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Results for “Furcation Defects”

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PubMed2006

Effect of early membrane removal on regeneration of Class II furcation defects in dogs.

BACKGROUND: This study evaluated the influence of early removal of an expanded polytetrafluoroethylene (ePTFE) membrane on periodontal regeneration. METHODS: The third and fourth mandibular bicuspids of six healthy mongrel dogs were used. Class II furcation lesions were surgically created making lesions chronic for 21 days. Full flaps were elevated, and ePTFE membranes were adapted over the defects. The membranes were removed at 2 weeks on the experimental sides (test group [TGr]) and at 4 weeks on the control side (control group [CGr]). The dogs were sacrificed 12 weeks following placement of the membranes, and the teeth were histologically processed. Area measurements of new tissue (NT), epithelium (EP), connective tissue (CT), and new bone (NB) and linear measurements of bone height (BH) and new cementum (NC) were made. Wilcoxon signed rank test (P <0.05; N = 6) was carried out to determine differences between groups. RESULTS: The area measurements (in mm2) for TGr and CGr, respectively, were as follows: 14.32 +/- 4.01 and 12.46 +/- 3.54 (NT); 0.04 +/- 0.09 and 0.01 +/- 0.04 (EP); 2.31 +/- 2.60 and 1.91 +/- 2.96 (CT); and 9.56 +/- 3.77 and 8.79 +/- 2.99 (NB). The results of the linear measurements (in mm) for TGr and CGr, respectively, were as follows: 3.85 +/- 1.21 and 4.03 +/- 0.94 (BH) and 10.91 +/- 1.72 and 10.59 +/- 1.80 (NC). There were no statistically significant differences between TGr and CGr for any measurement. CONCLUSION: The early removal of ePTFE membranes in Class II furcation defects in dogs did not affect periodontal regeneration.

Alveolar Process↗
PubMed2005

Treatment of human class II furcation defects using connective tissue grafts, bioabsorbable membrane, and resorbable hydroxylapatite: a comparative study.

OBJECTIVE: To evaluate clinical outcomes and assess digital subtraction radiographic changes after using bioabsorbable membrane (polyglycolic acid/polylactic acid--PGA/PLA) or a connective tissue graft (CTG) as a barrier, with or without resorbable hydroxylapatite (HA Resorb) in the treatment of mandibular class II furcations. METHODS: Fifty furcations in twenty patients with chronic periodontitis were divided into five treatment groups: (I) PGA/PLA; (II) PGA/PLA and resorbable hydroxylapatite; (III) CTG; IV) CTG and resorbable hydroxylapatite; and (V) flap debridement alone (control). Vertical and horizontal probing depths, vertical probing attachment level, gingival recession and standardized periapical radiographs were obtained at baseline and at 3, 6 and 12 months post-operatively. At 12 months, the treated teeth were exposed by re-entry to verify clinical results. RESULTS: All experimental groups (I, II, III and IV) showed statistically significant improvement in the clinical parameters and bone density as compared to the control group. However, no statistically significant differences were observed among any of the experimental groups. Percentages of complete furcation closure and sites still defined as class II furcations were, respectively, as follows: 40% and 20-30% for groups II and IV; 20% and 40% for groups I and III; 0% and 80% for control. Groups II and IV showed significant radiographic changes in bone gain at both 6 and 12 months, while groups I and III showed significant changes only at 12 months. CONCLUSIONS: (1) Guided tissue regeneration (GTR) therapy with or without resorbable hydroxylapatite showed significantly favorable results clinically and radiographically compared to flap debridement alone. (2) GTR plus resorbable hydroxylapatite (groups II and IV) showed higher percentages of complete furcation closure and more bone gain than GTR alone (groups I and III). (3) CTG may be used as an alternative to PGA/PLA bioabsorbable membrane with comparable potential. (4) Digital subtraction radiography may give higher accuracy in assessing results of periodontal therapy.

Absorbable Implants↗
PubMed2005

Regeneration of class II furcation defects: determinants of increased success.

One of the most important indications for guided tissue regeneration (GTR) treatment is class II furcation lesion. However, periodontal regeneration of this type of defect, although possible, is not considered totally predictable, especially in terms of complete bone fill. Many factors may account for variability in the response to regenerative therapy in class II furcation. The purpose of this review is to assess the prognostic significance of factors related to the patient (smoking, stress, diabetes mellitus, acquired immunodeficiency syndrome and other acute and debilitating diseases, and the presence of multiple deep periodontal pockets), local factors (furcal anatomy, defect morphology, thickness of gingival tissue and tooth mobility), surgical treatment (infection control, bone replacement grafts combined with barriers or GTR alone, type of barrier and surgical technique), and postoperative period (plaque control, membrane exposure, membrane retrieval and a regular supportive periodontal care program) for successful of GTR in class II furcations.

