Treatment of mandibular Grade II furcation defects using demineralized freeze-dried bone allograft alone or in combination with guided tissue regeneration membrane – A randomized controlled clinical trial.

Sudha Swati; Ira Gupta; Saranik Sarkar

doi:10.21276//ujds.2023.9.2.8

Sudha Swati Post Graduate Trainee, Rama University
Ira Gupta Professor, Department of Periodontology, Rama Dental College, Kanpur, UttarPradesh, India
Saranik Sarkar Consultant Periodontist, Dr. Sarkar's Dental Clinic & Implant Center, Howrah, WestBengal, India

DOI: https://doi.org/10.21276//ujds.2023.9.2.8

Abstract

Background– Periodontal disease, if not interfered, will headway further with attachment loss involving the bifurcation or trifurcation of multirooted teeth. Furcation involved molar teeth respond less favorably to conventional periodontal therapy alone resulting into tooth loss. Combining osseous grafting with guided tissue regeneration membrane may enhance the response to treatment as compared to graft – only therapy by achieving mechanical stabilization and preventing micromovement of the bone graft material.

Aim & Objective – To compare the efficacy of demineralized freeze-dried bone allograft alone or in combination with guided tissue regeneration membrane in the treatment of mandibular Grade II furcation defects.

Materials & method - In this study a total number of 20 patients with 20 mandibular sites (buccal grade II furcation involvement) were evaluated. They were divided into two groups: Control group (bone graft only) and test group (bone graft + GTR). The clinical parameters assessed were vertical probing depth, horizontal probing depth and relative clinical attachment level.

Results – In this study the statistical analyses comparing test and control sites at baseline revealed no significant differences between the two groups for any of the clinical parameters considered. At 6 month evaluation, significant difference was found between two groups regarding VPD, HPD and rCAL.

Conclusion – It was concluded that there is a significant enhanced effect of using DFDBA bone graft in combination with GTR membrane over bone graft alone for the treatment of mandibular Grade II furcation defects.

References

1. Newman MG, Takei H, Klokkevold PR, Carranza FA. Chronic PeriodontitisIn: Carranza’s Clinical Periodontology, 10thed, Elsevier, 2006;494-9.
2. McFall W. Tooth loss in 100 treated patients with periodontal disease. J Periodontol 1982; 53:539-49.
3. Becker W, Becker BE, Berg LE. Periodontal treatment without maintenance: A retrospective study in 44 patients. J Periodontol 1984; 55: 505-7.
4. Ji-Sook P, Jong-Jin S, Seong-Ho C, Ik-Sang M, Chong-Kwan K. Effects of pretreatment clinical parameters on bioactive glass implantation in intrabony periodontal defects. JPeriodontol 2001; 72: 730-40.
5. Karring T, Cortellini P. Regenerative therapy: Furcation Defects. Periodontol 2000 1999; 19: 115-37.
6. Mellonig JT. Decalcified freeze-dried bone allograft as an implant material in human periodontal defect. Int J Periodontics Restorative Dent 1984; 4:41-55.
7. Quintero G, Mellonig JT, Gambill V, Pellen G. A six-month clinical evaluation of decalcified freeze-dried bone allograft in periodontal osseous defects. J Periodontol 1982;53:726-30.
8. Bowers G, Granet M, Stevens M. Histologic evaluation of new attachment in humans. A preliminary report. J Periodontol 1985; 56:381-96.
9. Dorfer CE, Kim TS, Steinbrenner H, Holle R, Eickholz P. Regenerative periodontal surgery in interproximal intrabony defects with bioresorbable barriers. J Clin Periodontol 2000; 27: 162- 8.
10. Gottlow J, Nyman S, Karring T, Wennstrom J. New attachment formation in the human periodontium by guided tissue regeneration: Case reports. J Clin Periodontol 1986; 13: 604-16.
11. Becker W, Becker B, Prichard J, Caffesse R, Rosenberg E, Gian-Grasso J. Root isolation for new attachment. J Periodontol 1987; 58: 819-26.
12. Prathap S, Hegde S, Kashyap R, Prathap MS. Clinical evaluation of porous hydroxyapatite bone graft (Periobone G) with and without collagen membrane (Periocol) in the treatment of bilateral grade II furcation defects in mandibular first permanent molars. J Indian Soc Periodontol. 2013: 17; 2: 228-34.
13. Stahl S, Froum S, Kushner L. Healing responses of human teeth following the use of debridement grafting and citric acid root conditioning. II. Clinical and histologic observation: One year post surgery. J Periodontol1983;54:325-38.
14. Malathi KG, Dev JN, Kumar KS, Srikanth C, Ravi Chandra PV, Paul A. A clinical evaluation of a bioresorbable membrane and porous hydroxyapatite in the treatment of human molar class II furcations. J Indian SocPeriodontol.2013 ;17:617-23.
15. Lekovic V, Kenney EB, Kovacevic K, Carranza FA. Evaluation of guided tissue regeneration in Class II furcation defects. A clinical re-entry study. J Periodontol. 1989; 60:694-8.
16. Wang HL, Neal RB, Thomas CL, Syr Y, MacNeil RL. Evaluation of an absorbable collagen membrane in treating class II furcation defects. J Periodontol 1994;65:1029-36.
17. Lamb JW, Greenwell H, Drisko C, Henderson RD, Scheetz JP, Rebitski G. A comparison of porous and non-porous teflon membranes plus demineralized freeze- dried bone allograft in the treatment of class II buccal/lingual furcation defects: A clinical reentry study. J Periodontol. 2001;72:1580–7.