Western Society of Periodontics

Clinical Studies

Volume Number 4, 1995

Guided tissue regeneration in human furcation defects after using a biodegradable barrier: A multi-center feasibility study

This is a report on the GTR outcomes with the use of a biodegradable barrier in the treatment of Class II furcations using a multi-center feasibility study. The results after one year posttreatment are reviewed. Four centers utilizing a total of 29 patients with mandibular (buccal or lingual) and maxillary (buccal) molar Class II furcation defects were used in the study. Each patient received an initial scaling and root planing prior to surgery. The GTR surgery included a full-thickness mucoperiosteal flap to access the furcation, debridement of the root surface, application of a customized polylactic acid biodegradable barrier over the furcation site, and closure of the flap approximating the coronal border of the barrier. The surgical area was covered with periodontal dressing during the first two to three weeks, and twice-daily rinses with chlorhexidine were prescribed. Baseline sites were measured for probing depth, gingival margin location, and attachment level in both vertical and horizontal directions. Comprehensive periodontal examination measurements were recorded 3, 4, 6, 9, and 12 months after baseline evaluations.

Both plaque and gingival inflammation were maintained at low levels throughout the study period. Periodontal probing depth, which had a mean value of 6.0 mm at baseline, was statistically significantly reduced at three months and maintained for the 12 month period (mean 3.8 mm). Mean probing attachment loss (vertical) was 6.2 mm at baseline and 4.5 mm at 12 months. Mean probing attachment loss (horizontal) at baseline was 5.4 mm and reduced to 2.9 mm after 12 months. At the 12-month evaluation, 14 of the 29 furcations (48%) had fewer than 3 mm horizontal involvement. Nineteen furcations were Class I or had the minimal Class II depth of 3 mm. Ten furcations that were still Class II showed a mean depth decrease of 6.8 mm to 5.2 mm.

The present feasibility study was conducted to gather information with respect to technique sensitivity associated with GTR procedures and the variations in regenerative outcomes between different operators using a biodegradable barrier. This report suggests a favorable clinical outcome consistent with other studies. Nevertheless, further investigations with this membrane must be carried out before any practical predictability can be established. [D.S.S.]