HEALING IN PERIODONTAL DEFECTS TREATED BY DECALCIFIED FREEZE-DRIED BONE ALLOGRAFTS IN COMBINATION WITH EPTFE MEMBRANES - ASSESSMENT BY COMPUTERIZED DENSITOMETRIC ANALYSIS

This study quantitatively assessed radiographic changes in alveolar bo ne density by computer-assisted densitometric image analysis (CADIA) i n periodontal defects that were treated with decalcified freeze dried bone allograft (DFDBA) alone or in combination with interproximal expa nded polytetrafluoroethylene membranes (ePTFE). The radiographic chang es where then analyzed for correlation with the clinically assessed ch anges. The radiographic changes were evaluated on standardized radiogr aphs of treated sites treated prior to, 1 week after surgery, and 6 mo nths post-operatively. 15 patients with one pair of bilateral interpro ximal periodontal defects of similar morphology and greater-than-or-eq ual-to 6 mm in pocket depth participated. Analysis of the changes 6 mo nths after treatment showed that the increases in density in the defec t areas that received the graft were significantly greater than the ad jacent areas (p < 0.001). These adjacent areas, in contrast, demonstra ted significantly larger loss in radiographic density than the defect area (p < 0.001). The placement of DFDBA into the defects produced in itself significant increases in radiographic density, as illustrated b y the results of one week which remained at six months. Utilization of ePTFE addition to DFDBA did not lead to additional radiographic gains in the defect area. While at one week the analysis suggested increase d resorption by the combined treatment over grafting alone, such diffe rences did not persist at 6 months post-surgery. Analysis comparing CA DIA derived values for change with those of the clinical assessment re vealed some associations. When categorizing outcomes of density measur ements as equal to 0 or numerically greater than 0, changes in density showed a non-random correlation with clinical changes expressed by th e distance from CEJ to the bottom of the defect (p < 0.001) among site s treated by DFDBA. The corresponding correlation was not significant upon adjunctive treatment by ePTFE. Further analysis, however, demonst rated that the magnitudes of change by the different assessment method s were not significantly correlated. This may be an effect of the regi on-of-interest selection in this study. Further studies are needed to clarify the correlations between radiographic and clinical methods for assessing treatment effects.