| Gingivitis and periodontitis were infectious diseases that afflicted a high percentage of the population, even at younger ages. A report from the American Association for Dental Research that 48% of adults aged 35-44 had inflammation of the gingiva (gingivitis), and 22% destructive periodontal disease - a major cause of tooth loss, and the percentage in China was higher. The ultimate aim of periodontitis therapy was to realize periodontal regeneration, which was defined as the reproduction or reconstruction of lost or injured part of tissues whose structures were restored.Guided tissue regeneration (GTR), a surgical procedure that specifically aims to regenerate the periodontal tissues, had become a routine treatment method in the management of bone defects resulting from periodontal diseases. the membrane of GTR serves as a barrier that separates fast-growing soft tissue from the newly cleaned surface of the tooth root. The membrane enables slower-growing fibers and bone cells to migrate into the protected area. However, the effectiveness of GTR in the treatment of moderate and heavy bone defects was still unpredictable.PURPOSE:To evaluate the stability of clinical attachment level gains following guided tissue regeneration with Bio-gide and Bio-Oss in the treatment of moderate and heavy periodontal bone defects.Methods:41 patients suffering moderate and heavy periodontitis were enrolled. It comprised 23 men and 18 women. The age ranged from 18 to 59 years old (mean age 38.5). 41 teeth from these patients were randomly divided into 2 groups. 31 teeth were treated by GTR and BG (bone grafts). The soft (gum) tissue was surgically separated from these chosen tooth and the tooth surface was thoroughly cleaned and infected tissues were removed from the area. After cleaning some Bio-Oss was filled into the bone defects, and then a propotional piece of membrane called a Bio-Gide was placed against the tooth. 10 teeth were treated just by flap surgery (FS) as control. Following the therapy, specific instructions for proper oral hygiene and care of the area under treatment was provided. PD and AL were reexamined and recorded before and after surgery and analyzed. Differences between the groups were analyzed using Statistical Analysis System (SAS) 8.0. The criteria for statistical significance were accepted at the probability level P < 0.05. Results:All the 41 patients enrolled could finish the therapy and keep appropriate oral hygiene program after the surgery. The average length of new attachment formed in the group of GTR and BG was 3.71±0.52mm, which was significantly higher than the control (P<0.01), and less gingival recession occurs. Bone filling could observed at the sites of bone defects according to X-ray pictures. No statistically significant differences were found between 6-month and 12-month in both PD and AL (P >0.05).Conclusion:Combination of Bio-Gide and Bio-oss can get a stability of clinical attachment level gains in the treatment of posterior teeth with moderate and heavy bone defects. |
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