Treatment of angular bone defects with a composite bone grafting material in combination with a collagen membrane.
BACKGROUND
The purpose of this study was to evaluate the effect of a bioabsorbable collagen barrier (CB) in combination with a composite bone substitute (deproteinized bovine bone mineral with collagen, DBBM + C) in periodontal regeneration of angular bone defects in humans using a new application technique.


METHODS
Twelve patients participated, each contributing at least 1 defect site, which exhibited a probing depth (PD) of > or = 5 mm, a clinical attachment level (CAL) of > or = 6 mm, and was positive for bleeding on probing (BOP) following initial therapy. Twenty-two angular bone defects were filled with DBBM + C. A hole was placed in the membrane, which was then pulled over the tooth. The observation period was 2 years and included measurements of plaque, gingivitis, tooth mobility, PD, CAL, soft tissue recession, and bone level as assessed from standardized radiographs.


RESULTS
The residual PD and CAL were reduced to 3.3 mm (PD) and 5.6 mm (CAL) with a CAL gain of 3.2 mm at 24 months. The radiographic defect reduction (bone fill) was 4.0 mm after surgery and 2.2 mm at 24 months. The changes measured clinically and radiographically were more pronounced in sites with a deep intrabony defect component than in sites with shallow ones.


CONCLUSIONS
These findings indicate that angular bone defects can be successfully treated with DBBM + C in combination with CB. A degradation of the filler material seems to occur particularly during the first 6 months, but without affecting the clinical parameters, which improved consistently.
Zitzmann
Nicola U
NU
Clinic of Fixed and Removable Prosthodontics and Temporomandibular Joint Disorders, University of Basel, Switzerland. N.Zitzmann@unibas.ch
Rateitschak-Plüss
Edith
E
Marinello
Carlo P
CP
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D018786:Bone Substitutes / Q000627:therapeutic use*; D002417:Cattle; D003094:Collagen / Q000627:therapeutic use; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000601:surgery; D005891:Gingivitis / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D016014:Linear Models; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000601:surgery; D014086:Tooth Mobility / Q000601:surgery
D018786:Bone Substitutes; D008567:Membranes, Artificial; D003094:Collagen