Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

Abstract

Background Identifying factors affecting the treatment outcomes of guided tissue regeneration (GTR) in furcation defects is imperative in order to obtain predictable regeneration outcomes. The aims of this study were to evaluate the clinical outcomes and survival of furcation‐involved teeth treated with GTR, and potential factors affecting the results. Methods Furcation defects treated with GTR using an allogeneic cancellous bone graft and covered by an absorbable membrane with at least 1‐year follow‐up were selected. All data relative to the clinical outcomes were recorded. Analyses were conducted to evaluate the immediate (1‐year post‐op) clinical outcomes and the long‐term (the last assessment time) survival of the treated teeth. The effect of variables on the 1‐year post‐op clinical attachment level (CAL) changes and the tooth survival were assessed via multi‐level regression analyses and Cox Proportional‐Hazards Models. Results Ninety‐eight treated defects were selected. The average follow‐up was 5.3 ± 4.3 years. At the 1‐year post‐surgical recall, 1.23 ± 1.48 mm CAL gain was observed (P < 0.05). The 5‐ and 10‐year survival rates of the treated teeth were 86.5% and 74.3%, respectively. The vertical component of the defect and the location of the furcation were significantly related to the post‐surgical 1‐year CAL gain, whereas membrane exposure significantly affected tooth survival. Conclusion Within the limitations of this study, data suggests GTR using allogeneic cancellous bone graft and absorbable collagen membrane to be a viable option for treating furcation‐involved teeth if the defect morphology and the location of the defect are favorable.

Interproximal attachment gain: The challenge of periodontal regeneration

“…[42][43][44] The introduction of papilla preservation techniques [45][46][47] has had a positive impact on the stability of the wound and on the possibilities of achieving healing by primary intention, 42,43,48 which has been shown to be crucial for the outcomes of guided tissue regeneration. 49,50 Later on, with the concomitant evolution of biomaterials, minimally invasive and microsurgical approaches have been described. 42,43,48 These techniques involved a reduction in flap extensions and the use of bone grafts and/or biologics, such as enamel…”

Influence of restorative design on the progression of peri‐implant bone loss: A retrospective study

“…Over the last decades, dental implants have become an increasingly popular modality of treatment when replacing missing teeth 1,2 . Although traditional periodontal regeneration around teeth with severely compromised periodontal support remains a viable approach, 3,4 many clinicians today are more inclined to extract these teeth, perform socket grafting procedures, 5–7 and replace them with dental implants 8–10 . This is due to their high satisfactory results in terms of patient's function, esthetics, as well as long‐term survival rate 11–17 .…”

Platelet-Derived Growth Factor-Modulated Guided Tissue Regeneration with a Bioresorbable Membrane in Class III Furcation Defects: A Histometric Study in the Monkey

“…The results of this monkey study were not able to demonstrate a positive effect of the added growth factor PDGF, but might stress instead the importance of the direct postoperative healing phase [ 36 , 37 ], especially as far as barrier membrane exposure is concerned. Membrane exposure has been shown to worsen the results after periodontal regenerative surgery [ 38 , 39 ]. Colonization with microorganisms and faster membrane degradation are factors interfering with undisturbed proliferation of new ligament cells.…”