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
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.