Treatment of intrabony defects with resorbable materials, non-resorbable materials and flap debridement.
BACKGROUND
Different types of barriers are used in guided tissue regenerative procedures.


OBJECTIVE
This prospective study compared resorbable citric acid ester softened polylactic acid membranes (RM) and non-resorbable expanded polytetrafluoroethylene (ePTFE) barriers (NRM) in GTR treatment of intrabony defects.


METHODS
29 subjects were randomly assigned to the RM group or NRM group. Each patient received one GTR procedure. An open flap debridement (FD) was performed at another site 2 weeks later to evaluate healing potential. Clinical treatment outcomes were finally evaluated 12 months after surgery for changes of pocket depth PD, probing attachment level PAL, and probing bone level PBL, and radiographically for bone change using standardised radiographs.


RESULTS
No differences in healing patters after surgery were found between patients in the 2 study groups as evaluated from the FD surgical procedures. NRM treated sites showed less signs of post-surgical inflammation during the 1st 4 weeks of healing than did RM treated sites (p<0.05). GTR-treated defects in the RM group, initially 7.0+/-2.2 mm deep, showed PD reduction of 3.3+/-2.2 mm, PAL gain of 2.4+/-1.8 mm, PBL gain of 2.4+/-3.7 mm (28%) and a radiographic bone fill of 2.3+/-2.4 mm. Defects treated with the NRM exhibited PD reduction of 3.1+/-2.1 mm, PAL gain of 2.4+/-0.8 mm, PBL gain of 2.2+/-1.7 mm (25%) and a radiographic bone fill of 3.3+/-2.2 mm. All improvements were statistically significant (p<0.01) but there was no difference between RM and NRM treatments for any of the efficacy variables. The results of this study indicated that there was no clinically significant difference in treatment outcomes following GTR treatment of intrabony defects with citric acid ester softened polylactic acid membranes as compared to ePTFE barriers. The overall mean inter-proximal vertical bone defect fill at 12 months as assessed from intra-oral radiographs was 44% of the original mean defect depth.


CONCLUSIONS
Thus, no clinically significant difference in treatment outcomes was observed following GTR treatment of intrabony defects with citric acid ester softened polylactic acid membranes or ePTFE barriers.
Zybutz
M D
MD
Department of Periodontics, University of Washington, Seattle 98195, USA.
Laurell
L
L
Rapoport
D A
DA
Persson
G R
GR
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000704:Analysis of Variance; D001672:Biocompatible Materials / Q000737:chemistry; D019343:Citric Acid / Q000737:chemistry; D003646:Debridement; D005260:Female; 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 / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D011091:Polyesters; D011108:Polymers / Q000737:chemistry; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D016896:Treatment Outcome
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D019343:Citric Acid; D019344:Lactic Acid; C033616:poly(lactide); D011138:Polytetrafluoroethylene