Healing in periodontal defects treated by decalcified freeze-dried bone allografts in combination with ePTFE membranes. Assessment by computerized densitometric analysis.
This study quantitatively assessed radiographic changes in alveolar bone density by computer-assisted densitometric image analysis (CADIA) in periodontal defects that were treated with decalcified freeze dried bone allograft (DFDBA) alone or in combination with interproximal expanded polytetrafluroethylene membranes (ePTFE). The radiographic changes where then analyzed for correlation with the clinically assessed changes. The radiographic changes were evaluated on standardized radiographs of treated sites treated prior to, 1 week after surgery, and 6 months post-operatively. 15 patients with one pair of bilateral interproximal periodontal defects of similar morphology and > or = 6 mm in pocket depth participated. Analysis of the changes 6 months after treatment showed that the increases in density in the defect areas that received the graft were significantly greater than the adjacent areas (p < 0.001). These adjacent areas, in contrast, demonstrated significantly larger loss in radiographic density than the defect area (p < 0.001). The placement of DFDBA into the defects produced in itself significant increases in radiographic density, as illustrated by the results of one week which remained at six months. Utilization of ePTFE addition to DFDBA did not lead to additional radiographic gains in the defect area. While at one week the analysis suggested increased resorption by the combined treatment over grafting alone, such differences did not persist at 6 months post-surgery. Analysis comparing CADIA derived values for change with those of the clinical assessment revealed some associations.(ABSTRACT TRUNCATED AT 250 WORDS)
Guillemin
M R
MR
Department of Periodontics, University of Texas Health Science Center, San Antonio.
Mellonig
J T
JT
Brunsvold
M A
MA
Steffensen
B
B
D015502:Absorptiometry, Photon; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D005612:Freeze Drying; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008567:Membranes, Artificial; D010514:Periodontal Pocket / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D013997:Time Factors; D014021:Tissue Preservation; D014184:Transplantation, Homologous; D014945:Wound Healing
D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene