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Article: Healing, post-operative morbidity and patient perception of outcomes following regenerative therapy of deep intrabony defects

TitleHealing, post-operative morbidity and patient perception of outcomes following regenerative therapy of deep intrabony defects
Authors
Issue Date2004
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPE
Citation
Journal Of Clinical Periodontology, 2004, v. 31 n. 12, p. 1092-1098 How to Cite?
AbstractAim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of enamel matrix derivatives (EMD). This article reports on early healing events, post-operative morbidity and patient perceptions of the surgical outcomes. Material and Methods: One hundred and seventy-two patients with advanced chronic periodontitis and at least one intrabony defect of ≥ 3 mm were recruited in 12 centres in seven countries (European Research Group on Periodontology (ERGOPERIO)). Papilla preservation flaps were used to obtain access and primary closure. After debridement, and root conditioning, EMD was applied in the test subjects, and omitted in the controls. Healing was monitored 1, 2, 3, 4, 6 and 12 weeks after surgery. During the first 12 weeks of healing, supracrestal soft-tissue density was evaluated with a computer-assisted densitometric image analysis system (CADIA) using underexposed radiographs taken on a subset of 34 patients. Patient perceptions were evaluated with a questionnaire immediately after the procedure, at suture removal 1 week later and at 1 year. Results: Subjects reported little intraoperative or post-operative pain or discomfort for both test and controls. Twenty-four percent of controls and 30% of tests (p = 0.64) reported a degree of interference with daily activities for an average of 3 and 3.5 days, respectively. Post-surgical edema was noted in 25% of tests and 28% of controls. Wound dehiscence in the interdental portion of the flap was uncommon (14% of tests and 12% of controls at week 1) and of limited size. Root sensitivity was the most frequent post-operative adverse event: it affected 45% of test and 35% of controls (p = 0.55). Up to 6 weeks post-operatively, soft-tissue densities were significantly higher in subjects treated with EMD with respect to controls. One year after completion of the surgery, patients reported high levels of satisfaction with the outcomes. The most frequently reported benefits included the ability to preserve a tooth/dentition and to maintain/improve chewing ability. The cost and need for frequent follow-ups were cited as significant drawbacks. Conclusions: This study portrayed the early healing events, pain, discomfort and adverse events of papilla preservation flap surgery and the 1-year patient perceptions of the benefits and disadvantages of periodontal surgery in intrabony defects. Earlier gains in soft-tissue density were observed following application of EMD. In terms of patient-centered outcomes, however, both procedures performed in a similar manner. © Blackwell Munksgaard, 2004.
Persistent Identifierhttp://hdl.handle.net/10722/154282
ISSN
2015 Impact Factor: 3.915
2015 SCImago Journal Rankings: 1.848
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTonetti, MSen_US
dc.contributor.authorFourmousis, Ien_US
dc.contributor.authorSuvan, Jen_US
dc.contributor.authorCortellini, Pen_US
dc.contributor.authorBrägger, Uen_US
dc.contributor.authorLang, NPen_US
dc.date.accessioned2012-08-08T08:24:23Z-
dc.date.available2012-08-08T08:24:23Z-
dc.date.issued2004en_US
dc.identifier.citationJournal Of Clinical Periodontology, 2004, v. 31 n. 12, p. 1092-1098en_US
dc.identifier.issn0303-6979en_US
dc.identifier.urihttp://hdl.handle.net/10722/154282-
dc.description.abstractAim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of enamel matrix derivatives (EMD). This article reports on early healing events, post-operative morbidity and patient perceptions of the surgical outcomes. Material and Methods: One hundred and seventy-two patients with advanced chronic periodontitis and at least one intrabony defect of ≥ 3 mm were recruited in 12 centres in seven countries (European Research Group on Periodontology (ERGOPERIO)). Papilla preservation flaps were used to obtain access and primary closure. After debridement, and root conditioning, EMD was applied in the test subjects, and omitted in the controls. Healing was monitored 1, 2, 3, 4, 6 and 12 weeks after surgery. During the first 12 weeks of healing, supracrestal soft-tissue density was evaluated with a computer-assisted densitometric image analysis system (CADIA) using underexposed radiographs taken on a subset of 34 patients. Patient perceptions were evaluated with a questionnaire immediately after the procedure, at suture removal 1 week later and at 1 year. Results: Subjects reported little intraoperative or post-operative pain or discomfort for both test and controls. Twenty-four percent of controls and 30% of tests (p = 0.64) reported a degree of interference with daily activities for an average of 3 and 3.5 days, respectively. Post-surgical edema was noted in 25% of tests and 28% of controls. Wound dehiscence in the interdental portion of the flap was uncommon (14% of tests and 12% of controls at week 1) and of limited size. Root sensitivity was the most frequent post-operative adverse event: it affected 45% of test and 35% of controls (p = 0.55). Up to 6 weeks post-operatively, soft-tissue densities were significantly higher in subjects treated with EMD with respect to controls. One year after completion of the surgery, patients reported high levels of satisfaction with the outcomes. The most frequently reported benefits included the ability to preserve a tooth/dentition and to maintain/improve chewing ability. The cost and need for frequent follow-ups were cited as significant drawbacks. Conclusions: This study portrayed the early healing events, pain, discomfort and adverse events of papilla preservation flap surgery and the 1-year patient perceptions of the benefits and disadvantages of periodontal surgery in intrabony defects. Earlier gains in soft-tissue density were observed following application of EMD. In terms of patient-centered outcomes, however, both procedures performed in a similar manner. © Blackwell Munksgaard, 2004.en_US
dc.languageengen_US
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CPEen_US
dc.relation.ispartofJournal of Clinical Periodontologyen_US
dc.subject.meshAlveolar Bone Loss - Surgeryen_US
dc.subject.meshBone Density - Drug Effectsen_US
dc.subject.meshBone Regeneration - Drug Effectsen_US
dc.subject.meshBone Substitutes - Therapeutic Useen_US
dc.subject.meshDental Enamel Proteins - Therapeutic Useen_US
dc.subject.meshDental Papilla - Surgeryen_US
dc.subject.meshEpidemiologic Methodsen_US
dc.subject.meshHumansen_US
dc.subject.meshPatient Satisfactionen_US
dc.subject.meshSurgical Flaps - Adverse Effectsen_US
dc.subject.meshWound Healing - Drug Effectsen_US
dc.titleHealing, post-operative morbidity and patient perception of outcomes following regenerative therapy of deep intrabony defectsen_US
dc.typeArticleen_US
dc.identifier.emailLang, NP:nplang@hkucc.hku.hken_US
dc.identifier.authorityLang, NP=rp00031en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1600-051X.2004.00615.xen_US
dc.identifier.pmid15560811en_US
dc.identifier.scopuseid_2-s2.0-10444239433en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10444239433&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume31en_US
dc.identifier.issue12en_US
dc.identifier.spage1092en_US
dc.identifier.epage1098en_US
dc.identifier.isiWOS:000225264200010-
dc.publisher.placeDenmarken_US
dc.identifier.scopusauthoridTonetti, MS=35602248900en_US
dc.identifier.scopusauthoridFourmousis, I=6602718088en_US
dc.identifier.scopusauthoridSuvan, J=8322740800en_US
dc.identifier.scopusauthoridCortellini, P=7004422576en_US
dc.identifier.scopusauthoridBrägger, U=7005538598en_US
dc.identifier.scopusauthoridLang, NP=7201577367en_US
dc.identifier.citeulike36993-

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