Periodontal pathogens on polytetrafluoroethylene membrane for guided tissue regeneration inhibit healing

Abstract

This study determined the microbial composition of the apical parts of the expanded polytetrafluoroethylene membrane surfaces facing the gingiva and the tooth in guided tissue regeneration. Microbial and clinical features of 2-to-3 wall periodontal bony defects treated with membranes with and without concomitant use of systemic Augmentin therapy were also determined. 18 patients with 18 study sites participated. 9 patients received systemic 500 mg Augmentin 1 h prior to surgery, and 500 mg TID for 8 days thereafter. 9 patients received no systemic antimicrobial therapy. Microbiological examination was performed 1 h prior to surgery, at the time of membrane removal at week 6, and at 6 months post-surgery. Microbial morphotypes, total viable counts, and the occurrence of selected microbial species were determined by phase-contrast microscopy, selective and non-selective culture, and DNA probes. Study sites were examined for probing pocket depths and attachment levels. At baseline, no microbial or clinical parameter showed statistical differences between groups. At 6 months, the Augmentin group demonstrated a significantly higher (P = 0.032; Student t-test) mean probing attachment gain (36.5% of potential gain to the cemento-enamel junction) than the 9 control patients (22.4% of potential gain). At the time of removal, membranes in the Augmentin group showed significantly fewer organisms than membranes in the control group (52.2 x 10(6) versus 488.6 x 10(6)). Sites free of pathogens on the membrane surface toward the tooth gained the most clinical attachment, even in the presence of various pathogens on the gingiva-facing membrane surface.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of Early Membrane Removal on the Treatment of Mandibular Class II Furcation Defects - A Controlled Clinical Trial with Re-entry after 12 Months

“…In the present study, both groups presented limited bone regeneration, similar to that shown by Yukna et al (24) (mean horizontal furcation fill of 1.3 mm in the ePTFE group), lower than the average of most of the previous reports (6,22). Most probably these differences are due to local factors that influence the outcomes of regeneration in class II furcations.…”

“…Careful surgical technique and a strict protocol of biofilm control may have contributed to this. A previous study demonstrated that the membranes can be a retentive factor for bacterial colonization, and that membrane exposure to the oral cavity was negatively correlated with the results of the regenerative therapy (22).…”

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“…It has been suggested that the difference in distribution of the deposits might be affected by the texture and structural surface characteristics of the different membrane materials. 16,17,21 The highest accumulation of bacteria was found on cervical portions and lowest on apical portions of ePTFE in this study, which was consistent with previous studies.…”

“…10,11 The connective tissue and bacterial deposits on ePTFE and bioabsorbable barrier membranes used in GTR have been previously reported. 5,[12][13][14][15][16][17][18][19][20][21] The connective tissue integration on the outer surface of the membrane prevents membrane exposure and bacterial plaque colonization and thus enhances the clinical outcome following GTR. 19 Products derived from bacterial metabolism may influence and disrupt the blood clot in the early stages of healing 16 and influence the amount of new connective tissue formation.…”

“…5,[12][13][14][15][16][17][18][19][20][21] In the present study, connective tissue and bacterial deposits on SS were examined using ePTFE as the gold standard, because of its wellknown characteristics and clinical effectiveness. 2,3 Our study showed that the structure of connective portions were compared between SS and ePTFE (Figs 4A and 4B, respectively).…”