GUIDED TISSUE REGENERATION IN THE TREATMENT OF DEGREE-II FURCATIONS IN MAXILLARY MOLARS

The present clinical trial was designed to evaluate the clinical effec t of GTR in the treatment of degree II furcation defects in maxillary molars. 28 patients, 21 to 59 years of age, referred for treatment of advanced periodontal disease were included. They presented with simila r periodontal lesions in the right and the left maxillary molar region s, but had only one surface which exhibited furcation involvement. A t otal of 28 pairs of contralateral furcation defects of degree II inclu ding 18 interproximal pairs (10 mesial, 8 distal) and 10 buccal pairs, were available for the study. After the completion of basic therapy, the furcation involved molars in the right and left quadrants in each patient were randomly assigned to either a test or a control treatment procedure. Following flap elevation, scaling, root planing and granul ation tissue removal, an e-PTFE membrane at the test site was adjusted to cover the entrance to the furcation defect and adjacent bone and w as retained in this position with sling sutures. The mucoperiostal fla ps were subsequently adjusted and positioned to cover the entire surfa ce of the membrane and were secured in this position. An identical sur gical procedure was performed in the control tooth regions with the ex ception of the placement of a teflon membrane. No periodontal dressing was used. Starting the day before surgery and continuing for 7 days, the patients received 1+1 g of Amoxicillin per day; morning and evenin g. The sutures were removed after 10 days. At the test sites, the memb ranes were removed after 6 weeks of healing. The treated sites were ex amined and re-entry procedures performed 6 months after reconstructive surgery. Open flap debridement at maxillary furcations of degree II r esulted in some gingival recession and probing depth reduction, but no change occurred in parameters describing probing attachment or bone l evels. The addition of GTR at buccal furcations enhanced the treatment result by promoting probing attachment and bone gain and reduced the amount of soft tissue recession above what was accomplished by flap de bridement alone. No such benefit of membrane therapy was observed at m esial and distal furcations.