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PubMed2001

Regenerative therapy of furcation defect.

Furcation defects of multiple-root teeth are complications of progressive periodontal diseases. The recommended technique of regenerative therapy in furcation defects of the lower molars is implantation of hydroxylapatite or demineralized freeze-dried bone. A case of a completely absent interradicular bone of 46 tooth in a 35-year-old woman with generalized periodontitis is presented. After endodontic treatment and recovery of the tooth crown we undertook surgical treatment of the bone defect: open curettage, using the technique of Ramfjord and bony reconstruction with aloplastic material bioplant HTR (septodont). The preoperative preparation included clinical prophylaxis and chemical plaque inhibition; postoperatively, rinsing the mouth twice a day with 0.5% metronidazole. The patient was followed up clinically and radiographically up to the 6th month after treatment when the bone structure regenerated.

Humans↗

PubMed2002

A systematic review of guided tissue regeneration for periodontal furcation defects. What is the effect of guided tissue regeneration compared with surgical debridement in the treatment of furcation defects?

OBJECTIVES: To systematically review the evidence of effectiveness of guided tissue regeneration (GTR) for furcation defects. BACKGROUND: The evidence for the effectiveness of GTR in furcation defects has not yet been systematically appraised. METHODS: We searched for randomized controlled trials with at least 6 months' follow-up comparing GTR with surgical debridement (open flap debridement, OFD). Data sources included electronic databases, hand-searched journals and contact with experts. Screening, data abstraction and quality assessment were conducted independently by multiple reviewers. The primary outcome measure was reduction in open horizontal furcation depth, secondary outcomes were frequency of furcation closure, gain in horizontal and vertical probing attachment and reduction of vertical probing depth. RESULTS: For the primary outcome, reduction in horizontal furcation depth assessed during re-entry, the weighted mean difference between GTR and control was 1.51 mm (95% CI [0.39-2.62], chi-square for heterogeneity 67.6 (df = 3), P < 0.001) in mandibular class II furcations, 1.05 mm (95% CI [0.46-1.64, chi-square for heterogeneity 34.9 (df = 3), P < 0.001) in maxillary class II furcations, and 0.87 mm (95% CI [-0.08-1.82], chi-square for heterogeneity 0.1 (df = 4), P = 0.991) in studies that had combined mandibular and maxillary class II furcations. For the secondary outcomes, GTR treatment led to significantly better results than open flap debridement. No meta-analysis could be performed for frequency of furcation closure because of sparse data. CONCLUSIONS: Overall, GTR was consistently more effective than OFD in reducing open horizontal furcation depths, horizontal and vertical attachment levels and pocket depths for mandibular or maxillary class II furcation defects. However, these improvements were modest, variable and there was only a limited number of studies available to appraise the effects, thus limiting general conclusions about the clinical benefit of GTR. Future studies should aim to identify factors associated with achieving consistent and more pronounced benefits over open flap debridement.

Furcation Defects↗

PubMed2005

Bioactive glass and bioabsorbable membrane in the treatment of a maxillary class II furcation defect: case report with 6-month re-entry.

The combination of bone graft materials with guided tissue regenerative procedures has been shown to have predictable positive results in periodontal defects, especially furcations. The following case report will demonstrate a severe class II furcation defect in a maxillary molar that was treated with combination therapy using bioactive glass and a bioabsorbable membrane made of a copolymer of polylactic/polyglycolic acid. Six-month re-entry revealed substantial clinical fill of the furcation defect. Comparison radiographs also demonstrated fill in the region.

Absorbable Implants↗

PubMed1996

Hypothetical considerations in the regenerative treatment of molar furcation defects.

Treatment of the molar furcation defect is a challenge to the dental professional. Responses of molar furcation sites to both closed and open surgical debridement have not been shown to result in significant clinical improvement or bone fill. Regenerative techniques using grafting materials, guided tissue regeneration with resorbable and nonresorbable membranes, coronally positioned flaps, and combination techniques are more frequently used to treat class II molar furcations. The clinical responses to these surgical approaches have shown varied results. This article reviews some of the studies on regeneration in furcation defects as well as some of the uniqueness and complexities of the furcation problem. The bone morphology differences in molar bifurcation and trifurcation defects are discussed, and a bone morphologic classification is presented in an effort to standardize future regenerative studies in class II furcations.

