Guided tissue regeneration in the treatment of furcation defects in man
R. Pontoriero, Sture Nyman, Jan Lindhe, Edwin S. Rosenberg, F Sanavi
Abstract
R. Pontoriero, Sture Nyman, Jan Lindhe, Edwin S. Rosenberg, F Sanavi
Abstract
Abstract The regenerative potential of the periodontal tissues in degree II and III furcation detects at mandibular molars was assessed in a clinical trial using a surgical treatment technique based on the principles of guided tissue regeneration. The patient sample included 37 subjects who had periodontal lesions in the right and left mandibular molar regions, including advanced periodontal destruction within the radicular area. Following a baseline examination, the furcation‐involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of mucoperiosteal flaps and the placement of a teflon membrane to cover the entrance of the furcation area and the adjacent root surfaces as well as a portion of the alveolar bone apical to the crest. The flaps were repositioned and secured with interdental sutures. A procedure identical to the one used at the test teeth was performed at the control tooth regions with the exception of the placement of the teflon membrane. Following surgery, all patients were placed on a plaque control regimen which involved daily rinsing with chlorexidine gluconate and, in addition, professional tooth cleaning once every 2 weeks for 6 months. After 6 months of healing, the test and control sites were re‐examined. The findings demonstrated that the treatment of degree II furcation defects at mandibular molars using the principles of guided tissue regeneration in 19 sites out of 21 resulted in the resolution of the furcation defect. Conventional therapy reached the same goal in less than 20% of the cases treated. At degree III furcation defects, complete resolution occurred in 4 out of 16 sites treated with guided tissue regeneration. Partial resolution occurred in 9 out of 16 sites, while at 3 sites, a degree III involvement persisted. Treatment of degree III furcation involvements in the Control group failed to result in the resolution of any of the furcation defects.
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Abstract The regenerative potential of the periodontal tissues in degree II and III furcation detects at mandibular molars was assessed in a clinical trial using a surgical treatment technique based on the principles of guided tissue regeneration. The patient sample included 37 subjects who had periodontal lesions in the right and left mandibular molar regions, including advanced periodontal destruction within the radicular area. Following a baseline examination, the furcation‐involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of mucoperiosteal flaps and the placement of a teflon membrane to cover the entrance of the furcation area and the adjacent root surfaces as well as a portion of the alveolar bone apical to the crest. The flaps were repositioned and secured with interdental sutures. A procedure identical to the one used at the test teeth was performed at the control tooth regions with the exception of the placement of the teflon membrane. Following surgery, all patients were placed on a plaque control regimen which involved daily rinsing with chlorexidine gluconate and, in addition, professional tooth cleaning once every 2 weeks for 6 months. After 6 months of healing, the test and control sites were re‐examined. The findings demonstrated that the treatment of degree II furcation defects at mandibular molars using the principles of guided tissue regeneration in 19 sites out of 21 resulted in the resolution of the furcation defect. Conventional therapy reached the same goal in less than 20% of the cases treated. At degree III furcation defects, complete resolution occurred in 4 out of 16 sites treated with guided tissue regeneration. Partial resolution occurred in 9 out of 16 sites, while at 3 sites, a degree III involvement persisted. Treatment of degree III furcation involvements in the Control group failed to result in the resolution of any of the furcation defects.
Key concepts: Furcation defect, Molar, Medicine, Dentistry, Periodontal fiber, Dental alveolus, Mandibular molar, Interdental consonant