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

Abstract

Objective The aim of this study was to compare the clinical and radiographic efficacy of guided tissue regeneration with a modified perforated collagen membrane (MPM) or standard collagen membrane (CM) in the treatment of intrabony defects in patients with aggressive periodontitis (AgP). Materials and methods Fifteen AgP patients were included in the study. Two single intrabony defects of at least 3 mm depth with ≥ 6 mm probing pocket depth (PPD) from each patient were randomly assigned to either xenogenic graft plus MPM (test group) or xenogenic graft plus CM (control group). PPD, clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and at 12 months. The radiographic assessments included the measurements of defect depth (DD), change in alveolar crest position (ACP), linear defect fill (LDF), and percentage defect fill (%DF). Results After treatment, PPD, CAL, DD, and ACP values improved significantly in both groups, without statistical differences between them. However, with respect to LDF and %DF, the 12-month radiographic analysis at MPM-treated sites showed a significant improvement compared to the 6-month outcomes, that was not observed at control sites (additional LDF of 0.4 ± 0.5 mm, p = 0.010 and %DF of 6.4 ± 7.6%, p = 0.025). Conclusions Both strategies proved effective in the treatment of intrabony defects in patients with AgP. Nonetheless, enhanced LDF and %DF 12 months postoperatively at MPM-treated sites may stem from cellular and molecular migration from the periosteum and overlying gingival connective tissue through barrier's pores. Clinical relevance Modification of CM may have positive ramifications on periodontal regeneration.

Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: subtraction radiography outcomes, prognostic variables, and patient morbidity

“…With that in mind, Gamal and Iacono [14] were able to validate the superior clinical performance of novel modified perforated collagen membranes (MPM) in regenerative treatment of intrabony defects in patients diagnosed with severe ChP. Very recently, the authors of the present study demonstrated enhanced defect fill when using MPM compared with standard collagen membranes (CMs) in AgP patients [15]. Moreover, MPM resulted in improved periodontal regeneration in dehiscence defects in dogs with the formation of significantly denser bone trabeculations, more rapid bone maturation, and higher bone surface area, as compared with CM [16].…”

“…Adapting a split-mouth design, two comparative intrabony defects from each patient were selected and subsequently treated by one of the two periodontal regenerative treatment modalities in a 2-week time span. One defect was randomly treated with xenogenic graft plus modified perforated membrane (test), and the second defect was treated with xenogenic graft and standard collagen membrane (control) [15]. Randomization was performed before surgical treatment by the statistician, who used a computerized random number generator.…”

“…Additional information regarding patient flow, sample size calculation, and calibration has been thoroughly described in previous publication in Clinical Oral Investigations [15].…”

“…This study is a 12-month RCT of two periodontal treatment modalities of intrabony defects: GTR with MPM (tests) and GTR with CM (controls) in AgP patients. Its clinical and radiographic outcomes have previously been published [15]. The aim of this report was to measure changes in bone/graft density by means of DSR after GTR.…”

Guided tissue regeneration of intrabony defects with perforated barrier membranes, simvastatin, and EDTA root surface modification: A clinical and biochemical study

“…Moreover, Paolantonio et al reported more alveolar crest resorption after 1 year of receiving GTR with occlusive collagen membrane alone. On the other hand, Górski et al reported significant defect base fill following the use of PBM compared to OM in patients with aggressive periodontitis. CBL was found significantly higher in group 2 and group 4 compared with group 1, a finding that supports previous finding of more alveolar crest resorption associated with OM use when compared with that of the PBM at 9 months periods .…”