Alveolar Bone Loss↗

PubMed2006

Factors influencing treatment outcomes in mandibular Class II furcation defects.

BACKGROUND: Factors influencing treatment outcomes in furcation defects remain to be studied. Therefore, the aim of the study was to evaluate the association between factors and clinical parameters that may influence treatment outcomes in mandibular Class II furcation defects. METHODS: Twenty-seven systemically healthy subjects with a Class II buccal or lingual furcation defect in lower molars were treated. Clinical measurements (probing depth [PD], clinical attachment level [CAL], recession, mobility, plaque index [PI], and bleeding on probing [BOP]) and defect (vertical and horizontal defect depths) were obtained at initial and 6-month reentry surgeries. Treatment modalities (e.g., nine each in the following three groups: open flap debridement [OFD] alone, bone graft [BG], and bone graft plus a bioabsorbable collagen membrane [BG + C]), anatomic factors (presence of cervical enamel projection, presence of cervical restorations/fixed prosthesis, and location of furcations [buccal or lingual sides; first or second molars]), clinical parameters (initial mobility, initial PD at furcation, initial CAL at furcation, mean initial PD of the tooth, mean initial CAL of the tooth, initial horizontal PD at furcation, initial horizontal/vertical defect depth, PI, and BOP), and background factors (endodontic status, smoking status, and surgeon's experience) were analyzed for associations with probability of clinical improvement. RESULTS: The anatomic factors, clinical parameters, and background information were found to have no effect in influencing treatment outcome with the exception of initial vertical defect depth. An initial vertical defect depth >or=4 mm had a borderline significance (P = 0.06) of achieving a high probability of having a 1-mm vertical bone fill. In addition, treatment modality was found to be a major influence factor. Sites treated with BG were 16x more likely to have >50% vertical bone fill than open flap surgery. Furthermore, sites treated with BG were 64x more likely to have a 1-mm vertical defect fill compared to sites treated with OFD and 16x more likely to have a 2-mm vertical defect fill compared to sites treated with OFD or BG + C. However, the additional membrane does not enhance the regenerative outcomes achieved by BG alone. CONCLUSIONS: Initial vertical defect depth (>or=4 mm) and treatment modality (e.g., BG) were found to be the clinical parameter and factor that were associated with high probability of clinical improvement. Sites treated with BG, such as mineralized human cancellous allograft, were more likely to have greater vertical furcation defect fill than the conventional OFD surgery. Additional membrane placement does not enhance the treatment outcome achieved by BG alone.

Adult↗

PubMed2006

A clinical evaluation of anorganic bovine bone graft plus 10% collagen with or without a barrier in the treatment of class II furcation defects.

UNLABELLED: The use of bone replacement grafts with barrier membranes in class II furcation defects are aimed at improving the outcome of the regenerative technique. In this regard, however, there is a paucity of studies comparing the results obtained with bone grafts alone or in combination with barrier membranes. The aim of this study was to clinically compare an anorganic bovine bone graft plus 10% collagen (BO) with or without a bioresorbable collagen barrier (BG) in human mandibular molar class II furcation defects. METHODS AND MATERIALS: Twenty mandibular class II furcation defects (ten patients with bilateral defects) were treated either with BO (group I) or a combination of BO/BG (group II). Each defect was randomly assigned to either group I or group II. The soft tissue and hard tissue measurements including vertical probing depth (VPD), horizontal probing depth (HPD), clinical attachment level (CAL), gingival recession (GR), vertical depth of furcation defect (VDF), and horizontal depth of furcation defect (HDF) were recorded at baseline and six months after surgery. RESULTS: Both treatment procedures resulted in statistically significant reduction in VPD and HPD, gain in CAL, and reduction in VDF and HDF. There was a statistically significant difference between group I and group II in all soft and hard tissue parameters with the exception of VPD reduction and gingival recession. CONCLUSION: The findings of this study suggest superior clinical results with BO/BG treatment when compared to BO treatment in mandibular class II furcation defects.

