Prognostic factors for alveolar regeneration: effect of tissue occlusion on alveolar bone regeneration with guided tissue regeneration.
OBJECTIVE
Design criteria for guided tissue regeneration (GTR) devices include biocompatibility, cell occlusion, space-provision, tissue integration, and ease of use. The objective of this study was to evaluate the effect of cell occlusion and space-provision on alveolar bone regeneration in conjunction with GTR.


METHODS
Routine, critical-size, 6 mm, supra-alveolar, periodontal defects were created in 6 young adult Beagle dogs. Space-providing ePTFE devices, with or without 300-microm laser-drilled pores were implanted to provide for GTR. Treatments were alternated between left and right jaw quadrants in subsequent animals. The gingival flaps were advanced for primary intention healing. The animals were euthanized at week 8 post surgery. The histometric analysis assessed regeneration of alveolar bone relative to space-provision by the ePTFE device.


RESULTS
A significant relationship was observed between bone regeneration and space-provision for defect sites receiving the occlusive (beta = 0.194; p < 0.02) and porous (beta = 0.229; p < 0.0004) GTR devices irrespective of treatment (p = 0.14). The bivariate analysis showed that both space-provision and device occlusivity significantly enhanced bone regeneration. Hence, sites receiving the occlusive GTR device and sites with enhanced space-provision showed significantly greater bone regeneration compared to sites receiving the porous GTR device (p = 0.03) or more limited space-provision (p = 0.0002).


CONCLUSIONS
Cell occlusion and space-provision may significantly influence the magnitude of alveolar bone regeneration in conjunction with guided tissue regeneration.
Laboratory for Applied Periodontal and Craniofacial Regeneration, Department of Periodontology, Temple University School of Dentistry, Philadelphia, PA, USA. gpolimeni@hotmail.com
Giuseppe
G
Polimeni
Ki-Tae
KT
Koo
Mohammed
M
Qahash
Andreas V
AV
Xiropaidis
Jasim M
JM
Albandar
Ulf M E
UM
Wikesjö
D016301:Alveolar Bone Loss / Q000628:therapy*; D000818:Animals; D001861:Bone Regeneration; D004285:Dogs; D005964:Glucosyltransferases; D048091:Guided Tissue Regeneration / Q000379:methods*; D008297:Male; D008567:Membranes, Artificial; D015999:Multivariate Analysis; D019647:Oral Surgical Procedures / Q000379:methods*; D016062:Porosity; D011379:Prognosis
D008567:Membranes, Artificial; D005964:Glucosyltransferases; C430144:glucosyltransferase E