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.
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Acknowledgments
This study was partly supported by the Periodontal Research Fund of the Unit of Periodontology at the Eastman Dental Institute, University College London, UK, and a scholarship from the Royal Thai Government. The authors acknowledge supports from staff at the Eastman Clinical Investigation Centre, Dr. Jean Suvan for randomisation processes, Dr. Francesco D’Aiuto for technical support in the subtraction radiography, Ms. Bambai Hirani and Ms. Donna Moskal-Fritzpatrick for chair-side clinical assistance and trial coordination.
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This study was reviewed and approved by the National Hospital for Neurology and Neurosurgery/Institute of Neurology and the Eastman Joint Research Ethics Committee, London, UK (study reference: 04/Q0512/93).
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The authors declare that they have no competing interests.
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Rakmanee, T., Griffiths, G.S., Auplish, G. et al. Radiographic outcomes following treatment of intrabony defect with guided tissue regeneration in aggressive periodontitis. Clin Oral Invest 20, 1227–1235 (2016). https://doi.org/10.1007/s00784-015-1609-y
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DOI: https://doi.org/10.1007/s00784-015-1609-y