title: A Novel Surgical Approach for Treatment of Class II Furcation Defects Using Marginal Periosteal Membrane.
abstract: OBJECTIVE
  This study was designed to describe and evaluate the use of a vascularized marginal periosteal barrier membrane (MPM) harvested by a semilunar incision, alone or combined with a bone graft, in treatment of class II furcation defects in mandibular molars, compared to open flap debridement (OFD).
  
  
  METHODS
  Thirty class II furcation defects in mandibular molars were randomly assigned into three equal groups: Group I included OFD, Group II included defects treated with MPM, and Group III consisted of defects treated with MPM after applying demineralized freeze-dried bone allograft (DFDBA). At baseline and 6-month follow-up, vertical probing depth (VPD), clinical attachment level (CAL) measurements, along with a radiographic measurement of bone height (BH), were obtained for each defect. Transmission electron microscopy (TEM) was used for further evaluation of the histological changes associated with gingival samples related to each line of treatment.
  
  
  RESULTS
  Both Groups II and III reflected significant favorable outcomes in all the assessed parameters compared to OFD. A non-significant difference was found between both groups regarding VPD, while significant improvement in CAL and BH were detected in Group III (p ≤ 0.05). Favorable histological findings were also noticed in the test groups, with more improvement in Group III.
  
  
  CONCLUSIONS
  Placement of a vascularized MPM as a barrier membrane, using a semilunar incision, demonstrated a significant improvement in both clinical and histological outcomes of class II furcation defects in lower molars. When it was combined with DFDBA, a meaningful difference was found with regard to early wound healing and gain in CAL and BH.
authors.forename: Hala H
authors.initials: HH
authors.lastname: Hazzaa
authors.forename: Heba
authors.initials: H
authors.lastname: El Adawy
authors.forename: Hani M
authors.initials: HM
authors.lastname: Magdi
mesh_terms: D000328:Adult; D064591:Allografts / Q000637:transplantation; D000539:Alveolar Process / Q000000981:diagnostic imaging; D064592:Autografts / Q000473:pathology / Q000637:transplantation*; D016025:Bone Transplantation / Q000379:methods; D055113:Chronic Periodontitis / Q000601:surgery; D003094:Collagen; D003238:Connective Tissue / Q000473:pathology; D003646:Debridement / Q000379:methods; D004311:Double-Blind Method; D004848:Epithelium / Q000473:pathology; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D005881:Gingiva / Q000473:pathology; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000145:classification / Q000601:surgery*; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010521:Periosteum / Q000473:pathology / Q000637:transplantation*; D011859:Radiography; D013524:Surgical Flaps / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D003094:Collagen