Long-term clinical evaluation and SEM analysis of the e-PTFE and titanium membranes in guided tissue regeneration.
OBJECTIVE
This study aimed to evaluate clinical outcomes of titanium membrane and compare these findings with clinical outcomes of e-PTFE membrane, and to investigate the effect of bacterial contamination on both membranes with SEM during long-term healing.


RESULTS
Sixteen titanium and sixteen e-PTFE membranes were surgically placed adjacent to periodontally involved teeth. Seven titanium and 8 e-PTFE membranes were exposed between 4 and 6 weeks. There were no significant difference between groups for plaque and gingival index. Probing depth and clinical attachment level (CAL) were decreased in both groups when compared with baseline; however, these differences were not statistically significant. The CAL gains between the groups were statistically different in 3rd, 6th, 9th, 12th, and 24th months (p < 0.05), and the CAL gain was significantly higher in titanium membrane (p < 0.05). There was significant decrease in bleeding on probing from baseline in both groups (p < 0.05). Surfaces of 15 membranes were studied using SEM. The largest amount of bacteria was found on the external cervical surfaces of 15 exposed specimens. The entire surface showed the presence of slough epithelial cells, leukocytes, red blood cells, yeast, and microbial plaque. Thirteen external mid surfaces of the 15 specimens, external apical surfaces of three e-PTFE and 1 titanium membrane, internal collar surfaces of all specimens, internal mid surfaces of 5 e-PTFE and three titanium membranes and internal apical surface of only one e-PTFE membrane were infected.


CONCLUSIONS
This study demonstrated that titanium membrane is equivalent to e-PTFE membranes for GTR in the treatment of periodontal defects.
Toygar
Hilal Uslu
HU
Department of Periodontology, Faculty of Dentistry, Baskent University, 06490 Ankara, Turkey.
Guzeldemir
Esra
E
Department of Periodontology, Faculty of Dentistry, Baskent University, 06490 Ankara, Turkey.
Cilasun
Ulkem
U
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, 41190 Kocaeli, Turkey.
Akkor
Didem
D
Private Practice, Ankara, Turkey.
Arpak
Nejat
N
Department of Periodontology, Faculty of Dentistry, Ankara University, 06100 Ankara, Turkey.
D000328:Adult; D001419:Bacteria / Q000254:growth & development; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005881:Gingiva / Q000473:pathology / Q000648:ultrastructure; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D010510:Periodontal Diseases / Q000473:pathology / Q000628:therapy; D011138:Polytetrafluoroethylene / Q000737:chemistry*; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry*; D016896:Treatment Outcome; D014945:Wound Healing
D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene; D014025:Titanium