Chronic Disease↗
PubMed2001

Molar root anatomy and management of furcation defects.

BACKGROUND, AIMS: Furcally-involved teeth present unique challenges to the success of periodontal therapy. Anatomical and morphological complicating factors dictate modifications in treatment approaches used for managing these areas. METHOD: Various treatment approaches are available for furcally-involved teeth, the choice of which depends on selected interdependent factors. RESULTS: These factors, along with various approaches used in the treatment of furcally compromised teeth are discussed in this review, with particular emphasis on morphology, etiology, classification and diagnosis.

Dental Restoration, Permanent↗
PubMed1989

Evaluation of guided tissue regeneration in Class II furcation defects. A clinical re-entry study.

Twelve patients with two comparable furcation Class II lesions in lower molars were included in this study. After adequate presurgical preparation and pertinent clinical measurements, the areas were treated with full thickness flaps and thorough debridement and scaling and planing of the root surfaces. One of the defects was randomly selected to be covered with Gore-Tex periodontal material, held in place by sling sutures of expanded polytetrafluoroethylene. On both sites the flaps were positioned slightly coronal to their original level and sutured. After 6 months both sites were re-entered surgically and remeasured. The test sites showed a statistically significant reduction in pocket depth and gain in attachment levels while the controls had not changed from preoperative levels. No changes in bone levels were detected in test or control sites. However, because of the large variability in the measurements, and the short period of observation, there may be differences in bony changes between the two therapies. Studies with larger groups, more accurate methods, and longer time intervals are needed to better evaluate the effects of barrier membranes in periodontal healing.

Adult↗
PubMed1995

Guided tissue regeneration demineralized freeze-dried bone allograft: treatment of furcation defects in mandibular molars.

The present study evaluated the effects of combined guided tissue regeneration (GTR) and demineralized freeze-dried bone allograft (DFDBA) therapy on the healing of grade III furcation lesions in mandibular molars of seven periodontitis patients. De novo surgical debridement of furcation roofs by fine diamond bur was introduced. Routine presurgical preparation of teeth and a strict plaque control program were performed for at least six weeks before surgery. A papillary conserved full thickness mucoperiosteal flap was used in all cases. In addition to conventional debridement, odontoplasty was performed on the furcation areas with a diamond bur to eradicate inaccessible fissures or grooves and ensure calculus-free root surfaces. Following debridement, the bony defects were filled with DFDBA and covered with polytetrafluoroethylene (ePTFE) membranes. The flaps were then closed by interproximal sutures coronally positioned through the contact point. The ePTFE membranes were removed 6 to 7 weeks after operation. Clinical parameters such as probing depth (PD), gingival recession (GR), probing attachment level (PAL), tooth mobility (TM), and periapical x-ray were recorded at the baseline and 0, 3, 6, 9, and 12 months after removal of the ePTFE membrane. The results showed a significant increase in the probing attachment level and radiographic evidence of bone fill at the furcation sites. Thus, the addition of fine diamond bur debridement on the furcation in the GTR procedure with DFDBA grafting may be effective in the treatment of grade III furcation involvement.

Adult↗
PubMed1999

The use of biodegradable polylactic acid barrier materials in the treatment of grade II periodontal furcation defects in humans--Part II: A multicenter investigative surgical study.

This study evaluated whether differences in design of 3-dimensional polylactic acid barriers (EPi-Guide and Guidor) would influence hard tissue results in the treatment of Grade II furcations in humans. A multicenter study was conducted, using 40 patients with moderate to advanced bilateral chronic adult periodontitis of the mandibular first or second molars. After flap access, debridement, and root preparation, surgical bone level measurements were taken and membranes were placed on a random basis. Surgical reentry occurred at 1 year. Data collected from all 3 investigative centers were pooled and analyzed using an analysis of variance appropriate for a counterbalancing design. Both barrier materials resulted in significant gains of attachment level and defect reduction. The composite reduction in the vertical component of the osseous defects was greater in the sites treated with Epi-Guide as compared to those treated with Guidor; the difference between barriers reached statistical significance (P = 0.02).

Absorbable Implants↗
PubMed1992

Use of a collagen barrier to enhance healing in human periodontal furcation defects.

Guided tissue regeneration procedures are intended to selectively favor healing by the periodontal ligament tissues. However, in most studies of the efficacy of guided tissue regeneration, nonresorbable barriers and membranes have been used, necessitating their surgical removal after a time. The present study employed a resorbable collagen barrier to treat Class II function invasions. The results of this treatment were compared with the results of conventional therapy. For most clinical parameters, there was no statistically significant difference in the results of treatment with or without collagen membranes. Sites treated with a collagen barrier did exhibit statistically significant improvement in probing depth and horizontal osseous support; however, these findings cannot be attributed entirely to the placement of the collagen membrane.

Aged↗