Healing response of apicomarginal defects to two guided tissue regeneration techniques in periradicular surgery: a double-blind, randomized-clinical trial.
OBJECTIVE
To compare healing responses to periosteal sliding grafts and polyglactin 910 periodontal mesh used as guided tissue regeneration (GTR) materials/techniques when both periapical and periradicular bone loss are present.


METHODS
Thirty patients with suppurative chronic apical periodontitis with apicomarginal communication were selected and allocated randomly into two groups according to the barrier technique to be used during periradicular surgery: periosteal graft group (n = 15) and bioabsorbable membrane group (n = 15). Clinical and radiological evaluations were completed prior to surgery, a week later and every 3 months after surgery up to 12 months to measure the periodontal pocket depth (PD), clinical attachment level (CAL), gingival margin position (GMP), size of periapical lesion, percentage reduction of the periapical rarefaction, and periapical healing.


RESULTS
Both groups showed highly significant (P < 0.001) reductions in periodontal PD, CAL and size of periapical lesion at 12 months whilst GMP was unaltered. No significant difference between the experimental groups was evident for these parameters, or for the percentage reduction of size of the periapical lesion and clinical-radiographic healing.


CONCLUSIONS
Guided tissue regeneration applied to apicomarginal defects using sliding periosteal grafts and use of bioabsorbable membranes led to similar enhancements of the clinical outcome of periradicular surgery in terms of periapical healing, gain of periodontal support, PD reduction and minimal recession of the gingival margin.
Marín-Botero
M L
ML
Grupo de Investigación en Patología Oral, Periodoncia y Cirugía Alvéolo-Dentaria, Laboratorio de Inmunodetección y Bioanálisis Facultad de Odontología, Universidad de Antioquia, Medellín, Colombia.
Domínguez-Mejía
J S
JS
Arismendi-Echavarría
J A
JA
Mesa-Jaramillo
A L
AL
Flórez-Moreno
G A
GA
Tobón-Arroyave
S I
SI
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification / Q000601:surgery*; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000145:classification; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010482:Periapical Abscess / Q000601:surgery; D017622:Periodontal Attachment Loss / Q000145:classification / Q000601:surgery; D010514:Periodontal Pocket / Q000145:classification / Q000601:surgery; D010521:Periosteum / Q000637:transplantation; D011098:Polyglactin 910; D011446:Prospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D008567:Membranes, Artificial; D011098:Polyglactin 910