Consistently successful regenerative therapy for furcation defects using membrane techniques remains a challenge for clinicians. The purpose of this study was to determine if the thickness of tissue used to cover the membrane influences postsurgery recession. Thirty-seven (37) moderate to advanced adult periodontitis patients presenting with at least one mandibular or maxillary molar class 1 or 2 facial furcation involvement participated in the study. Mid-facial presurgery recession was recorded from the cemento-enamel junction to the free gingival margin at a reproducible point. Mid-facial tissue thickness was measured using calipers at a point 5 mm apical to the gingival margin of the mucogingival flap reflected at the time of guided tissue regeneration surgery. Patients were divided into 2 groups based upon tissue thickness measurement. Patients were then re-evaluated for recession at 6 months postsurgery. Sixteen (16) patients with tissue thickness < or = 1 mm demonstrated a mean 2.1 mm increase in recession, while 21 patients with tissue thickness > 1 mm exhibited a mean 0.6 mm increase in recession. We conclude that there is less post-treatment recession (P < 0.01) for tissue thickness > 1 mm than tissue thickness < or = 1 mm. Hence, thickness of gingival tissue covering a membrane appears to be a factor to consider if post-treatment recession is to be minimized or avoided.

The purpose of this study is to evaluate the potential of decalcified freeze-dried bone allograft (DFDBA) combined with a barrier material in the treatment of human molar furcation defects (experimental) as compared to the barrier technique alone (control). Fifteen pairs of Class II or III furcation invasion defects comprised the study group. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects from each pair were randomly selected to be treated with an expanded polytetrafluoroethylene membrane (e-PTFE) and DFDBA or the membrane alone. Additional measurements were made during surgery to determine crestal resorption, and vertical and horizontal open probing attachment. The membrane was removed 4 to 6 weeks post-insertion. Six months post-treatment, each site was surgically reentered and measurements repeated. Following either treatment, recession was minimal with statistically significant improvement in probing depth reduction and clinical attachment level gain favoring the combined technique. Hard tissue changes were comparable for alveolar crestal resorption, however, there was a distinct difference, statistically, for both horizontal and vertical bone repair favoring the use of the demineralized bone graft in combination with the e-PTFE membrane.

This study revealed the benefits of bioactive glass in the treatment of Class II furcation defects regarding the clinical parameters of probing depth reduction and the reduction in bleeding on probing.

The purpose of this study is to demonstrate the potential of using a barrier in the treatment of palato-gingival groove defects. The study group consisted of 10 patients. Prior to treatment, the palato-gingival groove on maxillary lateral incisors was measured with calibrated periodontal probe from the cemento-enamel junction (CEJ) to the free gingival margin (FGM) and from the FGM to the base of the pocket (BP). Probing depth (PD) was calculated and bleeding on probing indicated. Surgical procedures consisted of flap reflection, removal of granulation tissue, and scaling and root planning of the groove. An expanded polytetrafluoroethylene membrane was sutured over the palato-gingival groove. Six months postsurgery, all measurements were repeated. Statistical analysis compared results using means, standard deviations, and paired t tests. Results showed an improvement in clinical attachment gain, probing depth reduction, and decreased bleeding on probing. This study demonstrates the potential of guided tissue regeneration in the treatment of palato-gingival groove defects. A random blinded clinical trial is necessary, however, to fully assess the potential of this procedure in treatment of palato-gingival groove defects.

No abstract