Guided tissue regeneration in surgically‐produced furcation defects

Abstract

The aim of the investigation was to evaluate the potential for new attachment formation at various degree III furcation involvements in the beagle dog. 3 differently shaped furcation defects were prepared; one small and one large key-hole defect, and one furcation defect which was part of "circumferential" loss of attachment and bone. 15 beagle dogs were used in the experiments. The furcation defects were surgically created at mandibular premolars in the right and left side of the jaw. Test teeth were subsequently treated according to the GTR principle, while control teeth were treated without the application of membranes. The result from the histological examination of biopsy specimens revealed that GTR treatment may result in complete new attachment at surgically produced "through and through" furcation involvements in dogs. The study, however, also revealed that the size of the furcation defect as well as the shape of the surrounding alveolar bone were factors that determined the outcome of this kind of treatment. The treatment failures were consistently associated with flap recession during healing which resulted in the exposure of the furcation defect.

Characteristics of newly‐formed cementum following emdogain application

“…Such light microscopic splits seem to commonly occur in non-guided repair [30] and healing under (GTR) [31][32][33]. Recent studies of GTR also suggested that the formation of these artifacts did not depend on whether or not the root surfaces had been exposed surgically [33] or were exposed as a result of periodontitis [31,34]. Separation of regenerative cementum from the underlying dentin could not be prevented by the employment of growth and differentiation factors [35][36].…”

Application of autologous periosteal cells for the regeneration of class III furcation defects in Beagle dogs

“…In this study, the heights of defects were more than 4 mm, and the average area in the three groups was 10.62 mm 2 . Pontoriero et al (1992) pointed out that, in the ''horizontal'' defects only the bone wall in the bottom supported cells to induce periodontal regeneration. Hovey et al (2006) demonstrated that plaque was detrimental to traditional surgery and periodontal regeneration.…”

“…But its therapeutic effect on class III furcation defects was limited. Pontoriero et al (1992) reported that GTR was capable of closing class III furcation defects successfully in a dog model. However, the regeneration of class III furcation defects was always incomplete.…”

Periodontal regeneration following transplantation of proliferating tissue derived from periodontal ligament into class III furcation defects in dogs

“…Various surgical procedures have been developed for healing class II or III furcation defects (4,6), and various bone grafts and alloplastic materials have been transplanted (5,24,29); however, ankylosis, resorption, and long epithelial attachment are observed in alloplastic material-applied cases (8). It has been demonstrated that GTR is capable of successfully closing class III furcation defects in a dog model (11,17,18); however, the regeneration of class III furcation defects is often incomplete, even when GTR is employed, suggesting that this treatment is not effective for large, class III furcation defects (15,21,22), as it depends on natural healing ability. Since pPDL is basically capable of synthesizing periodontal tissue after transplantation, this treatment may be applicable to large periodontal tissue defects.…”