Periodontal repair in dogs: expanded polytetrafluoroethylene barrier membranes support wound stabilization and enhance bone regeneration.
ABSTRACT A wound stabilizing effect of expanded polytetrafluoroethylene (ePTFE) membranes was evaluated in supra-alveolar periodontal defects in 5 beagle dogs. The defects, 5 to 6 mm in height, were surgically created around the 2nd, 3rd, and 4th mandibular premolar teeth in contralateral jaw quadrants. The root surfaces were conditioned with heparin, which, in this model, has been demonstrated to compromise periodontal healing and result in formation of a long junctional epithelium. Wound closure included application of ePTFE membranes around each premolar tooth in one jaw quadrant in each dog and flap positioning coronal to the cemento-enamel junction in both jaw quadrants. Healing progressed uneventfully except for 3 teeth in 2 dogs, which experienced membrane exposure. The dogs were sacrificed after a 4-week healing period and tissue blocks were prepared for histometric analysis. Connective tissue repair in heparin+membrane-treated teeth averaged 98% of the defect height compared to 84% in control heparin-treated teeth (P < or = 0.05). Junctional epithelium formation was smaller in membrane-treated teeth than in control teeth (P < or = 0.05) and was usually terminated coronal to the membrane. Bone regeneration was enhanced in membrane-treated teeth compared to controls (P < or = 0.01) and was strongly correlated to the area under the membrane in teeth without membrane exposure (r2 = 0.993; P = 0.002). This correlation was reduced when teeth with membrane exposure were included in the analysis (P < or = 0.05). Cementum regeneration was minimal under both treatment conditions. Root resorption was increased in membrane-treated compared to control teeth (P < or = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Periodontology 2000 02/2006; 41:30-47. · 3.96 Impact Factor
Article: Single flap approach with and without guided tissue regeneration and a hydroxyapatite biomaterial in the management of intraosseous periodontal defects.[show abstract] [hide abstract]
ABSTRACT: The single flap approach (SFA) is a minimally invasive procedure designed for periodontal reconstructive procedures of intraosseous periodontal defects characterized by a dominant unilateral, buccal or oral, extension. This study evaluates the adjunctive effect of guided tissue regeneration (GTR) combined with a hydroxyapatite (HA) biomaterial in the management of intraosseous periodontal defects accessed with SFA compared to SFA alone. Twenty-four intraosseous defects (in 24 patients) were randomly allocated to treatment with SFA or SFA + HA/GTR. Clinical outcomes were assessed 6 months post-surgery. Five sites in the SFA + HA/GTR group showed incomplete closure at week 2, which resolved spontaneously. There were no statistically significant or clinically meaningful differences in mean (+/-SD) clinical attachment gain (4.7 +/- 2.5 versus 4.4 +/- 1.5 mm), probing depth reduction (5.3 +/- 2.4 versus 5.3 +/- 1.5 mm), and gingival recession increase (0.4 +/- 1.4 versus 0.8 +/- 0.8 mm) between the SFA + HA/GTR and SFA groups. SFA with and without HA/GTR seems to be a valuable minimally invasive approach in the treatment of deep intraosseous periodontal defects. Under the present experimental conditions, the additional HA/GTR protocol offers no significant adjunctive effect.Journal of Periodontology 09/2010; 81(9):1256-63. · 2.60 Impact Factor
Article: A resin-modified glass ionomer cement barrier for treating degree II furcation defects: a pilot study in dogs.[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to evaluate in an animal model the healing of degree II furcation defects treated with: an experimental barrier of resin-modified glass-ionomer cement (GIC), a polylactic acid barrier (GUI), and flap surgery (CTR). In 3 beagles, 18 class II furcation defects were surgically produced in mandibular and maxillary premolars and exposed to plaque accumulation for 21 days. Following a full flap, notches were made at the base to the bone defect. GIC barriers were prepared immediately before use from a commercial product and fit to place with the same product. The GIC barriers were removed after 30 days and the dogs euthanized after 120 days. Histologic sections were analyzed in a computer-assisted microscope. Epithelium, new cementum with inserting fibers, and connective tissue lining the root surface in-between notches were measured and medians of percentage values calculated. In the GIC, epithelium constituted 3.5% (median values) of the notch-to-notch root area; new cementum was 83.6% and connective tissue 12.9%. These values were 0%, 73.6%, and 26.4% for the GUI group and 35.6%, 43.2%, and 0% for the CTR group. Bone fill median values were 54.3% for GIC, 20.6% for GUI, and 24.6% for CTR. GIC and GUI prevented epithelial migration and promoted the formation of new periodontal tissues in experimentally induced class II furcation defects in dogs.Acta Odontologica Scandinavica 03/2006; 64(1):37-41. · 1.07 Impact Factor