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Article: Clinical performance of a regenerative strategy for intrabony defects: Scientific evidence and clinical experience

TitleClinical performance of a regenerative strategy for intrabony defects: Scientific evidence and clinical experience
Authors
KeywordsBone regeneration
Comparison studies
Enamel matrix derivative
Grafts, bone
Membranes, artificial
Membranes, bioabsorbable
Periodontal regeneration
Titanium
Issue Date2005
Citation
Journal of Periodontology, 2005, v. 76, n. 3, p. 341-350 How to Cite?
AbstractBackground: The aim of the present study was to evaluate the clinical performance of a regenerative strategy for the treatment of deep intrabony defects. Methods: This patient cohort study involved 40 patients with one deep interdental intrabony defect each. They were treated with periodontal regeneration using four different regenerative methods (expanded polytetrafluoroethylene [ePTFE] titanium reinforced membranes, bioabsorbable membranes alone, bioabsorbable membranes with a bone replacement graft [combination], or enamel matrix derivative), according to predefined criteria and decision-making algorithms. Defects were accessed with papilla preservation flaps performed with the aid of an operating microscope and microsurgical instruments. A stringent plaque control regimen was enforced in all the patients during the 1-year observation period. Outcomes included evaluation of the complete primary closure of the interdental space (CLOSURE), gains in clinical attachment (CAL), and reductions in probing depths (PD). Results: CLOSURE was achieved in all treated defects and was maintained in 90% of cases for the entire healing period. At 1 year the observed CAL gains were 6 ± 1.8 mm on average, corresponding to a resolution of 92.1% ± 12% of the initial intrabony (CAL%) component of the defect. Average PD reduction was 6.1 ± 1.9 mm and was associated with minimal increase in gingival recession (-0.1 ± 0.7 mm). The 12 sites treated with titanium reinforced ePTFE membranes resulted in a 1-year CAL gain of 6.8 ± 2.2 mm (CAL%: 94.7 ± 13.4); the 11 cases treated with combination therapy showed a 1-year CAL gain of 5.4 ± 1.7 mm (CAL%: 88.2 ± 9.6); the seven sites treated with bioabsorbable barriers resulted in 5.9 ± 1.2 mm of CAL gain (CAL%: 88.9 ± 11.5); and the 10 sites treated with enamel matrix gained on average 5.9 ± 1.5 mm of CAL (CAL%: 88.9 ± 11.5). No significant differences were observed among the four approaches. Conclusion: The use of an evidence-based regenerative strategy resulted in clinically relevant amounts of CAL gains, shallow pockets, and minimal gingival recession with the four regenerative approaches.
Persistent Identifierhttp://hdl.handle.net/10722/230738
ISSN
2015 Impact Factor: 2.844
2015 SCImago Journal Rankings: 1.070

 

DC FieldValueLanguage
dc.contributor.authorCortellini, Pierpaolo-
dc.contributor.authorTonetti, Maurizio S.-
dc.date.accessioned2016-09-01T06:06:41Z-
dc.date.available2016-09-01T06:06:41Z-
dc.date.issued2005-
dc.identifier.citationJournal of Periodontology, 2005, v. 76, n. 3, p. 341-350-
dc.identifier.issn0022-3492-
dc.identifier.urihttp://hdl.handle.net/10722/230738-
dc.description.abstractBackground: The aim of the present study was to evaluate the clinical performance of a regenerative strategy for the treatment of deep intrabony defects. Methods: This patient cohort study involved 40 patients with one deep interdental intrabony defect each. They were treated with periodontal regeneration using four different regenerative methods (expanded polytetrafluoroethylene [ePTFE] titanium reinforced membranes, bioabsorbable membranes alone, bioabsorbable membranes with a bone replacement graft [combination], or enamel matrix derivative), according to predefined criteria and decision-making algorithms. Defects were accessed with papilla preservation flaps performed with the aid of an operating microscope and microsurgical instruments. A stringent plaque control regimen was enforced in all the patients during the 1-year observation period. Outcomes included evaluation of the complete primary closure of the interdental space (CLOSURE), gains in clinical attachment (CAL), and reductions in probing depths (PD). Results: CLOSURE was achieved in all treated defects and was maintained in 90% of cases for the entire healing period. At 1 year the observed CAL gains were 6 ± 1.8 mm on average, corresponding to a resolution of 92.1% ± 12% of the initial intrabony (CAL%) component of the defect. Average PD reduction was 6.1 ± 1.9 mm and was associated with minimal increase in gingival recession (-0.1 ± 0.7 mm). The 12 sites treated with titanium reinforced ePTFE membranes resulted in a 1-year CAL gain of 6.8 ± 2.2 mm (CAL%: 94.7 ± 13.4); the 11 cases treated with combination therapy showed a 1-year CAL gain of 5.4 ± 1.7 mm (CAL%: 88.2 ± 9.6); the seven sites treated with bioabsorbable barriers resulted in 5.9 ± 1.2 mm of CAL gain (CAL%: 88.9 ± 11.5); and the 10 sites treated with enamel matrix gained on average 5.9 ± 1.5 mm of CAL (CAL%: 88.9 ± 11.5). No significant differences were observed among the four approaches. Conclusion: The use of an evidence-based regenerative strategy resulted in clinically relevant amounts of CAL gains, shallow pockets, and minimal gingival recession with the four regenerative approaches.-
dc.languageeng-
dc.relation.ispartofJournal of Periodontology-
dc.subjectBone regeneration-
dc.subjectComparison studies-
dc.subjectEnamel matrix derivative-
dc.subjectGrafts, bone-
dc.subjectMembranes, artificial-
dc.subjectMembranes, bioabsorbable-
dc.subjectPeriodontal regeneration-
dc.subjectTitanium-
dc.titleClinical performance of a regenerative strategy for intrabony defects: Scientific evidence and clinical experience-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1902/jop.2005.76.3.341-
dc.identifier.pmid15857066-
dc.identifier.scopuseid_2-s2.0-18744402174-
dc.identifier.volume76-
dc.identifier.issue3-
dc.identifier.spage341-
dc.identifier.epage350-

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