HEALING IN PERIODONTAL DEFECTS TREATED BY DECALCIFIED FREEZE-DRIED BONE ALLOGRAFTS IN COMBINATION WITH EPTFE MEMBRANES .1. CLINICAL AND SCANNING ELECTRON-MICROSCOPE ANALYSIS

This study clinically evaluates the use of decalcified freeze-dried bo ne allograft (DFDBA) in conjunction with an expanded polytetrafluoroet hylene (ePTFE) membrane specifically designed for the treatment of int erproximal intraosseous defects. It also examines by SEM, plaque conta minated membranes retrieved from patients. 15 advanced periodontitis p atients with two bilateral interproximal probing depths of greater-tha n-or-equal-to 6 mm participated. After hygiene phase, measurements wer e made to determined soft tissue recession, pocket depth, clinical att achment levels and amount of keratinized tissue. Defects from each pai r were randomly treated with ePTFE plus DFDBA (experimental) or DFDBA alone (control). Measurements were made during the surgery to determin e crestal resorption, defect resolution and defect fill. Membranes wer e removed at 4 to 6 weeks and analyzed by SEM. Each site was surgicall y reentered and measurements repeated at six months. Both groups showe d clinical and statistically significant changes when compared to base line (P<0.01), but no difference between groups. The experimental grou p showed increased soft tissue recession vs control group, 0.9 versus 0.4 mm, and loss of keratinized tissue 1.6 versus 0.1 mm (P < 0.0001). Control sites showed a 58% bone fill while experimental sites had 70% bone fill. There were no clear patterns of microbial colonization or cell adherences in either side of the membrane. It was concluded that the presence of plaque on the membranes did not compromise the initial clinical healing during the first 4-6 weeks. Results suggest a benefi cial effect with the use of either technique for the treatment of intr aosseous defects.