Absorbable Implants↗

PubMed1992

Guided tissue regeneration in surgically-produced furcation defects. An experimental study in the beagle dog.

The aim of the investigation was to evaluate the potential for new attachment formation at various degree III furcation involvements in the beagle dog. 3 differently shaped furcation defects were prepared; one small and one large key-hole defect, and one furcation defect which was part of "circumferential" loss of attachment and bone. 15 beagle dogs were used in the experiments. The furcation defects were surgically created at mandibular premolars in the right and left side of the jaw. Test teeth were subsequently treated according to the GTR principle, while control teeth were treated without the application of membranes. The result from the histological examination of biopsy specimens revealed that GTR treatment may result in complete new attachment at surgically produced "through and through" furcation involvements in dogs. The study, however, also revealed that the size of the furcation defect as well as the shape of the surrounding alveolar bone were factors that determined the outcome of this kind of treatment. The treatment failures were consistently associated with flap recession during healing which resulted in the exposure of the furcation defect.

Alveolar Bone Loss↗

PubMed2000

The role of resective periodontal surgery in the treatment of furcation defects.

Resective therapy for the treatment of furcation defects is an essential part of the periodontal therapist's armamentarium. Root resection can successfully treat specific furcation defects that cannot be solved by other surgical and nonsurgical approaches. Complications with these resective procedures are not rare but are usually avoidable when specific endodontic, surgical and restorative guidelines are followed.

Dental Restoration, Permanent↗

PubMed2006

Periodontal regeneration following transplantation of proliferating tissue derived from periodontal ligament into class III furcation defects in dogs.

The aim of this study was to evaluate the healing of class III furcation defects following transplantation of proliferating tissue derived from periodontal ligament (pPDL). Two weeks after removing alveolar bone, pPDL was excised. Class III furcation defects were created in the mandibular premolars. pPDL was transplanted into the furcation defects in the experimental group, while no treatment was performed on the furcation defects in the controls. Two, four and eight weeks after surgery, histologic examination, quantitative RT-PCR, and immunohistochemistry were carried out. bFGF and VEGF mRNA showed a significant increase in pPDL. In the pPDL treatment group, new cementum regenerated around almost the entire circumference of the furcation, with new bone filling most of the defect, while the control group presented epithelial downgrowth and defects filled with connective tissue. These results provide histological evidence that pPDL plays an important role in wound healing by promoting periodontal regeneration in class III furcation defects.

Animals↗

PubMed1990

Treatment of periodontal furcation defects. Coronally positioned flaps versus dura mater membranes in class II defects.

Mandibular class II furcation defects in 19 subjects were treated using 2 different methods of wound closure. In 16 of the defects, the wound was closed with a coronally positioned surgical flap secured by crown-attached sutures. In 15 of the defects, a collagenous membrane (freeze-dried dura mater) was placed to cover the exposed defect, followed by suturing of the surgical flap at the level of the alveolar crest. After use of a coronally positioned flap, an average of 70% of the defect volume became filled with bone, with complete closure by bone fill for 9 of the 16 treated defects. After use of dura mater membrane, 38% of the defect volume was filled with bone, with complete bony closure for 3 of the 15 treated defects. The results following use of coronally positioned flaps support our previous findings and the potentials of this technique. The results following use of dura mater membranes, together with recently reported risk for spread of virus with dura implants, do not justify the use of dura mater for these regenerative purposes.

Adult↗

PubMed2004

Radiographic parameters as prognostic indicators for healing of class II furcation defects.

