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 outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap alone. A multicenter randomized controlled clinical trial.
AIM This prospect i ve multicenter r and omized controlled clinical trial was design ed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material . MATERIAL S AND METHODS One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries . All patients had at least one intrabony defect of > or = 3 mm . The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure . After debridement , the regenerative material was applied in the test subjects , and omitted in the controls . At baseline and 1 year following the interventions , clinical attachment levels ( CALs ) , probing pocket depths ( PPDs ) , recession , full-mouth plaque scores and full-mouth bleeding scores ( FMBS ) were assessed . RESULTS One year after treatment , the test defects gained 3.3 + /- 1.7 mm of CAL , while the control defects yielded a significantly lower CAL gain of 2.5 + /- 1.5 mm . Pocket reduction was also significantly higher in the test group ( 3.7 + /- 1.8 mm ) when compared with the controls ( 3.2 + /- 1.5 mm ) . A multivariate analysis indicated that the treatment , the clinical centers , baseline PPD and baseline FMBS significantly influenced CAL gains . Odds ratios ( ORs ) of achieving above-median CAL gains were significantly improved by the test procedure ( OR = 2.6 , 95 % CI 1.2 - 5.4 ) and by starting with deeper PPD ( OR = 1.7 , 1.3 - 2.2 ) but were decreased by receiving treatment at the worst-performing clinical center ( OR = 0.9 , 0.76 - 0.99 ) . CONCLUSIONS The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains , PPD reductions and predictability of outcomes with respect to papilla preservation flaps 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 .