Periodontal repair after surgical debridement with and without cartilage allografts.
The effect of a cartilage allograft on healing in intrabony defects treated by open flap curettage was investigated at 130 surgical sites in 4 patients. Thinned mucoperiosteal flaps were elevated and the intrabony defects were debrided. A stent with stainless steel pins was used to measure defect depth at fixed locations adjacent to the root surfaces. The bony defects treated ranged from 0-9 mm with a mean intraosseous depth of 2.4 mm. 62 sites received cartilage implants and 68 sites were treated by surgical debridement only. The flaps were readapted and sutured to the level of the alveolar crest. After 16 weeks the defects were remeasured. Both treatment methods resulted in a mean apical shift of -0.09 mm of the base of the defects that were less than 3 mm and a mean coronal shift of 0.9 mm in defects that were greater than 3.5 mm in depth. The repair in deeper lesions increased with the number of intrabony walls. Mean pocket depth at flap curettage sites was reduced from 5.4-3.3 mm (P less than 0.01) at 16 weeks. At sites receiving the cartilage, the mean pocket depth decreased from 5.6-3.6 mm (P less than 0.01). Pocket reduction resulted from a combination of surgical recession and a mean gain of 1 mm in clinical attachment (P less than 0.05 for flap curettage sites only). The cartilage implants provided no statistically significant advantage in either bony or soft tissue repair over flap debridement alone. Although bony repair is influenced by depth and configuration of the intrabony defects, significant gains in attachment and reductions in pocket depth may occur independently of changes at the base of the intrabony defects.
D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D003646:Debridement; D003774:Dental Plaque Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000473:pathology / Q000503:physiopathology; D013524:Surgical Flaps; D014945:Wound Healing