Multi-center clinical comparison of combination anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) and ABM in human periodontal osseous defects. 6-month results.
BACKGROUND
Intraosseous periodontal defects present a particular treatment problem. New bone replacement grafts offer promise for improved results.


METHODS
The role of a synthetic cell-binding peptide (P-15), combined with anorganic [corrected] bovine-derived hydroxyapatite bone matrix (ABM), was compared to ABM alone in human periodontal osseous defects in a controlled, monitored, multi-center trial. Following appropriate initial preparation procedures, flap surgery with defect and root debridement was performed. Two osseous defects per patient were treated randomly with each procedure after surgical preparation. Appropriate periodontal maintenance schedules were followed, and at 6 to 7 months, re-entry flap surgery was performed for documentation and finalization of treatment.


RESULTS
T test and Mann-Whitney U analyses of patient mean values from 33 patients revealed that the combination ABM/P-15 grafts demonstrated significantly better mean defect fill of 2.9 +/- 1.2 mm (72.9%) versus a mean defect fill of 2.2 +/- 1.4 mm (50.67%) for defects treated with ABM (P<0.05). Other hard tissue findings showed similar clinically superior results with the use of ABM/P-15. Relative defect fill results showed 81% positive (50% to 100% defect fill) responses with ABM/P-15 and 67% positive responses with ABM. There were 3.5 times as many optimal results (> or = 90% defect fill) with ABM/P-15 and twice as many failures (minimal response) with ABM. Soft tissue findings showed no significant differences between treatments.


CONCLUSIONS
These results suggest that the use of the P-15 synthetic cell-binding peptide combined with ABM yields better clinical results than the ABM alone in intrabony periodontal defects.
Yukna
R A
RA
Department of Periodontics, Louisiana State University School of Dentistry, New Orleans 70119-2799, USA.
Krauser
J T
JT
Callan
D P
DP
Evans
G H
GH
Cruz
R
R
Martin
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000601:surgery*; D000704:Analysis of Variance; D000818:Animals; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D003094:Collagen / Q000627:therapeutic use*; D017886:Durapatite; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000627:therapeutic use*; D012086:Reoperation; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D018786:Bone Substitutes; D010446:Peptide Fragments; C407062:cell-binding peptide P-15; D003094:Collagen; D017886:Durapatite