Treatment of Intrabony Defects with Anorganic Bone Matrix/P-15 or Guided Tissue Regeneration in Patients with Aggressive Periodontitis

Abstract

Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.

Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial

“…Surprisingly, only two RCT studies (three articles) have been reported in the literature and none of the biomaterials used could be affiliated with better outcomes. In Queiroz et al's study, the use of a nonresorbable barrier resulted in similar changes to those obtained in patients in which the bone substitute was mixed with P-15 without any membrane [33]. In Rakmanee et al's research, both clinical and radiographic results showed substantial comparability between GTR procedures and access flap therapies [27,34].…”

Periodontal regeneration in aggressive periodontitis patients: A systematic review of the literature

“…A summary of the studies' characteristics is presented in Table . Two RCT (three articles) were found to be moderate risk of bias . Of the other included studies, 12 were case reports; one was a retrospective study; and six were non‐randomized, comparative studies .…”

“…Most of the included studies reported the outcomes obtained after the treatment of young participants, apparently confirming that AgP seemed to be related to the age of development. However, it should be noted that some studies considered patients' age as an inclusion criteria, thus limiting a priori the number of older participants. This aspect is a direct consequence of the fact that age of onset was considered a diagnostic criterion.…”

Effect of Early Membrane Removal on the Treatment of Mandibular Class II Furcation Defects - A Controlled Clinical Trial with Re-entry after 12 Months

“…Experimental studies demonstrated the regenerative potential of GTR to promote periodontal regeneration (3,5). The clinical efficacy of this procedure for Class II furcation regeneration was established in a meta-analysis carried out by Kinaia et al (18).…”

“…Expanded polytetrafluoroethylene (ePTFE) membrane is a non-resorbable material extensively investigated for the treatment of periodontal defects, with significant gains in new attachment (5). The period for membrane removal varies from 4 to 6 weeks after placement (6); a previous study has shown the benefit of ePTFE membrane retrieval at this time (7), and longer periods did not provide additional benefits (8).…”