OBJECTIVE: To evaluate radiographic measurements for use as prognostic indicators for healing of class II furcation defects following regenerative therapy. MATERIAL AND METHODS: In 17 patients (eight females), 33 class II furcation defects (mandibular buccal (n=10) and lingual (n=12), and maxillary buccal (n=11)) were treated using the barrier membrane technique. Twenty-six furcations were treated using a bioabsorbable membrane, while a nonresorbable membrane was used to treat the remaining seven furcation defects. Clinical parameters and standardized radiographs were obtained before as well as 6 and 24 months after therapy. All radiographs were digitized and evaluated by an examiner blinded to the clinical data. The following distances were measured: cemento-enamel junction line (CEJ-line) to alveolar crest (AC) at the furcation site (AC-CEJ line), CEJ-line to the furcation fornix (Fx-CEJ line), width of the furcation at the level of the AC (FW) as well as the distance from Fx to a straight line between the AC mesial and distal of the tooth (Fx-AC line). RESULTS: Statistically significant (p<0.001) horizontal attachment gains could be observed 6 and 24 months after therapy (6 months: 1.49+/-0.85 mm; 24 months: 1.14+/-0.91 mm). However, a small but statistically significant (p=0.031) attachment loss of 0.35 mm was observed between the 6 and 24 months examination. Multilevel regression analyses identified baseline probing depth (p=0.0017) and 3 of the radiographic distances as prognostic factors: Fx-CEJ line (p=0.014), FW (p=0.0535), Fx-AC line (p=0.0827). CONCLUSION: The analysis of presurgical radiographs may yield information on the success of the regenerative therapy of buccal and lingual class II furcation defects. A long root trunk, a wide furcation entrance and an Fx coronal to the AC have negative influences on the success of therapy. Further, a deep probing depth at the furcation site at baseline increases the likelihood for more favourable horizontal attachment gain in furcations.

Absorbable Implants↗

PubMed2003

Guided tissue regeneration for the treatment of periodontal intrabony and furcation defects. A systematic review.

BACKGROUND: Many clinical studies have demonstrated that guided tissue regeneration (GTR) is a successful treatment modality of periodontal reconstructive surgery and it has become an accepted procedure in most periodontal practices. RATIONALE: The purpose of this structured review was to assess the efficacy of guided tissue regeneration (GTR) procedures in patients with periodontal osseous defects compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes. It extends the scope of previous GTR systematic reviews, which were limited to randomized controlled studies, by the scope of outcome measures examined, and the duration of the study. FOCUSED QUESTION: In patients with periodontal osseous defects, what is the effect of physical barriers compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes? SEARCH PROTOCOL: An electronic search of the Cochrane Oral Health Group Trials Register and MEDLINE databases was performed. Manual searching of journals included Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research up to January 2002. This manual search also included review of relevant bibliographies. Two manufacturers of GTR devices were contacted regarding unpublished data. SELECTION CRITERIA INCLUSION CRITERIA: Studies were selected for review if the evidence level was 3B (cohort) or above, at least 6 months duration, and compared a test GTR intervention with a surgical control. EXCLUSION CRITERIA: Studies with experimental design problems; histologic or microbiological investigations; or those with outcome measurements, study populations, or study duration not consistent with the inclusion criteria were excluded. Primary outcome measures for intrabony defects were: clinical attachment level (CAL) gain, probing depth reduction (PD), gingival recession (REC) reduction; for furcation defects: vertical probing attachment level (VPAL) gain, vertical probing depth reduction (VPD), horizontal probing depth reduction (HPD), horizontal open probing attachment level gain (HOPA), and vertical open probing attachment level gain (VOPA). Meta-analysis was performed to compare GTR procedures to other surgical treatments and to examine the resulting clinical outcomes. MAIN RESULTS: 1. For the primary outcome variables, in both intrabony-defect and furcation-defect studies, GTR was favored over open flap debridement (OFD) therapies (P < 0.0001). 2. No differences were detected among barrier types, but barrier types could explain some heterogeneity in the results. 3. Augmentation of the GTR barrier with a particulate graft enhanced VPD (P < 0.05), VPAL, and HOPA, but none of the intrabony outcomes. REVIEWER'S CONCLUSIONS: Overall, GTR is consistently more effective than OFD in the gain of clinical attachment and probing depth reduction in the treatment of intrabony and furcation defects.

