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International Poster Journal of Dentistry and Oral Medicine
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Int Poster J Dent Oral Med 11 (2009), No. 2     15. June 2009

Int Poster J Dent Oral Med 2009, Vol 11 No 2, Poster 442

Long-term Results of Guided Tissue Regeneration Therapy with non-resorbable and bioabsorbable barriers

Language: English
 

Authors:
Dr. Bernadette Pretzl, PD Dr. Dr. Ti-Sun Kim,
Sektion Parodontologie, Poliklinik für ZEH, MZK-Klinik Heidelberg
Prof. Dr. Peter Eickholz
Poliklinik für Parodontologie des Carolinum, Johann-Wolfgang-Goethe-Universität Frankfurt

Date/Event/Venue:
July 2-5, 2008
IADR 2008
Convention Center Toronto, Canada
 

Objectives

10-year follow-up to evaluate the long-term results after GTR therapy of infrabony defects using non-resorbable and bioabsorbable barriers.
 

Guided Tissue Regeneration

 
Fig. 1-2: Intraoperative view: Membrane placement (patient #5)  
 
Fig. 3-4: Intraoperative view: Membrane placement (patient #5)
 
 

Material and Methods

Patients

• 12 patients aged 32 to 62 years (mean age 46.1 ± 10.1)
• written informed consent
• one pair of similar contralateral infrabony defects per patient
• GTR surgery 10 years before
• random assignment of one defect within each patient to a non-resorbable (control: C) and the other to a bioabsorbable (test: T) barrier

Examination

At 6 sites per tooth at baseline, 12 and 120 ± 6 months after surgery:
• GI and PlI [Löe 1967]
• PD and CAL-V to the nearest 0.5 mm using a straight periodontal probe (reference for CAL-V measurements: cemento-enamel junction (CEJ) / margin of restoration
• At the 120 ± 6 months examination, vertical probing bone level (PBL-V) under local anaesthesia
• samples for Interleukin-1-testing (IAI, Zuchwil/CH; Hain Lifescience, Nehren/Germany)
• detailed questionnaire on smoking, dental care, social status, and nutrition

Statistical analysis

• statistical unit: patient
• primary outcome variable: change of CAL-V
• secondary outcome variable: PBL-V
• SystatTM for Windows Version 10, Systat Inc. Evanston IL, USA
 

Results

• Eight of 12 patients available for 120 ± 6 months examinations
• Twelve and 120 months after GTR therapy vertical attachment (CAL-V) gain was statistically significant (p < 0.05) in both groups
• However, 120 ± 6 months after GTR therapy 3 infrabony defects (2 controls, 1 test) had lost >2mm of the attachment gained 12 months after GTR
• A statistically significant mean CAL-V loss of 1.7 ± 1.3mm was observed from 12 to 120 ± 6 months in the control group
• One tooth in the control group was lost between 60 and 120 ± 6 months.
• The case series failed to show statistically significant differences between test and control regarding CAL-V gain 120 ± 6 months after surgery.

Pat # Age Teeth Test/Control Defect Site Regular SPT Number of Recalls Mean± SD GBI Mean± SD PCR Smoking IL-1β-
poly-
morphism
Other
1 59 31/19 mesial/distal + 22 1.9 ± 2.1 17.0 ± 6.3 never - -
2 49 14/3 mesial/distal + 21 2.1 ± 2.4 30.7 ± 14.4 never - -
3 45 13/5 distal/mesial - 10 5.7 ± 4.3 13.2 ± 5.1 never - -
4 54 19/30 mesial + 27 2.9 ± 4.3 29.5 ± 12.8 never - -
5 35 21/27 distal + 15 5.1 ± 4.7 21.7 ± 18.6 active - -
8 50 27/22 mesial - 8 7.4 ± 5.1 15.1 ± 11.2 never - -
9 32 29/20 mesial/distal + 17 4.5 ± 3.5 13.9 ± 6.3 never - -
10 20 19/30 distal + 21 5.2 ± 4.3 21.0 ± 12.3 never - -
11 37 14/3 distal + 18 4.2 ± 3.1 32.5 ± 10.3 former - -
12 64 13/4 distal + 19 9.0 ± 8.4 22.4 ± 7.1 active - -
13 42 22/27 mesial + 17 8.0 ± 6.2 23.1 ± 10.2 active + -
Polydioxanon Polylactide
Pat # PAL-V Baseline 12 Months 120 Months PAL-V Baseline 12 Months 120 Months
1 10.0 4.5 5.0 10.0 4.0 10.5*
2 9.0 4.0 6.5* 9.0 5.0 5.0
3 8.0 6.0 6.5 8.5 5.0 lost
4 9.0 4.0 6.5* 9.0 7.0 5.0
5 9.5 6.0 10.0* 10.0 5.0 9.0*
8 9.0 3.0 5.0 6.0 2.5 4.5
9 8.5 6.0 5.0 9.5 5.5 5.0
10 5.0 2.0 3.5 6.0 2.0 3.5
11 7.0 3.0 3.5 7.0 2.5 3.5
12 9.0 5.5 7.5 10.0 6.0 lost
13 8.5 7.5 8.5 10.0 6.5 8.5

• PBL-V measurements after 10 years could be obtained only in 10 defects of 5 patients
• A PBL-V gain of 2.7 ± 1.7 mm (P = 0.018) was observed in the test group and of 0.8 ± 0.6 mm (P = 0.035) in the control group.
• However, PBL-V gain in the study failed to show statistically significant differences between Polyglactin 910 and ePTFE.

Fig. 5-7: Of each patient standardized radiographs were obtained pre-surgical, 12 and 120 month after surgery (patient #1)
 

Conclusions

CAL-V gain achieved 12 months after GTR therapy in infrabony defects using both non-resorbable and bioabsorbable barriers was stable after 10 years in 12 of 16 defects.
 

This Poster was submitted by Dr. Bernadette Pretzl.
 

Correspondence address:
Dr. Bernadette Pretzl
MZK-Klinik Heidelberg
Sektion Parodontologie, Poliklinik für ZEH
Im Neuenheimer Feld 400
69120 Heidelberg