Guided tissue regeneration in the treatment of furcation defects in mandibular molars

Abstract

The present investigation was designed to evaluate the regenerative potential of the periodontal tissues in degree III furcation defects at mandibular molars using a treatment procedure based on the principle of guided tissue regeneration. The patient sample included 21 patients, 26-65 years of age, who presented periodontal lesions in the right and left molar regions including "through and through" furcation defects. After an initial examination, each patient was subjected to a series of full-mouth scaling and root planing. 2-3 months later, they were recalled for 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 muco-periosteal flaps at the buccal and lingual aspects of the molars. Granulation tissue was removed and the exposed root surfaces were debrided and planed. The width and the height of the entrance openings to the furcation defects were assessed. A teflon membrane was adjusted to cover the entrances to the defects (buccal and lingual) and was retained in the manner described by Pontoriero et al. (1988). The flaps were repositioned on the outer surface of the membrane and secured by sutures which were removed after 10 days. Following surgery, the patients were instructed to rinse the mouth twice daily for 4 weeks with chlorhexidine gluconate. The membranes were removed after a healing period of 1-2 months. A surgical procedure identical to the test procedure was performed in the control tooth regions with the exception of the placement of membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristics of Newly Formed Bone during Guided Bone Regeneration: Observations by Immunohistochemistry and Confocal Laser Scanning Microscopy.

“…The principle of GBR was originally based on guided tissue regeneration (GTR) methods which isolated bone defects from gingival connective tissues 1,6,8,9,13,21,[24][25][26][27] and created an exclusive space into which only cells from the surrounding bone could migrate. Becker et al 1) compared new bone formation with or without the GBR method.…”

A clinical comparison of the new attachment obtained by guided tissue regeneration and coronally positioned flap techniques in the management of human molar furcation defects

“…A membrane placed over the furcation aperture may provide good wound protection, similar to the coronally positioned flap. 5 Pontoriero et al 3 also pointed out that, especially in f u r c ation treatment using teflon membranes, it should be realized that the soft tissue coverage of the entrance of the furcation may be a factor of importance in success. A membrane placed over the f u r c ation aperture may provide good wo u n d protection, similar to the coronally positioned flap.…”

“…They reported that 14 out of 21 sites which were treated with barriers showed complete closure of the furcation defects, while only two out of 21 sites which were treated with conventional surgery without the barriers resulted in furcation closure. The same investigators 5 further made the evaluation on the treatment of Class III furcations in mandibular molars, and reported that out of 21 'through-and-through' furcation defects which were treated with GTR, eight of them exhibited complete closure and 10 exhibited partial closure of the furcation as they were observed clinically. None of the previous 21 Class III furcations treated by conventional surgery alone healed with complete with guided tissue regeneration or coronally positioned flap by:…”

Hard Tissue Formation by Human Periodontal Ligament Fibroblast Cells Treated with an Emdogain^|^reg;-Derived Oligopeptide in vitro

“…Currently, many patients still choose guided tissue regeneration (GTR) with a nonresorbable or resorbable membrane, an autogenous graft or a combination of these methods for periodontal regenerative therapy in Japan [10][11][12] . Therefore, to best utilize the clinical data obtained regarding the regenerative effects and postoperative stability of EMD, EMD-derived synthetic peptides should be developed.…”