Absorbable Implants↗

PubMed1998

GTR treatment of degree III furcation defects following application of enamel matrix proteins. An experimental study in dogs.

The aim of the present study was to evaluate the effect of enamel matrix proteins (EMD) on periodontal wound healing in degree III furcation defects in dogs. The experiment was performed in 5 foxhound dogs. 2 months prior to the start of the experiment, the 2nd and 4th lower premolars were extracted. Degree III furcation defects were created in the 3rd mandibular premolars (3P3). The furcation defects were subsequently exposed to reconstructive surgery. Buccal and lingual full thickness flaps were elevated in the lower premolar regions. The exposed root surfaces of the experimental teeth were planed. A notch was placed in the roots at the base of the defect. In one side of the mandible (Test group), phosphoric acid gel was applied over the root surfaces for 15 s. The acid was removed by flushing the root surfaces with sterile saline. Subsequently, a gel of EMD was applied to cover all instrumented root surfaces. Following gel application, a resorbable barrier membrane was adjusted to cover the buccal and lingual entrances of the furcation defect. The flaps were repositioned to cover the barrier and sutured. The contralateral premolar (Control group) received the same treatment, but acid etching was not performed and EMD was not applied prior to barrier installation. 4 months after reconstructive surgery, the animals were sacrificed and biopsies from the 3P3 regions harvested. The biopsies were placed in a fixative, demineralized in EDTA, dehydrated and embedded in paraffin. 3 mesiodistal sections, representing the central portion of the furcation site, were selected for histological analysis of the defect. The furcation defects of both the Test and Control groups were clinically closed and were found to harbor bone and periodontal ligament tissue which appeared to be in structural continuity with a newly formed root cementum. The relative amounts of mineralized bone, bone marrow and periodontal ligament tissue that had formed were similar in the Test and the Control group. In the Test group, however, the cementum that had formed in the apical portion of the furcation defect was different from the corresponding tissue in the coronal portion, and also different from the cementum observed in the Control group. In the apical portion of the test defect a thin (12 microm) acellular cementum had been laid down, while in the coronal portion a thick (32 microm) cellular cementum, similar to the cementum found in the Control group, could be observed. The current observation, hence, seems to confirm that EMD when applied onto an instrumented and acid etched dentine surface may create an environment conducive for the formation of acellular cementum.

Acid Etching, Dental↗

PubMed2003

Impaired healing response of periodontal furcation defects following flap debridement surgery in smokers. A controlled clinical trial.

OBJECTIVES: The purpose of the present parallel-design, controlled clinical trial was to evaluate the treatment outcome of periodontal furcation defects following flap debridement surgery (FDS) procedure in cigarette smokers compared to non-smokers. MATERIALS AND METHODS: After initial therapy, 31 systemically healthy subjects with moderate to advanced periodontitis, who presented at least one Class I or II molar furcation defect, were selected. Nineteen patients (mean age: 40.3 years, 15 males) were smokers (>or=10 cigarettes/day) and 12 patients (mean age: 44.8 years, 3 males) were non-smokers. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS), probing pocket depth (PPD), vertical clinical attachment level (v-CAL), and horizontal clinical attachment level (h-CAL) were assessed immediately before and 6 months following surgery. RESULTS: Overall, statistically significant v-CAL gain was observed in smokers (1.0 +/- 1.3 mm) and non-smokers (1.3+/-1.1 mm), the difference between groups being statistically significant (p=0.0003). In proximal furcation defects, v-CAL gain amounted to 2.3+/-0.7 mm in non-smokers as compared to 1.0+/-1.1 mm in smokers (p=0.0013). At 6 months postsurgery, non-smokers presented a greater h-CAL gain (1.3+/-1.1 mm) than smokers (0.6+/-1.0 mm), with a statistically significant difference between groups (p=0.0089). This trend was confirmed in both facial/lingual (1.4+/-1.0 versus 0.8+/-0.8 mm) and proximal furcation defects (1.2+/-1.3 versus 0.5+/-1.2 mm). The proportion of Class II furcations showing improvement to postsurgery Class I was 27.6% in smokers and 38.5% in non-smokers. After 6 months, 3.4% of presurgery Class I furcation defects in smokers showed complete closure, as compared to 27.8% in non-smokers. CONCLUSIONS: The results of the present study indicated that (1) FDS produced clinically and statistically significant PPD reduction, v-CAL gain, and h-CAL gain in Class I/II molar furcation defects, and (2) cigarette smokers exhibited a less favorable healing outcome following surgery in terms of both v-CAL and h-CAL gain.

