In most respects , all membranes and enamel matrix derivative ( EMD ) delivered better outcomes , in the range of 1 to 2 mm , than open flap debridement .
The use of any barrier type or EMD configuration was found to yield more Clinical Attachment Level ( CAL ) gain than any open flap configuration .
GTR was confirmed to be superior to open flap debridement
In a 1998 review article , Laurell and colleagues performed a meta- analysis of relevant guided tissue regeneration ( GTR ) articles over the previous 20 years ( 1 ) .
The purpose of the present research was to exp and on that work , particularly search ing for trends discriminating between bioabsorbable and non-bioabsorbable barriers , as well as the use of enamel matrix derivative , with respect to interproximal bony defects .
Clinical evaluation of calcium sulfate in combination with demineralized freeze-dried bone allograft for the treatment of human intraosseous defects.
BACKGROUND Medical- grade calcium sulfate ( CS ) is a biocompatible , bioabsorbable , and clinical ly versatile ceramic for use in bone repair . This study compared the clinical efficacy of a combination of calcium sulfate dihydrate , as a binder and barrier , and demineralized freeze-dried bone allograft ( DFDBA ) to polytetrafluoroethylene ( ePTFE ) and DFDBA for the treatment of human periodontal defects . METHODS Two intrabony defects were compared in each of 19 patients with chronic periodontitis . After initial preparation , full-thickness mucoperiosteal flaps were elevated , osseous defects debrided , and the roots prepared ( ultrasonic , h and curets , and tetracycline conditioning ) . Defects were r and omly treated with either a combination graft of DFDBA with CS ( 4:1 ) covered by a CS barrier or with DFDBA and fitted with an ePTFE barrier . Flaps were coronally positioned to obtain primary closure . Clinical soft tissue measurements were recorded at 6 months , and all study sites were surgically reentered for evaluation . RESULTS The mean presurgical measurements for defects r and omized to the CS and ePTFE treatments , respectively , were similar for attachment level ( AL ; 6.2 + /- 1.8 mm and 6.1 + /- 1.7 mm ) , probing depth ( PD ; 6.3 + /- 1.1 mm and 6.2 + /- 1.1 mm ) , and gingival recession ( 0.1 + /- 1.9 mm and 0.2 + /- 1.4 mm ) . Defects treated with CS or ePTFE demonstrated statistically significant ( P < or = 0.0001 ) reductions in mean PD ( 2.7 + /- 1.4 mm and 3.4 + /- 1.3 mm , respectively ) and gains in mean AL ( 1.8 + /- 1.5 mm and 1.7 + /- 1.4 mm , respectively ) . Recession increased by 0.8 + /- 1.4 mm at CS sites and 1.6 + /- 1.7 mm at ePTFE-treated sites ( P < or = 0.05 ) . Pretreatment mean defect depths were 4.1 + /- 1.0 mm and 3.7 + /- 1.0 mm for CS and ePTFE sites , respectively . Reentry evaluations revealed a mean defect fill of 2.7 + /- 1.5 mm and 2.5 + /- 0.9 mm for the CS and ePTFE sites , respectively , with a corresponding mean defect resolution of 80.3 + /- 18.7 % and 76.7 + /- 18.5 % . The CS and ePTFE sites did not differ significantly in mean defect fill or defect resolution . CONCLUSIONS The results of this study indicate that calcium sulfate , when used as a binder and barrier in combination with DFDBA , supports significant clinical improvement in intrabony defects , as evidence d by reductions in probing depth , gains in clinical attachment level , and defect fill and resolution .  Calcium sulfate represents an important alternative to non-resorbable ePTFE barriers in combination with DFDBA for the treatment of intrabony defects
In most respects , all membranes and enamel matrix derivative ( EMD ) delivered better outcomes , in the range of 1 to 2 mm , than open flap debridement .
The use of any barrier type or EMD configuration was found to yield more Clinical Attachment Level ( CAL ) gain than any open flap configuration .
GTR was confirmed to be superior to open flap debridement
In a 1998 review article , Laurell and colleagues performed a meta- analysis of relevant guided tissue regeneration ( GTR ) articles over the previous 20 years ( 1 ) .
The purpose of the present research was to exp and on that work , particularly search ing for trends discriminating between bioabsorbable and non-bioabsorbable barriers , as well as the use of enamel matrix derivative , with respect to interproximal bony defects .