Thanasak Rakmanee1,2, Gareth S Griffiths1,3, Gita Auplish1, Ulpee Darbar1, Aviva Petrie4, Irwin Olsen1, Nikolaos Donos5,6. 1. Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK. 2. Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand. 3. School of Clinical Dentistry, University of Sheffield, Sheffield, UK. 4. Biostatistics Unit, UCL Eastman Dental Institute, London, UK. 5. Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK. n.donos@ucl.ac.uk. 6. Department of Periodontology, UCL-Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, UK. n.donos@ucl.ac.uk.
Abstract
OBJECTIVE: The aim of this study was to compare clinical outcomes between guided tissue regeneration (GTR) and access flap (AF) surgery in patients with aggressive periodontitis (AgP). METHODS:Eighteen AgP patients with similar bilateral intrabony defects were treated in this split-mouth, single-blinded, randomised, controlled clinical trial. All patients presented with ≥3 mm intrabony defects and ≥5 mm periodontal pocket depths (PPD). In each patient, one defect was treated with a polyglycolide membrane according to the GTR principle, whereas the contralateral side was treated with AF. For both sides, a simplified papilla preservation flap was used. At baseline, 6 and 12 months post-surgery, the clinical attachment levels (CAL) and PPD were evaluated. RESULTS: At 6 and 12 months, at the GTR sites, the mean [95 % CI] CAL gain was 1.7 mm [1.1, 2.3] and 1.6 mm [0.9, 2.1], respectively, while the mean [95 % CI] PPD reduction was 2.3 mm [1.9, 2.8] and 2.4 mm [1.9, 2.8], respectively. Similar CAL (1.6 mm [1.0, 2.2] and 2.1 mm [1.4, 2.7]) and PPD (2.0 mm [1.5, 2.4] and 2.5 mm [2.0, 3.0]) outcomes were observed at the control sites at 6 and 12 months, respectively. Notably, at the GTR-treated sites, 13 subjects presented with various degrees of membrane exposure. CONCLUSIONS: Both therapies were effective in the treatment of intrabony defects in AgP patients, and no statistically significant differences between them could be demonstrated, possibly as a result of the differing degrees of membrane exposure at the GTR sites. CLINICAL RELEVANCE: Both periodontal regeneration and conventional periodontal surgery are effective treatments for AgP patients.
RCT Entities:
OBJECTIVE: The aim of this study was to compare clinical outcomes between guided tissue regeneration (GTR) and access flap (AF) surgery in patients with aggressive periodontitis (AgP). METHODS: Eighteen AgP patients with similar bilateral intrabony defects were treated in this split-mouth, single-blinded, randomised, controlled clinical trial. All patients presented with ≥3 mm intrabony defects and ≥5 mm periodontal pocket depths (PPD). In each patient, one defect was treated with a polyglycolide membrane according to the GTR principle, whereas the contralateral side was treated with AF. For both sides, a simplified papilla preservation flap was used. At baseline, 6 and 12 months post-surgery, the clinical attachment levels (CAL) and PPD were evaluated. RESULTS: At 6 and 12 months, at the GTR sites, the mean [95 % CI] CAL gain was 1.7 mm [1.1, 2.3] and 1.6 mm [0.9, 2.1], respectively, while the mean [95 % CI] PPD reduction was 2.3 mm [1.9, 2.8] and 2.4 mm [1.9, 2.8], respectively. Similar CAL (1.6 mm [1.0, 2.2] and 2.1 mm [1.4, 2.7]) and PPD (2.0 mm [1.5, 2.4] and 2.5 mm [2.0, 3.0]) outcomes were observed at the control sites at 6 and 12 months, respectively. Notably, at the GTR-treated sites, 13 subjects presented with various degrees of membrane exposure. CONCLUSIONS: Both therapies were effective in the treatment of intrabony defects in AgP patients, and no statistically significant differences between them could be demonstrated, possibly as a result of the differing degrees of membrane exposure at the GTR sites. CLINICAL RELEVANCE: Both periodontal regeneration and conventional periodontal surgery are effective treatments for AgP patients.
Authors: T Rakmanee; E Calciolari; I Olsen; U Darbar; G S Griffiths; A Petrie; Nikolaos Donos Journal: Clin Oral Investig Date: 2018-11-29 Impact factor: 3.573