Thanasak Rakmanee1,2, Gareth S Griffiths3, Gita Auplish1, Ulpee Darbar1, Aviva Petrie4, Irwin Olsen1, Nikolaos Donos5,6. 1. Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, UK. 2. Faculty of Dentistry, Thammasat University, Patumthani, 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, 256 Gray's Inn Road, London, WC1X 8LD, UK. n.donos@ucl.ac.uk. 6. Institute of Dentistry Barts & The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), New Road, London. n.donos@ucl.ac.uk.
Abstract
OBJECTIVES: This study reports the radiographic analysis of a split-mouth, single-blinded, randomised controlled clinical trial which was designed to compare the efficacy of simplified papilla preservation flap (SPPF) with or without guided tissue regeneration (GTR) in patients with aggressive periodontitis (AgP). METHODS:Eighteen AgP patients who had similar bilateral intrabony defects were treated. In all patients, the defects presented with radiographic evidence of an intrabony defect ≥3 and ≥5 mm of periodontal pocket depths (PPD). The surgical procedures included access for root instrumentation using SPPF alone (control) or, after debridement, a placement of resorbable GTR membrane (test). The standardised radiographic assessments were carried out at pre-surgical baseline and at 6 and 12 month post-surgery. Radiographic linear measurements and subtraction radiography were used as the method of analysis. RESULTS: Both treatments showed significant improvements in linear radiographic bone fill and defect resolution at 6 and 12 months, compared to baseline. The 12-month subtraction radiography at the GTR sites showed a significant improvement compared to the 6-month outcomes. CONCLUSIONS: Both therapies were effective in the treatment of intrabony defects in AgP patients although no significant differences between them could be demonstrated. The finding that the bone fill and resolution of the defect at the GTR sites were significantly higher at 12 months than at 6 months after treatment indicates that bone regeneration is still an ongoing process at 6 months post-surgery. CLINICAL RELEVANCE: Radiographic assessment of periodontal regeneration should be carried out at 12 months post-surgery in order to evaluate the complete healing of the bony defect.
RCT Entities:
OBJECTIVES: This study reports the radiographic analysis of a split-mouth, single-blinded, randomised controlled clinical trial which was designed to compare the efficacy of simplified papilla preservation flap (SPPF) with or without guided tissue regeneration (GTR) in patients with aggressive periodontitis (AgP). METHODS: Eighteen AgP patients who had similar bilateral intrabony defects were treated. In all patients, the defects presented with radiographic evidence of an intrabony defect ≥3 and ≥5 mm of periodontal pocket depths (PPD). The surgical procedures included access for root instrumentation using SPPF alone (control) or, after debridement, a placement of resorbable GTR membrane (test). The standardised radiographic assessments were carried out at pre-surgical baseline and at 6 and 12 month post-surgery. Radiographic linear measurements and subtraction radiography were used as the method of analysis. RESULTS: Both treatments showed significant improvements in linear radiographic bone fill and defect resolution at 6 and 12 months, compared to baseline. The 12-month subtraction radiography at the GTR sites showed a significant improvement compared to the 6-month outcomes. CONCLUSIONS: Both therapies were effective in the treatment of intrabony defects in AgP patients although no significant differences between them could be demonstrated. The finding that the bone fill and resolution of the defect at the GTR sites were significantly higher at 12 months than at 6 months after treatment indicates that bone regeneration is still an ongoing process at 6 months post-surgery. CLINICAL RELEVANCE: Radiographic assessment of periodontal regeneration should be carried out at 12 months post-surgery in order to evaluate the complete healing of the bony defect.
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