Abstract
Background: There is still inadequate information available regarding the role of GTR techniques in such lesions with the presently available data suggesting that there is a possibility of healing of apico-marginal defects without use of GTR technique by using modern microsurgical procedures. Fewer randomized-clinical trials have evaluated the response of GTR membranes in the treatment of apico-marginal defects. Aim: The present prospective, controlled clinical trial was, therefore, planned to evaluate the role of collagen membrane as GTR material in the healing of apico-marginal defects. Subjects and Methods: Thirty patients meeting inclusion criteria were selected and allocated randomly to either the GTR membrane group or, the control group. Clinical and radiographic examination was done after one week for baseline measurements and then, during follow-ups at regular intervals of 3, 6, 9, and 12 months after the procedure. The criteria for success included the absence of clinical signs and symptoms and signs of radiographic healing. Statistical Analysis Used: The statistical analysis of the ordinal data was carried-out by using non-parametric methods. Mann-Whitney and Wilcoxon signed rank test were used for the unpaired and paired data respectively. Chi-square test was used to evaluate dichotomous data. Results: Significant reductions were observed in the periodontal pocket depth (PD), clinical attachment level (CAL), gingival margin position (GMP) and the size of the peri-apical lesion at 12-month follow-up (P < 0.05) in each treatment group except gingival margin position (GMP) in the GTR membrane group with the corresponding P value being 0.059. The results for the reduction in the size of the peri-apical lesion were, also, found to be statistically significant with the corresponding P value being <0.05. Furthermore, 83.33% of the patients showed complete healing in case of GTR membrane group while the same was found to be 90.9% in case of the control group although the difference in the percentage reduction in the size of the peri-apical lesion at different time intervals after surgery was found to be statistically insignificant between the two groups. Conclusion: The results of the present study indicated that there might not be any additional clinical advantage obtained from GTR membrane barriers in the surgical management of isolated apico-marginal defects of primary endodontic origin with absent or, minimal proximal bone loss.
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