PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 1 (2004), No. 3     1. Oct. 2004
PERIO - Periodontal Practice Today 1 (2004), No. 3  (01.10.2004)

Page 247-253

Periodontal Regeneration: A Split-Mouth Controlled Clinically 5-Year Case Study
Gassmann, Georg/Westermann, Dirk/Grimm, Wolf-Dieter
Guided tissue regeneration (GTR) with biodegradable polylactide/polyglycolide acid (PLA/PGA) membranes was compared to open curettage and scaling and root planing (SRP) and reevaluated after 6 months and 5 years. Wound healing up to the sixth week postoperatively is considered to be important for the regenerative effect. The purpose of the study was to determine whether GTR is superior to open curettage and SRP. Thirty-six teeth in 20 patients (8 females/12 males) with an average age of 44.6 years (17-64 years) were treated with GTR, applying resorbable PLA/PGA membranes. Either open curettage or SRP was carried out on contralateral teeth. After 2, 4 and 6 weeks, wound healing was assessed. After intraindividual comparison to conventionally treated reference teeth, the difference of the clinical attachment level (!CAL), furcation involvement, and PPD was measured 6 months and 5 years postoperatively. The statistical significance was tested with the Mann-Whitney U-test. Disturbed wound healing was only seen after the GTR procedure (8 membrane exposures after 2 weeks, 1 after 4 weeks, none after 6 weeks). After 6 months, !CAL measured 1.5 mm (3.9 mm/2.4 mm) in comparison to open curettage and 0.9 mm (3.3 mm/2.3 mm) compared to SRP. Five years after GTR, there was a mean attachment gain of 3.8 mm. Our study shows that GTR with resorbable membranes is superior to open curettage and SRP in the treatment of vertical bone defects.

Keywords: resorbable PLA/PGA membranes, furcation involvement, vertical bony defects, guided tissue regeneration, GTR