Adult↗

PubMed1997

Guided periodontal tissue regeneration in Class II furcation defects following treatment with a synthetic bioabsorbable barrier.

The purpose of this study was to evaluate guided periodontal tissue regeneration (GPTR) wound healing in Class II furcation defects following surgical treatment with a synthetic bioabsorbable barrier manufactured from a copolymer of glycolide and lactide. Periodonal lesions were induced in four adult male rhesus monkeys around the mandibular first, second, and third molar teeth using orthodontic elastics. After obtaining approximately 30% bone loss, the elastics were replaced by a stainless steel wire which had a projection extending into the furcation. Once similar contralateral Class II furcation defects had been created, the wires were removed, and an oral hygiene program was initiated and maintained until completion of the study. Three weeks after commencing oral hygiene, flap surgery was performed in the mandibular molar region and the root surfaces were thoroughly scaled and root planed to the apical portion of the defects. A bioabsorbable barrier was then placed to cover the furcation defects on one side of the jaw (i.e., test sites). No barriers were placed on the contralateral molars (i.e., control sites). Five months after surgery, the animals were sacrificed and the teeth with their supporting periodontium were processed for light microscopic evaluation. Clinical healing progressed normally and was similar in both groups. Histologic observations from control specimens indicated repair with epithelium and connective tissue occupying the majority of the furcation defects. Test specimens exhibited definitive evidence of regeneration with significantly greater new connective tissue attachment, cementum deposition, and bone formation than the control sites (P < 0.001). It was concluded that this bioabsorbable barrier facilitated GPTR wound healing in Class II furcation defects.

Alveolar Bone Loss↗

PubMed2006

Effects of a mineralized human cancellous bone allograft in regeneration of mandibular Class II furcation defects.

BACKGROUND: A solvent-preserved, mineralized human cancellous bone allograft (MBA) was recently developed. However, its effect in regenerating furcation defects remains to be determined. Hence, the aim of the study is to evaluate the effects of this newly introduced MBA, with and without a bioabsorbable collagen membrane, for the treatment of mandibular class II furcation defects. METHODS: Thirty subjects with Hamp's Class II buccal or lingual furcation defects in lower molars were randomly assigned to open flap debridement (OFD), MBA, or MBA with a bioabsorbable collagen membrane (guided tissue regeneration [GTR]+MBA) groups. Clinical and defect measurements were obtained at the initial visit and at 6-month reentry surgeries. The data were analyzed for intra- and intergroup comparisons and associations of treatment with probability of clinical improvement. RESULTS: Out of a total of 30 subjects, 27 individuals completed the study. Vertical bone fill (VBF) was -1.6+/-2.1 mm in OFD, 1.9+/-1.4 mm in MBA, and 0.7+/-0.9 mm in GTR+MBA groups. VBF in MBA and GTR + MBA groups was significantly higher than that in the OFD group (P<0.05). Horizontal bone fill (HBF) was 0.2+/-1.7 mm, 1.1+/-0.9 mm, and 1.1+/-0.9 mm for OFD, MBA, and GTR+MBA groups, respectively. However, HBF, recession, clinical attachment level gain, and probing depth reduction at furcations showed no differences among groups. CONCLUSIONS: Results obtained from this study indicate that solvent-preserved, mineralized human cancellous allograft, with or without collagen membrane, can significantly improve bone fill in mandibular Class II furcation defects. In addition, initial vertical defect depth was found to be the only factor that was associated with a higher probability of clinical improvement.

