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 .
Guided tissue regeneration in conjunction with hydroxyapatite-collagen grafts for intrabony defects. A clinical and radiological evaluation.
This clinical and radiological study evaluated the healing of 3 + 2 + 1 wall-combined intrabony defects treated using the guided tissue regeneration technique ( GTR ) with and without hydroxyapatite-collagen alloplastic graft material s ( HAC ) , in comparison to that of HAC alone and conventional flap surgery ( CF ) .  40 interproximal defects with probing depth > 6 mm were treated in 18 adult periodontitis patients of ages 35 - 60 years . After non-surgical therapy , the defects were r and omly grouped into 4 groups of 10 defects each . These groups were design ated : ( 1 ) exp and ed polytetrafluoroethylene membrane ( e-PTFE ) , ( 2 ) e-PTFE + HAC , ( 3 ) HAC alone and ( 4 ) CF . At 6 months , the following changes in parameters were recorded . Mean PPD reduction for each group was 5.83 , 5.85 , 3.80 and 3.17 mm respectively . PPD reduced very significantly in all groups ( p < 0.01 ) , the highest and lowest reductions in PPD being for the e-PTFE + HAC and CF group respectively . Comparison between the 4 groups showed higher PPD reduction in both membrane groups than in either of the non membrane groups ( p < 0.05 ) with the difference between the e-PTFE and CF groups being very highly significant ( p < 0.001 ) . Mean attachment gain for the 4 groups was 3.70 , 3.80 , 2.60 and 2.1 mm , respectively . Similarly attachment gain for all groups was very significant ( p < 0.01 ) and the highest and lowest attachment gains were for the e-PTFE + HAC and CF group respectively . Both membrane groups showed significantly more attachment gain than the CF group ( p < 0.05 ) . Change in probing bone level ( BL ) for the 4 groups was 1.60 , 1.90 , 1.0 and 0.65 mm respectively . Again the highest changes in BL were recorded for the e-PTFE + HAC group . Significant differences were found between both membrane groups and the CF group ( p < 0.05 ) . Radiological evaluation using st and ardized radiographs and millimeter grids showed change in radiographic bone level at the deepest point of the defect on the radiograph to be 1.50 , 1.55 , 0.85 and 0.60 mm , respectively and this was significantly higher in both membrane groups than in the CF group ( p < 0.05 ) . This study therefore found e-PTFE membranes both alone and when combined with HAC to lead to more attachment gain and bone fill than did HAC alone or CF . It found HAC combined with e-PTFE to perform better although not significantly better than e-PTFE alone
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 .