Guided Tissue Regeneration Therapy of 203 Consecutively Treated Intrabony Defects Using a Bioabsorbable Matrix Barrier. Clinical and Radiographic Findings

Abstract

THE AIM OF THIS RETROSPECTIVE three-center study was to evaluate guided tissue regeneration (GTR) therapy in a clinical periodontal setting. The material consisted of 203 consecutively treated intrabony defects > or = 4 mm in 143 patients using a bioabsorbable matrix barrier. Each center followed the same protocol for presurgical, intrasurgical, and follow up examinations. Initial therapy, surgical, and follow-up treatments followed the routine of each center. Treatment was evaluated after 1 year by clinical assessments for probing depth (PD) reduction and clinical attachment level (CAL) gain and by bone fill from computer digitized radiographs. Initial intrabony defect depth averaged 6.3 +/- 1.0 mm clinically and 5.7 +/- 1.8 mm radiographically. Mean PD was reduced from 9.0 +/- 1.0 mm to 3.3 +/- 1.0 mm. Mean CAL gain amounted to 4.8 +/- 1.5 mm corresponding to 79 +/- 13% of the initial intrabony defect depth; 78% of the defects exhibited CAL gain > or = 4 mm. Bone fill averaged 3.2 +2- 1.8 mm. Together with a crestal resorption of 1.1 +/- 1.4 mm this resulted in a defect resolution of 4.3 +/- 1.9 mm or 72%. Forty-seven percent (47%) of the variability in CAL gain could be explained by defect depth, defect width, early barrier exposure, and presence of plaque in the treated area. CAL gain and bone fill were positively correlated to the intrabony defect depth; i.e., the deeper the defect the more the CAL gain and bone fill. Sites with barrier exposure during the first 2 weeks of healing showed significantly less CAL gain than sites at which exposure occurred at a later stage or not at all. Presence of plaque in the treated area had a significant negative impact on both CAL gain and bone fill. It was concluded that GTR-treatment of intrabony defects > or = 4 mm in a periodontal specialist practice will result in clinical attachment level gain and bone fill comparable to what has been demonstrated in case studies and controlled clinical trials. The predictability to obtain CAL gain > or = 4 mm in defects > or = 4 mm was 78%.

Surgical Treatment of Infrabony Defects With Autologous Platelet Concentrate or Bioabsorbable Barrier Membrane: A Prospective Case Series

“…The mean distance measured from CEJ to base of defect from the radiographs (8.78 ± 2.48 mm for APC sites; 7.34 ± 1.59 mm for control sites) was less than that measured at surgery (9.2 ± 2.86 mm for test sites; 8 ± 1.58 mm for MEM sites) (Table 2). A similar discrepancy of ∼1 mm between direct clinical measurement and measurement from radiographs also was reported by Falk et al 23 …”

Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months

“…The mean changes were averaged between the outcomes at the buccal and lingual sides of the defects n numbers of defects influence the ΔCAL and ΔPPD following GTR therapy [40][41][42]. The GTR sites of the present study had an average baseline PPD of 6.…”

Clinical and radiographical evaluation of a bioresorbable collagen membrane of fish origin in the treatment of periodontal intrabony defects: A preliminary study

“…Although these clinical changes were statistically significant between baseline and final measurements within the groups, no statistically significant differences were found between the test and control groups [Table 1]. Cortellini[17] and Falk[18] et al . have reported greater gain in the clinical attachment level after GTR; however, these authors were dealing with deeper initial intrabony defects.…”