Gingival crevicular fluid bone morphogenetic protein-2 release profile following the use of modified perforated membrane barriers in localized intrabony defects: a randomized clinical trial.
BACKGROUND
In guided tissue regenerative surgery, membrane perforations may serve as a mechanism for the passage of cells and biologic mediators from the periosteum and overlying gingival connective tissue into the periodontal defects. To test this assumption, this study was designed to evaluate levels of bone morphogenetic protein-2 (BMP-2) in gingival crevicular fluid (GCF) during the early stages of healing for sites treated with modified perforated membranes (MPMs) as compared with occlusive membranes (OMs).


METHODS
Fifteen non-smoking patients with severe chronic periodontitis participated in this prospective, randomized and single-blinded clinical trial. Each patient contributed two interproximal contralateral defects that were randomly assigned to either an experimental modified perforated membrane group (15 sites) or a control occlusive membrane group (15 sites). Plaque index, gingival index, probing depth(PD), clinical attachment level (CAL) and the relative intrabony depth of the defect (rIBD) were measured at baseline and reassessed at three, six and nine months after therapy. Gingival crevicular fluid samples were collected on day 1 and 3, 7, 14, 21, and 30 days after therapy.


RESULTS
The MPM-treated group showed a statistically significant improvement in PD reduction and clinical attachment gain compared to the OM control group. Similarly, rIBD was significantly reduced in MPM-treated sites as compared with those of the OM group. BMP-2 concentrations peaked in the MPM samples obtained during the early postoperative period (days 1, 3 and 7) with a statistically significant difference compared with OM-treated groups. BMP-2 levels decreased sharply in the samples obtained at days 14, 21 and 30 with non-significant higher levels in MPM samples as compared with those of OM sites.


CONCLUSIONS
Within the limits of the present study, one can conclude that MPM coverage of periodontal defects is associated with a significant initial increase in GCF levels of BMP-2, a factor that could improve the clinical outcomes of guided tissue regenerative surgery.
Ahmed Y
AY
Gamal
Mohamed
M
Aziz
M H
MH
Salama
Vincent J
VJ
Iacono
D000328:Adult; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000539:Alveolar Process / Q000473:pathology; D055396:Bone Morphogenetic Protein 2 / Q000032:analysis*; D055113:Chronic Periodontitis / Q000601:surgery; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000473:pathology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000473:pathology; D011446:Prospective Studies; D016037:Single-Blind Method; D013524:Surgical Flaps / Q000601:surgery; D014945:Wound Healing / Q000502:physiology
C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D008567:Membranes, Artificial