Radiographic defect depth and width for prognosis and description of periodontal healing of infrabony defects.
BACKGROUND
The aims of the present study were to evaluate 1) defect depth and width as a prognostic factor and 2) change in defect width as a describing parameter of periodontal healing in infrabony defects treated by regenerative therapy after 6 and 24 months.


METHODS
In 24 patients with advanced periodontitis, 39 infrabony defects were treated by guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (ePTFE) (n = 7) or bioabsorbable barriers (n = 32). Clinical parameters were assessed and 39 standardized radiographs (in triplicate) were taken before and 6 and 24 months after surgery. Using a computer-assisted analysis, the depth, width, and angle of the bony defects were measured.


RESULTS
Statistically significant vertical clinical attachment gains (CAL-V: 3.15 +/- 1.63 mm to 3.31 +/- 1.65 mm; P<0.001) and bony fill (1.30 +/- 2.53 mm; P<0.01 to 1.54 +/- 2.70 mm; P<0.005) were observed 6 and 24 months postsurgically. In a multilevel regression analysis CAL-V gain was predicted by baseline CAL-V (P <0.0001), actual smoking (P <0.05), and age (P <0.1). Bony fill could be predicted by baseline height of the infrabony component (P<0.0001), gingival index at baseline (P<0.05), and actual smoking (P <0.01). In narrow (<26 degrees) and deep (> or = 3 mm) infrabony defects bony fill was more pronounced than in wide and shallow defects (P <0.05).


CONCLUSIONS
Improvement achieved by guided tissue regeneration in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and to some extent clinically more favorably to GTR therapy than wide and shallow defects. However, depth of the infrabony component was a stronger prognostic parameter than defect angle. Actual smoking impairs the results of GTR therapy in infrabony defects.
Klein
F
F
Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University Heidelberg, Germany.
Kim
T S
TS
Hassfeld
S
S
Staehle
H J
HJ
Reitmeir
P
P
Holle
R
R
Eickholz
P
P
D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D001861:Bone Regeneration; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D016014:Linear Models; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D017622:Periodontal Attachment Loss / Q000000981:diagnostic imaging; D011379:Prognosis; D019252:Radiography, Dental, Digital; D012907:Smoking; D014945:Wound Healing
D008567:Membranes, Artificial