Periodontal regeneration of human intrabony defects with bioresorbable membranes. A controlled clinical trial
The aim of this study was to test the clinical efficacy of a GTR treatment approach using bioresorbable barrier membranes, as compared with the clinical efficacy of GTR with nonresorbable barrier membranes or with conventional flap surgery, in the treatment of deep interproximal intrabony defects.
A total of 36 patients with 36 interproximal defects were enrolled in the study. The patients were assigned to one of three treatments: resorbable membranes (R), nonresorbable membranes (ePTFE), and modified Widman flap surgery. The defects did not extend into the furcation. Probing depth (PD), marginal recession (Rec), and clinical attachment level (CAL) were recorded with a manual pressuresensitive probe. Clinical measurements at the time of the surgery included the following: distance from the cementoenamel junction (CEJ) to the bottom of the defect (CEJ-BD), distance from the CEJ to the most coronal extension of the interproximal bone crest (CEJ-BC), and the depth of the three-wall component. The intraosseous component of the defects (INFRA) was defined as INFRA = (CEJ-BD) - (CEJ-BC). At one year there was increased CA1 in all groups and decreased PD. CAL gains of 5.2 + 1.4 mm were observed in the ePTFE, 4.6 + 1.2 mm gains were obtained in the R group, and the MWF group displayed CAL gains of 2.3 + 0.8 mm. Differences in CAL gains between the membrane control group (nonresorbable) and the test group (R) were not statistically significant. Both the test and the control groups showed significantly greater CAL gains than the MWF group. Gingival recession was observed, to a limited extent, following all the employed treatment modalities.
In conclusion, the use of nonresorbable or resorbable barrier membranes resulted in clinically and statistically significant improvements in clinical attachment levels and probing depths. These two treatments were equally effective and significantly better than conventional access flaps. [C.C.]
Cortellini P., G.P.P. Prato, and M. Tonetti, J Periodont, 67:217,1996