Periodontal healing following reconstructive surgery: effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized controlled clinical trial

Abstract

OBJECTIVE: The objective of this randomized-controlled clinical trial was to evaluate the adjunctive effect of guided tissue regeneration (GTR) using a bioresorbable polylactic acid (PLA) barrier device when combined with autogenous bone grafting in the treatment of deep intra-bony periodontal defects. MATERIAL AND METHODS: Forty systemically healthy patients (20 females; mean age 53 years; non-smokers) participated in the study. Using a parallel-group study design, one intra-bony defect in each of 20 subjects received GTR using the bioresorbable PLA barrier device (Atrisorb), combined with autogenous bone grafting. One intra-bony defect in each of the remaining 20 subjects received bone grafting solo (control). Treatments were evaluated at 9 months post-surgery. RESULTS: One patient (GTR) was withdrawn from the study due to circumstances unrelated to the study. Eighty-nine per cent of the PLA barriers became exposed within 3 weeks following surgery. Pre-surgery probing depths for GTR and control intra-bony defects averaged (+/-SE) 7.1+/-0.3 mm. Significant probing depth reduction (2.7+/-0.3 versus 2.4+/-0.4 mm), attachment-level gain (1.7+/-0.3 versus 1.7+/-0.5 mm), and bone fill (1.2+/-0.4 versus 1.2+/-0.5 mm) were observed for the GTR and control sites, respectively (p< or =0.02). However, there were no statistically significant differences between treatment protocols. CONCLUSIONS: The results suggest that GTR using the bioresorbable PLA barrier device does not provide additional value to reconstructive surgery including autogenous bone grafting in intra-bony periodontal defects.