Human histologic evaluation of bioactive ceramic in the treatment of periodontal osseous defects

This study examined the healing of intrabony defects around 5 teeth treated with bioactive glass ceramic (PerioGlas). Healing was evaluated by clinica l measurements, radiographic observation, and histologic analysis. The prot ocol included a presurgical phase of scaling and root planing therapy, with measurements obtained immediately prior to the surgical procedures and aft er 6 months of healing. Following therapy there was a mean of 2.7 mm of pro bing depth reduction, 2.2 mm of clinical attachment gain, and 0.5 mm of rec ession. The histologic analysis revealed healing by a long junctional epith elium with minimal new connective tissue attachment to the teeth, except in one case where the intrabony region demonstrated new cementum formation an d new connective tissue attachment. Graft particles were found to be biocom patible, as evidenced by being embedded in a stroma of dense connective tis sue with minimal inflammatory infiltrate. There was minimal new bone format ion limited to the most apical borders of the defects. No signs of periodon tal regeneration as defined by new cementum, periodontal ligament, and bone formation on a previously diseased root surface were observed. Although th e clinical results are encouraging and radiographs evidenced radiopacities within the defects, histologic analysis revealed that as a periodontal graf ting material, bioactive glass ceramic has only limited regenerative proper ties.