The Use of Autogenous Periosteal Grafts as Barriers for the Treatment of Intrabony Defects in Humans

Abstract

The purpose of this study was to evaluate the clinical effectiveness of a connective tissue graft including periosteum used as a barrier for guided periodontal tissue regeneration in interproximal bony defects. An open flap debridement of a comparable interproximal bony defect in the same patient was used as a control. This study was performed at 2 different clinical centers. Six paired defects were treated at one center, and 16 paired defects at the other. Reentry surgeries were performed at 6 months. Preoperative comparisons of control and experimental sites with respect to clinical parameters and osseous measurements were similar. Post-surgical experimental sites produced more gain in clinical attachment (1.25 mm on buccal and 1.25 mm on lingual sites at center A and 1.26 mm on buccal and 1.18 mm on lingual sites at center B) and osseous defect fill (1.84 mm on buccal and 2.00 mm on lingual sites at center A and 1.66 mm on buccal and 2.04 mm on lingual sites at center B) when compared to control sites. The results of this trial indicate that clinical resolution of interproximal periodontal defects can be obtained with periosteal grafts used as barriers.

Periosteal pedicle graft for the treatment of gingival recession defects: a novel technique

“…Various research papers have been published explaining the osteogenic potential of human periosteal grafts. 7,[14][15][16] The use of periosteum as a barrier membrane for the treatment of periodontal defects was published by Lekovic et al in 1991 17 and again in 1998 by Lekovic et al 18 and Kwan et al 19 In their studies, they used connective tissue grafts obtained from the palate and covered the periodontal defect with donor tissue before suturing over the donor tissue with gingival flaps. This procedure produced results similar to improvements found with barrier membranes.…”

Additional use of autogenous periosteal barrier membrane combined with regenerative therapy in the interproximal intrabony defects: case series

“…8 The soft tissue healing was more favorable and speedy when an EMD was added to the regenerative periodontal surgery from the author's clinical experiences. Previous studies 17,18 on the use of autogenous periosteal graft as barriers in intrabony defects reported greater approximately 1mm CAL gain over sites treated by open flap debridement procedure alone. A periosteal graft in intrabony defects has the potential to stimulate bone formation and reduce the PPD when used as a graft material and barrier membrane.…”

Subperiosteal Connective Tissue Grafts for Pocket Reduction and Preservation of Gingival Esthetics: A Case Report

“…Furthermore, subperiosteal connective tissue grafts may have acted as a "natural" autogenous GTR membrane in this case, possibly allowing periodontal ligament cells, osteoblasts, and cementoblasts to repopulate the apical part of the wound. Autogenous periosteal grafts have been used as a GTR membrane for the treatment of intrabony defects 75 and lower molar furcations 76 for attachment gain. It is not known whether the grafted connective tissue in subperiosteal grafting forms an attachment directly to the root surface as has been determined in mucogingival surgery or whether it acts like a GTR membrane to allow other cells to play a key role in repair.…”