Abstract

Healing following periodontal reconstructive surgery including surgical implantation of a collagen matrix or demineralized freeze-dried bone allograft (DFDBA) was evaluated in a preclinical (collagen) and a clinical (DFDB A) study.

Contralateral periodontal fenestration defects in 7 beagle dogs were used to evaluate the effect of a collagen matrix on periodontal healing. The defects (6x4 mm) were created through the buccal cortical plates of the maxillary canine teeth following elevation of mucoperiosteal flaps. The collagen was fitted to the defects on one side, while contralateral defects served as controls. Raps were repositioned and sutured. Dogs were sacrificed 4 weeks after surgery and block sections including teeth and surrounding structures were prepared for histometric analysis. No meaningful differences in cementum and bone regeneration were observed between treatments. There was seemingly more bone regeneration and significantly more cementum regeneration in the apical than in the coronal aspect of the defects. Root resorption was observed in one collagen and one control defect. Ankylosis was not observed. The results suggest that the maxillary canine periodontal fenestration defect can be used as a model to evaluate factors that may enhance cementum and bone regeneration. The collagen matrix neither enhanced nor inhibited periodontal healing in this model.

Clinical healing following periodontal reconstructive surgery including wound closure supported by an expanded polytetrafluoroethylene (ePTFE) membrane with or without DFDBA was evaluated in 20 intrabony defects. Ten intrabony defects, one in each of 10 patients, were treated with reconstructive surgery including the ePTFE membrane with DFDBA. Another 10 defects, one in each of 10 other patients, received the ePTFE membrane alone. A postsurgical protocol emphasizing wound stabilization and infection control was used. Healing was evaluated 6 months post surgery. Both groups exhibited similar pre-surgical probing and defect depths. For the ePTFE with DFDBA group, pre-surgical probing and defect depths averaged 7.9±1.8 and 8.3±1.6 mm, respectively. Probing depth reduction following therapy approximated 2.8±2.5 mm, clinical attachment gain 2.1±2.8 mm, defect bone fill 1.5+1.9 mm, and gingival recession increase 0.7±1.5 mm. For the ePTFE group, pre-surgical probing and defect depths averaged 7.2±1.1 and 6.3±1.9 mm, respectively. Probing depth reduction following therapy approximated 3.7+1.2 mm, clinical attachment gain 1.8±2.1 mm, defect bone fill 1.7±2.1 mm, and gingival recession increase 1.9±1.4 mm. Probing depth reduction, clinical attachment gain, and defect bone fill were statistically significant compared to baseline for both treatment groups. No significant differences were found between groups for the clinical parameters except for a significant difference in probing depth reduction at defect adjacent sites. The addition of DFDBA to the membrane procedure did not appear to enhance periodontal healing beyond that achieved by the membrane alone in the treatment of intrabony defects.

It may be concluded that, within the limitations of this studies, neither the collagen matrix nor the DFDBA-implant significantly influenced periodontal healing.

LLU Discipline

Periodontics

Department

Periodontics

School

Graduate School

First Advisor

Ulf M. E. Wikesjö

Second Advisor

Knut A. Selvig

Third Advisor

Grenith J. Zimmerman

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1994

Date (Title Page)

6-1994

Language

English

Library of Congress/MESH Subject Headings

Periodontics -- surgery

Type

Thesis

Page Count

2; vi, 37

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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