Adult↗

PubMed1999

The effect of postsurgical antibiotics and a bioabsorbable membrane on regenerative healing in Class II furcation defects.

BACKGROUND: The purpose of this randomized, controlled, blinded, clinical investigation was to determine the effect of postsurgical antibiotics on osseous healing in Class II furcation defects. METHODS: Twenty-four Class II furcation defects in 24 patients were treated with either a polylactide bioabsorbable membrane, demineralized freeze-dried bone allograft (DFDBA) plus antibiotics (GBA or test group) or with a polylactide membrane and DFDBA alone (GB or control group). Twelve patients were included in each group. The antibiotic regimen consisted of ciprofloxacin 250 mg twice daily and metronidazole 250 mg tid for 1 week followed by a 7-week regimen of doxycycline hyclate 50 mg daily. Treatment was performed on either mandibular buccal or lingual, or maxillary buccal Class II furcation defects. Defects were randomly selected by a coin toss for treatment and all open and closed measurements were performed by a blinded examiner. Final open and closed measures from a stent were repeated at the 9-month second stage surgery. Power analysis to determine superiority of antibiotic treatment showed that a 12 per group sample size would yield 93% power to detect a 1.5 mm difference and 64% power to detect a 1 mm difference. RESULTS: Mean open horizontal probing depth reductions at 9 months were greater for the GBA group than for the GB group (2.92+/-1.78 versus 2.50+/-1.62 mm); however, these differences were not statistically significant. Seven of 12 furcations (58%) in the GBA group demonstrated >50% vertical defect fill at 9 months compared to 8 of 12 furcations (67%) in the GB group. There were no significant differences in mean open horizontal probing depth reduction between smokers and non-smokers in either the GBA or GB groups. Membrane exposure did not appear to affect regenerative healing in either the GBA or GB groups. CONCLUSIONS: The administration of postsurgical antibiotics did not produce statistically superior osseous healing of Class II furcation defects. This result may be attributable to membrane design which facilitates connective tissue ingrowth, thereby preventing bacterial downgrowth and contamination of the newly regenerated tissues.

Absorbable Implants↗

PubMed1998

GTR treatment of degree III furcation defects with 2 different resorbable barriers. An experimental study in dogs.

The aim of the present study was to describe the periodontal tissue that formed after GTR when different resorbable barriers were applied to degree III furcation defects. The study was performed in 5 foxhound dogs. The 2nd and 4th premolars in both sides of the mandible were extracted. Degree III furcation defects were produced in the 3rd mandibular premolars. 5 weeks later, GTR therapy using a barrier composed by a polylactide-glycolide copolymer was performed on one quadrant (group A). In the contralateral quadrant, a barrier made of polylactide and citric acid ester (group B) was used. The dogs were sacrificed 6 months after reconstructive therapy. Tissue blocks containing the experimental teeth were excised, demineralised in EDTA and embedded in paraffin. Serial sections were cut in the mesio-distal plane and parallel with the long axis of the roots. The microtome was set at 7 microm. The sections were stained in hematoxyline and eosin. From each biopsy, 3 sections representing the central part of the furcation were selected for light microscopic examination. In the healed furcation sites, descriptive histological analysis and histomorphometric measurements of the newly formed tissues were performed. In both groups the root surface of the healed furcation defects was covered by a cellular, extrinsic-intrinsic fibers type cementum. The composition of the newly formed periodontal ligament was similar in both groups. The proportions of bone, bone marrow and periodontal ligament, however, were substantially larger in group A than in group B. In Group B, an area in the previous furcation defect was consistently occupied by a granuloma. It is suggested that the presence of the granuloma in the healed furcation defect prevented bone regrowth.

Animals↗