Results from our analysis suggest that there is no statistically significant difference in PAL gain between GTR and EMD. The clinical outcomes of this pilot study may be of little significance, considering the small number of patients, but it has provided an important base for a controlled clinical trial (with a larger number of patients) which is currently in progress.
The patients were reevaluated at one year postop. Probing attachment level (PAL) gain and PD reduction were analyzed. In the Emdogain group the PAL before surgery (PAL 0) and the PD before surgery (PD 0) were respectively 9.9+/-1.4 and 8.5+/-1.6 mm. The PAL gain and the PD reduction at 1 year postsurgery were respectively 4.1+/-1.8 and 5.3+/-1.9 mm. The group of patients treated with membranes showed that PAL 0 and PD 0 were respectively 8.9+/-1.9 and 8.1+/-1.9. The PAL gain was 4.3+/-1.9 mm and the PD reduction was 5.6+/-1.5 mm. The mean PAL gain expressed by percentage (PAL gain/PAL 0) for the group treated with EMD was 41%, while it was 48% for the group treated with GTR. Results from our analysis suggest that there is no statistically significant difference between GTR and EMD treatments in terms of PAL gain, PD reduction and recession variation. Applying the regression model to a group of patients with a PAL 0 > or =8 mm, we observed a better clinical outcome in terms of PAL gain (difference of 0.3 mm) in patients treated with the GTR procedure compared to those treated with EMD. Covariance analysis showed a strong correlation in both groups of patients between PAL gain and full mouth bleeding score, and between PAL gain and defect morphology and depth.
The use of membranes for periodontal regeneration is well established. In clinical use, the exposure of membranes to the oral microflora may result in a pathway for periodontal infections. An important role in this process is played by Porphyromonas gingivalis. The purpose of the present study was to examine the colonization of 6 different bioresorbable and nonresorbable membranes for periodontal regeneration by the strain DSM 20709 of P. gingivalis and to determine the time needed by this microorganism to pass through the membranes. A device consisting of a tube sealed with the membranes and filled with a medium suitable for the growth of P. gingivalis was incubated in a bigger tube containing the same medium to study the process of colonization and the crossing of membranes. The outer tube was inoculated with 10(4) cells of P. gingivalis DSM 20709. The passage of bacteria through the membranes was monitored at 6, 24, and 48 hours by counting the number of cells in the inner tube. The colonized membranes were observed using a scanning electron microscope. Differences in the behavior of the 6 membranes analyzed were demonstrated.
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