title: Six-year clinical evaluation of HTR synthetic bone grafts in human grade II molar furcations.
abstract: A biocompatible microporous composite of PMMA (poly-methyl-methacrylate), PHEMA (poly-hydroxy-ethyl-methacrylate) and calcium hydroxide bone replacement graft material (Bioplant HTR Synthetic Bone) was evaluated in 16 maxillary molar and 10 mandibular molar Grade II furcations in 13 patients. Following initial preparation, full thickness flaps were raised to gain access to the furcations; mechanical hand and ultrasonic root and defect debridement and chemical tetracycline root preparation were performed; furcation and adjacent osseous defects in each patient were grafted with HTR Synthetic Bone; and the host flaps replaced or slightly coronally positioned. Weekly, then monthly deplaquing was performed until surgical re-entry at 6-12 months. Patients were then followed on approximate 3-month recalls for > or = 6 yr. Evaluation of the primary clinical outcome of furcation grade change showed that in the maxilla 5/16 furcations were clinically closed, 9/16 were Grade I, and 2/16 remained Grade II; while in the mandible 3/10 were clinically closed, 5/10 were Grade I, and 2/10 remained Grade II. Other significant clinical changes included decrease in mean horizontal furcation probing attachment level from 4.4 mm at surgery to 2.2 mm at re-entry to 2.0 mm at 6 yr, decrease in probing pocket depth from 5.4 mm at surgery to 3.0 mm at re-entry to 3.2 mm at 6 yr, and improvement in vertical clinical probing attachment level from 5.4 mm at surgery to 4.2 mm at re-entry to 4.1 mm at 6 yr (all p < 0.05 from surgery to re-entry and surgery to 6 yr, n.s. from re-entry to 6 yr via ANOVA). These favorable results with HTR polymer are similar to several reports with other graft materials and with GTR barriers, and suggest that HTR polymer may have a beneficial effect in the clinical management of Grade II molar furcations.
authors.affiliation: Louisiana State University School of Dentistry, New Orleans, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Yukna
authors.forename: C N
authors.initials: CN
authors.lastname: Yukna
mesh_terms: D000328:Adult; D000543:Alveoloplasty / Q000379:methods; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D003188:Composite Resins / Q000627:therapeutic use*; D003646:Debridement; D003773:Dental Plaque / Q000517:prevention & control; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D008334:Mandible; D008437:Maxilla; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D008963:Molar / Q000601:surgery*; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D011102:Polyhydroxyethyl Methacrylate / Q000627:therapeutic use*; D012086:Reoperation; D016745:Root Planing; D013524:Surgical Flaps; D013752:Tetracycline / Q000627:therapeutic use; D016896:Treatment Outcome; D014464:Ultrasonic Therapy
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D018786:Bone Substitutes; D003188:Composite Resins; D008768:Methylmethacrylates; D011102:Polyhydroxyethyl Methacrylate; C040206:HTR composite; D013752:Tetracycline