Supportive Periodontal Therapy After Reconstructive Periodontal Surgery

This study clinically evaluates the use of decalcified freeze-dried bone allograft (DFDBA) in conjunction with an expanded polytetrafluoroethylene (ePTFE) membrane specifically designed for the treatment of interproximal intraosseous defects. It also examines by SEM, plaque contaminated membranes retrieved from patients. 15 advanced periodontitis patients with two bilateral interproximal probing depths of > or = 6 mm participated. After hygiene phase, measurements were made to determined soft tissue recession, pocket depth, clinical attachment levels and amount of keratinized tissue. Defects from each pair were randomly treated with ePTFE plus DFDBA (experimental) or DFDBA alone (control). Measurements were made during the surgery to determine crestal resorption, defect resolution and defect fill. Membranes were removed at 4 to 6 weeks and analyzed by SEM. Each site was surgically reentered and measurements repeated at six months. Both groups showed clinical and statistically significant changes when compared to baseline (P < 0.01), but no difference between groups. The experimental group showed increased soft tissue recession vs control group, 0.9 versus 0.4 mm, and loss of keratinized tissue 1.6 versus 0.1 mm (P < 0.0001). Control sites showed a 58% bone fill while experimental sites had 70% bone fill. There were no clear patterns of microbial colonization or cell adherences in either side of the membrane. It was concluded that the presence of plaque on the membranes did not compromise the initial clinical healing during the first 4-6 weeks. Results suggest a beneficial effect with the use of either technique for the treatment of intraosseous defects.

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Evaluation of guided tissue regeneration in interproximal defects

Gouldin

Fayad²,

Mellonig

1996

J Clinic Periodontology

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This study clinically evaluates the use of expanded polytetrafluoroethylene (ePTFE) membranes with or without the addition of decalcified freezedried bone allograft (DFDBA) in the treatment of interproximal intraosseous defects. 25 patients (26 paired defects) diagnosed with advanced periodontitis and having at least 2 bilateral interproximal probing depths of > or = 6 mm participated in the study. After the hygiene phase, measurements were made to determine soft tissue recession, pocket depth, and clinical attachment levels. Defects from each pair were randomly treated with either ePTFE alone (control), or ePTFE+DFDBA (experimental). Measurements were made during the surgery to determine crestal resorption, defect resolution and defect fill. Membranes were removed at 4 to 6 weeks. At 6 months, the soft and hard tissue measurements (surgical reentry) were repeated. Both groups showed statistically significant improvement when compared to baseline (p < 0.001), but no difference was determined between groups. Control sites showed a 50% bone fill and experimental sites had 54% bone fill. The defect resolution changes were also similar between control and experimental groups, respectively (80%, 74%). For this short-term study, it was concluded that either technique was beneficial for the treatment of intraosseous defects. Other studies are needed to assess the long-term stability of the improvements rendered by these treatments.

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Supportive Periodontal Therapy After Reconstructive Periodontal Surgery

Cited by 3 publications

References 28 publications

Supportive periodontal care: the effect of periodic subgingival debridement compared with supragingival prophylaxis with respect to clinical outcomes

Supportive periodontal care: the effect of periodic subgingival debridement compared with supragingival prophylaxis with respect to clinical outcomes

Healing in periodontal defects treated by decalcified freeze‐dried bone allografts in combination with ePTFE membranes

Evaluation of guided tissue regeneration in interproximal defects

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