Long-term clinical results on the use of bone-replacement grafts in the treatment of intrabony periodontal defects. Comparison of the use of autogenous bone graft plus calcium sulfate to autogenous bone graft covered with a bioabsorbable membrane.
BACKGROUND
Many clinical investigations have demonstrated the benefits of different regenerative approaches in the treatment of infrabony defects. The aim of this investigation was to evaluate the results obtained with the combination of autogenous bone grafting plus calcium sulfate and to compare this outcome with the results obtained using autogenous bone grafting with a bioabsorbable membrane.


METHODS
Twelve subjects participated in this split-mouth trial. Twelve 2- or 3-wall periodontal defects were treated with a combination of autogenous bone grafting plus calcium sulfate (test) and were compared to 12 defects treated with autogenous bone grafting with a bioabsorbable membrane (control). Before surgery, subjects were instructed in oral hygiene techniques, and scaling and root planing were completed. Surgery was identical for both groups except for the regenerative material. After healing, subjects followed a periodontal maintenance program. Probing depth (PD), clinical attachment level, and bleeding on probing were recorded at baseline, 6 months, and 6 years.


RESULTS
There were no statistical differences between test and control defects at baseline. At 6 months, there was a PD reduction of 4.3 +/- 1.0 mm in the control group and 4.4 +/- 1.1 mm in the test group. There was a clinical attachment gain of 3.5 +/- 1.1 mm in the control group and 3.6 +/- 1.0 mm in the test group. At 6 years, there was a PD reduction of 3.3 +/- 1.0 mm in the control group and 4.2 +/- 1.2 mm in the test group. There was a clinical attachment gain of 2.6 +/- 1.2 mm in the control group and 2.4 +/- 1.1 mm in the test group. Differences between treatment groups were not statistically significant at 6 months or 6 years.


CONCLUSIONS
Both therapies led to significant short- and long-term improvements in the outcome variables assessed.
Orsini
Marco
M
Department of Periodontology, Faculty of Odontology, University Complutense Madrid, Madrid, Spain. orsinident@inwind.it
Orsini
Giovanna
G
Benlloch
Dunia
D
Aranda
Juan Jose
JJ
Sanz
Mariano
M
D020341:Absorbable Implants; D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001672:Biocompatible Materials; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D002133:Calcium Sulfate / Q000627:therapeutic use*; D003094:Collagen; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing; D014182:Transplantation, Autologous; D016896:Treatment Outcome
C106416:Bio-Gide; D001672:Biocompatible Materials; D018786:Bone Substitutes; D008567:Membranes, Artificial; D003094:Collagen; D002133:Calcium Sulfate