Guided tissue regeneration/deproteinized bovine bone mineral or papilla preservation flaps alone for treatment of intrabony defects. II: radiographic predictors and outcomes
Author
: Antonio Lin˜ ares
Publisher
: journal of clinical periodontology
Summary :Objectives: This study reports the secondary analysis of a randomized-controlled
clinical trial designed to assess the efficacy of deproteinized bovine mineral and a
collagen membrane in the treatment of intrabony defects. The specific aims of this
report are (1) to analyse the radiographic bone changes 1 year after therapy and (2) to
assess the association between radiographic defect angle and treatment outcomes.
Materials and Methods: Baseline and 12-month radiographs were collected from
120 patients with advanced chronic periodontitis from 10 centres in seven countries as
part of a multi-centre clinical trial. All patients had at least one intrabony defect
X3mm in depth. The treatment consisted of simplified or modified papilla
preservation flaps to access the defect. After debridement of the area, a deproteinized
bovine mineral and a collagen membrane were applied in the test subjects, and omitted
in the controls. Main outcome measures were radiographic bone fill and defect
resolution 1 year after surgery.
Results: One hundred and twenty pairs of radiographs were obtained, of which 110
pairs were measurable (57 tests and 53 controls). One year after treatment, radiographic
resolution of the intrabony component was significantly higher in the test group
(3.2 1.7mm) when compared with the controls (1.7 1.9mm). Multivariate analysis
indicated that the treatment and the baseline radiographic depth of the intrabony defect
significantly influenced the radiographic bone fill of the intrabony defect 1 year
following treatment. The percentage of resolution of the defect was influenced by the
treatment provided and the baseline plaque score. The baseline radiographic defect
angle did not show a significant impact on the clinical and radiographic outcomes.
Conclusions: Regenerative periodontal surgery with a deproteinized bovine bone
mineral and a collagen membrane offered additional benefits in terms of radiographic
resolution of the intrabony defect and predictability of outcomes with respect to papilla
preservation flaps alone.
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