deeper the vertical component, the greater the repair.…”

“…Despite the limited number of trials evaluating the outcome of furcation therapy in conjunction with GTR and different filling materials, there seems to exist a trend for better horizontal resolution of furcation using combined therapy (2,3,7,38). The function of a grafting material in association with GTR would be as a scaffold to ensure clot stabilization and to provide and maintain space whenever the membrane may have the possibility to collapse, therefore, reducing the space for regeneration.…”