GTR therapy of intrabony defects using 2 different bioresorbable membranes: 12-month results.
This prospective split-mouth study was designed to compare the clinical and radiographic healing results in intrabony periodontal defects 12 months after GTR therapy with 2 different bioresorbable barriers. The study comprised 25 healthy patients with one pair of contralaterally located intrabony defects with a probing pocket depth of > or = 6 mm and radiographic evidence of angular bone loss of > or = 4 mm. The 2 defects of each patient were randomized for treatment either with polylactic acid (PLA) membranes or with polyglactin-910 (PG-910) membranes. The patients received systemic doxycycline (100 mg/d) for 11 days postoperatively. One blinded examiner recorded the following clinical parameters using a pressure calibrated probe at baseline and after 12 months: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), and probing attachment level (PAL). The vertical relative attachment gain (V-rAG) was calculated as a % of the PAL gain related to the maximum possible attachment gain (expressed by the intraoperatively measured depth of the osseous defect). Geometrically standardized intraoral radiographs were quantitatively evaluated for bone changes (density, area) in the defect region using digital subtraction radiography (DSR). Clinical and radiographic data were statistically analyzed using the Wilcoxon-signed-rank test (alpha=0.05). Postoperative membrane exposures occurred in 9 PLA and 13 PG-910 treated sites. After 12 months of healing, both barrier types provided significant PPD reductions and PAL gain [median (25/75 percentile)]: deltaPPD [PLA: 3.0 (2.0/4.0) mm; PG-910: 3.0 (2.0/4.5) mm]; deltaPAL [PLA: 3.0 (2.5/4.0) mm; PG-910: 2.0 (1.0/4.0) mm]. V-rAG amounted to 60% in PLA sites and 54% in PG-910 sites. DSR revealed significant bone density gain after 12 months. 58.3% of the initial defect area in PLA sites and 54.0% of the initial defect area in PG-910 sites showed bone density gain. Neither clinical nor radiographic data revealed any significant difference between the 2 barrier types after 12 months. In conclusion, this 12-month study demonstrated that PLA and PG-910 membranes provided similar favorable regeneration results in deep intrabony periodontal defects.
Christgau
M
M
Department of Operative Dentistry and Periodontology, University of Regensburg, Germany.
Bader
N
N
Schmalz
G
G
Hiller
K A
KA
Wenzel
A
A
D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000737:chemistry; D015519:Bone Density; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005889:Gingival Recession / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011091:Polyesters; D011098:Polyglactin 910 / Q000737:chemistry; D011108:Polymers / Q000737:chemistry; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012038:Regeneration; D016037:Single-Blind Method; D013382:Subtraction Technique; D014945:Wound Healing
D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; D011098:Polyglactin 910; C033616:poly(lactide); D004318:Doxycycline