Guided tissue regeneration in intrabony defects using an experimental bioresorbable polydioxanon (PDS) membrane. A 24-month split-mouth study.
OBJECTIVE
The comparison of the clinical, radiographic, and microbiological healing results in deep intrabony defects following GTR therapy with two different bioresorbable membranes in a prospective split-mouth design.


METHODS
31 pairs of contralateral intrabony defects were randomly treated with either an experimental Polydioxanon (PDS) membrane or a Polylactic acid (PLA) matrix barrier. After 6, 12 and 24 months, healing results were assessed using clinical examinations (REC, PPD, CAL, vertical relative attachment gain V-rAG), quantitative digital subtraction radiography (amount and area of bone density changes), and microbiological analysis.


RESULTS
Postoperative membrane exposures occurred in 14 PDS and 2 PLA treated sites. 6, 12 and 24 months p.o., both membranes provided a significant gain in CAL [median values: 6 months (PDS vs. PLA: 3.0 vs. 3.0 mm); 12 and 24 months (PDS vs. PLA: 4.0 vs. 4.0 mm)], which corresponded to a V-rAG of 57.1% (PDS) vs. 62.5% (PLA) after 24 months. PDS and PLA treated sites revealed significant bone density gain 6, 12 and 24 months after surgery. 38.8% (PDS) vs. 41.8% (PLA) of the initial defect areas showed bone density gain. While the gain in bone density was significantly greater in PDS than in PLA sites, neither CAL gain nor the area of bone density changes revealed significant differences. Microbiological culture revealed similar bacterial loads in PDS and PLA sites during the first 12 months.


CONCLUSIONS
This 24-month study indicates that the PDS and PLA membranes can provide similar favorable regeneration results in deep intrabony periodontal defects, although considerably more postoperative membrane exposures have to be expected in PDS treated sites.
Christgau
M
M
Department of Operative Dentistry and Periodontology, University of Regensburg, Regensburg, Germany. michael.christgau@klinik.uni-regensburg.de
Bader
N
N
Felden
A
A
Gradl
J
J
Wenzel
A
A
Schmalz
G
G
D020341:Absorbable Implants; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001672:Biocompatible Materials; D001861:Bone Regeneration; D002951:Citrates; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology; D016687:Polydioxanone; D011091:Polyesters; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D013382:Subtraction Technique; D014945:Wound Healing
D001672:Biocompatible Materials; D002951:Citrates; C105021:Guidor; D008567:Membranes, Artificial; D011091:Polyesters; D016687:Polydioxanone