Western Society of Periodontics

Clinical Studies

Volume Number 4, 1995

Clinical use of a bioresorbable matrix barrier in guided tissue regeneration therapy. Case series

This is a case report study to evaluate the efficacy and clinical performance of bioresorbable membrane, including soft tissue reactions to the device during healing, changes in probing depths, probing attachment levels, and recession. The three-center study looked at 66 defects in 59 patients. The furcation defects were mandibular Class II defects with a horizontal probing attachment level not exceeding 7 mm. The intrabony defects had two or three walls with a minimum probing depth of 6 mm and an intrabony defect depth exceeding 3 mm as measured on the radiographs. Presurgical therapy consisted of OHI and full-mouth scaling and root planing. Patients with optimal oral hygiene were included in the study. The surgery was performed three months after the presurgical phase. Full-thickness flaps were raised at the buccal and lingual aspects of the involved teeth, and a vertical-releasing incision was placed not closer than one tooth mesial to the experimental site. The defects were debrided of granulation tissue, root surfaces were scaled and planed, and no osseous recontouring was carried out. A suitable barrier configuration was then adapted to cover the defect and 2-3 mm of the surrounding bone. Patients were prescribed V-penicillin 2 g b.i.d. x 5 days and 0.2% chlorhexidine digluconate b.i.d. x 6 weeks. Maintenance care consisted of professional tooth cleaning once every two weeks for three months and once every four weeks for the next three months. After six months, maintenance was tailored according to the patient's needs.

The furcation defects were observed to have uneventful healing. The inflammation was found only in three defects and was limited to the first month of healing. Mean pocket depth was reduced from 6.6 to 2.9 with a mean of 3.7 mm. The mean gain of PAL-V was 3.9; PAL-M, 3.3 mm. Nine of the defects were considered closed, nine converted to Class I, and one defect was left unchanged. The mean recession was 0.3 mm. In intrabony defects, the mean PD was reduced from 8.4 to 3.0 with the mean being 5.4 mm. The gain of PAL was 4.9. All sites except for one gained 2 „ mm in clinical attachment. Recession was 0.5 mm. It was concluded by the authors that the use of the matrix barrier resulted in decreased probing depth, an increase in clinical attachment, and very low gingival recession. [M.C.R.]