Periodontal healing following reconstructive surgery: Effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized-controlled trial 10-year follow-up

Per Nygaard-Østby, Vibeke Bakke, Oddny Nesdal, Cristiano Susin, Ulf M E Wikesjö

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: The objective of this 10-year randomized-controlled trial follow-up was to evaluate the stability of treatment outcomes following the implantation of autogenous bone graft with or without guided tissue regeneration (GTR) in the treatment of deep intra-bony periodontal defects. Materials and Methods: Forty patients exhibiting deep intra-bony periodontal defects were included in a randomized-controlled trial evaluating the adjunctive effect of GTR to autogenous bone graft. Twenty-six of 39 patients completing the original study were available for follow-up 10 years post-treatment. The patients had been included in a structured maintenance programme and were evaluated using the criteria of the original study by the same investigators. Results: Significant improvements in the probing depth and clinical attachment level were observed for both groups between baseline and 9 months. Whereas the autogenous bone graft+GTR group showed significant improvements in probing bone levels and increased gingival recession at 9 months, no significant differences were observed for the autogenous bone graft group. Nine-month within-group results were maintained throughout the 10-year follow-up. Nevertheless, between-group comparisons at 10 years showed that the autogenous bone graft+GTR group exhibited significantly greater probing depth reduction (mean ± SE: 4.2 ± 0.5 versus 2.7 ± 0.5 mm, p=0.023) and probing bone-level gain (3.9 ± 0.8 versus 1.3 ± 0.9 mm, p=0.034) than the autogenous bone graft group. Borderline significant differences between the autogenous bone graft+GTR and the autogenous bone graft groups were observed for clinical attachment level gain at 10 years (3.8 ± 0.5 versus 2.2 ± 0.7 mm, p=0.067), whereas no significant differences were observed for gingival recession (0.7 ± 0.3 versus 0.6 ± 0.5 mm, p>0.05). Conclusions: The results of this randomized study suggest that statistically significant differences were found with the adjunct use of GTR to an autogenous bone graft at 10 years. Nevertheless, these results should be interpreted with caution in light of its clinical relevance and biological rationale. Importantly, resolution of deep intra-bony periodontal defects can be maintained in the presence of a structured maintenance programme emphasizing high oral hygiene standards.

Original languageEnglish (US)
Pages (from-to)366-373
Number of pages8
JournalJournal of Clinical Periodontology
Volume37
Issue number4
DOIs
StatePublished - Apr 1 2010

Fingerprint

Reconstructive Surgical Procedures
Guided Tissue Regeneration
Bone Transplantation
Randomized Controlled Trials
Bone and Bones
Equipment and Supplies
Transplants
Gingival Recession
Maintenance
Oral Hygiene

Keywords

  • Autogenous bone graft
  • Barrier membrane
  • Guided tissue regeneration
  • Long term
  • Periodontal regeneration
  • Polylactic acid
  • Randomized-controlled trial

ASJC Scopus subject areas

  • Periodontics

Cite this

Periodontal healing following reconstructive surgery : Effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized-controlled trial 10-year follow-up. / Nygaard-Østby, Per; Bakke, Vibeke; Nesdal, Oddny; Susin, Cristiano; Wikesjö, Ulf M E.

In: Journal of Clinical Periodontology, Vol. 37, No. 4, 01.04.2010, p. 366-373.

Research output: Contribution to journalArticle

@article{96cc4d3fab714efd8440f0fa9b15dcda,
title = "Periodontal healing following reconstructive surgery: Effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized-controlled trial 10-year follow-up",
abstract = "Objective: The objective of this 10-year randomized-controlled trial follow-up was to evaluate the stability of treatment outcomes following the implantation of autogenous bone graft with or without guided tissue regeneration (GTR) in the treatment of deep intra-bony periodontal defects. Materials and Methods: Forty patients exhibiting deep intra-bony periodontal defects were included in a randomized-controlled trial evaluating the adjunctive effect of GTR to autogenous bone graft. Twenty-six of 39 patients completing the original study were available for follow-up 10 years post-treatment. The patients had been included in a structured maintenance programme and were evaluated using the criteria of the original study by the same investigators. Results: Significant improvements in the probing depth and clinical attachment level were observed for both groups between baseline and 9 months. Whereas the autogenous bone graft+GTR group showed significant improvements in probing bone levels and increased gingival recession at 9 months, no significant differences were observed for the autogenous bone graft group. Nine-month within-group results were maintained throughout the 10-year follow-up. Nevertheless, between-group comparisons at 10 years showed that the autogenous bone graft+GTR group exhibited significantly greater probing depth reduction (mean ± SE: 4.2 ± 0.5 versus 2.7 ± 0.5 mm, p=0.023) and probing bone-level gain (3.9 ± 0.8 versus 1.3 ± 0.9 mm, p=0.034) than the autogenous bone graft group. Borderline significant differences between the autogenous bone graft+GTR and the autogenous bone graft groups were observed for clinical attachment level gain at 10 years (3.8 ± 0.5 versus 2.2 ± 0.7 mm, p=0.067), whereas no significant differences were observed for gingival recession (0.7 ± 0.3 versus 0.6 ± 0.5 mm, p>0.05). Conclusions: The results of this randomized study suggest that statistically significant differences were found with the adjunct use of GTR to an autogenous bone graft at 10 years. Nevertheless, these results should be interpreted with caution in light of its clinical relevance and biological rationale. Importantly, resolution of deep intra-bony periodontal defects can be maintained in the presence of a structured maintenance programme emphasizing high oral hygiene standards.",
keywords = "Autogenous bone graft, Barrier membrane, Guided tissue regeneration, Long term, Periodontal regeneration, Polylactic acid, Randomized-controlled trial",
author = "Per Nygaard-{\O}stby and Vibeke Bakke and Oddny Nesdal and Cristiano Susin and Wikesj{\"o}, {Ulf M E}",
year = "2010",
month = "4",
day = "1",
doi = "10.1111/j.1600-051X.2010.01532.x",
language = "English (US)",
volume = "37",
pages = "366--373",
journal = "Journal of Clinical Periodontology",
issn = "0303-6979",
publisher = "Blackwell Munksgaard",
number = "4",

