Clinical evaluation of demineralized-unicortical-ilium-strips for guided tissue regeneration.
This study compared demineralized-unicortical-ilium-strips (DUIS) and an expanded polytetrafluoroethylene (ePTFE) physical barrier in combination with decalcified freeze-dried bone allograft (DFDBA) for treatment of Class II mandibular furcations. Twenty patients with adult periodontitis and at least 2 furcation invasions participated in this study. Probing depth (PD), clinical attachment level (CAL), and bone fill were measured at 6 and 12 months. Standardized radiographs were analyzed using computer assisted densitometric image analysis (CADIA). Fifteen of 20 patients completed the 12-month evaluation. At 6 months both control and test groups showed significant reductions in PD from baseline (P < 0.01). PD reduction for the ePTFE + DFDBA sites was 2.13 mm +/- 1.25, and the DUIS + DFDBA, 1.77 mm +/- 1.21. CAL at 6 months was sustained to 12 months when the net gains in CAL for ePTFE + DFDBA being 1.30 mm +/- 1.45 (P < 0.01) and for DUIS + DFDBA sites 1.13 mm +/- 1.68 (P < 0.02). The horizontal furcation PD decreased 2.87 mm +/- 1.68 (P < 0.01) in the ePTFE + DFDBA and 1.70 mm +/- 1.69 (P < 0.01) for DUIS + DFDBA sites over 12 months. The evaluation of the hard tissue response at the 12-month re-entry demonstrated a bone fill of 2.37 mm (75%) +/- 2.04 (P < 0.01) with ePTFE + DFDBA and 1.83 mm (79%) +/- 1.57 (P < 0.01) with DUIS + DFDBA. DUIS material and ePTFE showed significant improvements in clinical parameters and neither material proved to be significantly better. However, a larger sample size may have permitted us to demonstrate statistically significant differences between the materials. The positive results from the utilization of DUIS for GTR and the advantage of its bioresorbability warrant further investigation. The study found limitations in the use of CADIA for evaluation of guided tissue regeneration in furcations.
Yamaoka
S B
SB
University of Texas Health Science Center-San Antonio, Department of Periodontics, USA.
Mellonig
J T
JT
Meffert
R M
RM
Arnold
R M
RM
Nummikoski
P V
PV
Mealey
B L
BL
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D016025:Bone Transplantation / Q000379:methods*; D003648:Decalcification Technique; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D017823:Furcation Defects / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D007085:Ilium; D007091:Image Processing, Computer-Assisted; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000473:pathology / Q000601:surgery; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011138:Polytetrafluoroethylene; D018401:Sample Size; D014184:Transplantation, Homologous
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene