CLINICAL AND MICROBIOLOGICAL EVALUATION OF A BIOABSORBABLE AND A NONRESORBABLE BARRIER MEMBRANE IN THE TREATMENT OF PERIODONTAL INTRAOSSEOUS LESIONS

Citation
Es. Macdonald et al., CLINICAL AND MICROBIOLOGICAL EVALUATION OF A BIOABSORBABLE AND A NONRESORBABLE BARRIER MEMBRANE IN THE TREATMENT OF PERIODONTAL INTRAOSSEOUS LESIONS, Journal of periodontology, 69(4), 1998, pp. 445-453
Citations number
58
Categorie Soggetti
Dentistry,Oral Surgery & Medicine
Journal title
ISSN journal
00223492
Volume
69
Issue
4
Year of publication
1998
Pages
445 - 453
Database
ISI
SICI code
0022-3492(1998)69:4<445:CAMEOA>2.0.ZU;2-1
Abstract
CLINICAL AND MICROBIOLOGICAL FEATURES of periodontal healing in barrie r membrane-treated sites were determined in a randomized clinical tria l. The study included 10 patients with advanced adult periodontitis an d a minimum of one set of similar 2 to 3 wall intraosseous periodontal lesions with no furcation involvement. In each patient, one periodont al lesion was treated with a biodegradable membrane and a contralatera l lesion with a nonresorbable barrier membrane. Within the preceding 3 months of regenerative therapy, all patients received full mouth osse ous surgery except for the sites for regeneration, were instructed in oral hygiene, and were prescribed systemic ciprofloxacin and metronida zole (250 mg of each, TID, 8 days), starting 7 days before membrane pl acement. At baseline and at 6 months postsurgery, probing depth and cl inical attachment level were assessed in each study site. The subgingi val presence of suspected periodontal pathogens was determined by non- selective and selective culture and by DNA probe analyses, and of huma n cytomegalovirus (HCMV) and Epstein-Barr virus type 1 (EBV-1) by a ne sted-polymerase chain reaction detection method. At baseline, the barr ier-treated sites did not differ significantly in clinical and microbi al parameters. Mean baseline probing depth was 7.8 +/- 1.1 mm for bioa bsorbable and 7.9 +/- 1.3 mm for nonresorbable barrier-treated sites. At 6 months, sites treated with bioabsorbable barrier revealed 4.6 +/- 1.7 mm gain of clinical attachment (range: 1 to 7 mm) and sites treat ed with nonresorbable barrier 4.2 +/- 2.0 mm (range: 1 to 8 mm). The 1 1 barrier-treated sites that harbored 10% or less bacterial pathogens and were free of HCMV and EBV-1 averaged significantly more clinical a ttachment gain than the 9 sites that yielded more than 10% bacterial p athogens and/or test viruses (5.6 mm versus 3.0 mm; P = 0.005). The pr esent data suggest bioabsorbable and nonresorbable barriers provide si milar clinical healing of 2 to 3 wall intraosseous periodontal lesions , emphasize the importance of controlling bacterial pathogens prior to and during periodontal healing, and point to the possible detrimental role of HCMV and EBV-1 in periodontal repair.