}

TY - JOUR

T1 - Periodontal healing following reconstructive surgery

T2 - Effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized-controlled trial 10-year follow-up

AU - Nygaard-Østby, Per

AU - Bakke, Vibeke

AU - Nesdal, Oddny

AU - Susin, Cristiano

AU - Wikesjö, Ulf M E

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Objective: The objective of this 10-year randomized-controlled trial follow-up was to evaluate the stability of treatment outcomes following the implantation of autogenous bone graft with or without guided tissue regeneration (GTR) in the treatment of deep intra-bony periodontal defects. Materials and Methods: Forty patients exhibiting deep intra-bony periodontal defects were included in a randomized-controlled trial evaluating the adjunctive effect of GTR to autogenous bone graft. Twenty-six of 39 patients completing the original study were available for follow-up 10 years post-treatment. The patients had been included in a structured maintenance programme and were evaluated using the criteria of the original study by the same investigators. Results: Significant improvements in the probing depth and clinical attachment level were observed for both groups between baseline and 9 months. Whereas the autogenous bone graft+GTR group showed significant improvements in probing bone levels and increased gingival recession at 9 months, no significant differences were observed for the autogenous bone graft group. Nine-month within-group results were maintained throughout the 10-year follow-up. Nevertheless, between-group comparisons at 10 years showed that the autogenous bone graft+GTR group exhibited significantly greater probing depth reduction (mean ± SE: 4.2 ± 0.5 versus 2.7 ± 0.5 mm, p=0.023) and probing bone-level gain (3.9 ± 0.8 versus 1.3 ± 0.9 mm, p=0.034) than the autogenous bone graft group. Borderline significant differences between the autogenous bone graft+GTR and the autogenous bone graft groups were observed for clinical attachment level gain at 10 years (3.8 ± 0.5 versus 2.2 ± 0.7 mm, p=0.067), whereas no significant differences were observed for gingival recession (0.7 ± 0.3 versus 0.6 ± 0.5 mm, p>0.05). Conclusions: The results of this randomized study suggest that statistically significant differences were found with the adjunct use of GTR to an autogenous bone graft at 10 years. Nevertheless, these results should be interpreted with caution in light of its clinical relevance and biological rationale. Importantly, resolution of deep intra-bony periodontal defects can be maintained in the presence of a structured maintenance programme emphasizing high oral hygiene standards.

AB - Objective: The objective of this 10-year randomized-controlled trial follow-up was to evaluate the stability of treatment outcomes following the implantation of autogenous bone graft with or without guided tissue regeneration (GTR) in the treatment of deep intra-bony periodontal defects. Materials and Methods: Forty patients exhibiting deep intra-bony periodontal defects were included in a randomized-controlled trial evaluating the adjunctive effect of GTR to autogenous bone graft. Twenty-six of 39 patients completing the original study were available for follow-up 10 years post-treatment. The patients had been included in a structured maintenance programme and were evaluated using the criteria of the original study by the same investigators. Results: Significant improvements in the probing depth and clinical attachment level were observed for both groups between baseline and 9 months. Whereas the autogenous bone graft+GTR group showed significant improvements in probing bone levels and increased gingival recession at 9 months, no significant differences were observed for the autogenous bone graft group. Nine-month within-group results were maintained throughout the 10-year follow-up. Nevertheless, between-group comparisons at 10 years showed that the autogenous bone graft+GTR group exhibited significantly greater probing depth reduction (mean ± SE: 4.2 ± 0.5 versus 2.7 ± 0.5 mm, p=0.023) and probing bone-level gain (3.9 ± 0.8 versus 1.3 ± 0.9 mm, p=0.034) than the autogenous bone graft group. Borderline significant differences between the autogenous bone graft+GTR and the autogenous bone graft groups were observed for clinical attachment level gain at 10 years (3.8 ± 0.5 versus 2.2 ± 0.7 mm, p=0.067), whereas no significant differences were observed for gingival recession (0.7 ± 0.3 versus 0.6 ± 0.5 mm, p>0.05). Conclusions: The results of this randomized study suggest that statistically significant differences were found with the adjunct use of GTR to an autogenous bone graft at 10 years. Nevertheless, these results should be interpreted with caution in light of its clinical relevance and biological rationale. Importantly, resolution of deep intra-bony periodontal defects can be maintained in the presence of a structured maintenance programme emphasizing high oral hygiene standards.

KW - Autogenous bone graft

KW - Barrier membrane

KW - Guided tissue regeneration

KW - Long term

KW - Periodontal regeneration

KW - Polylactic acid

KW - Randomized-controlled trial

UR - http://www.scopus.com/inward/record.url?scp=77949696389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77949696389&partnerID=8YFLogxK

U2 - 10.1111/j.1600-051X.2010.01532.x

DO - 10.1111/j.1600-051X.2010.01532.x

M3 - Article

C2 - 20447260

AN - SCOPUS:77949696389

VL - 37

SP - 366

EP - 373

JO - Journal of Clinical Periodontology

JF - Journal of Clinical Periodontology

SN - 0303-6979

IS - 4

ER -