Five-year stability of clinical attachment after regenerative treatment of infrabony defects compared to controls.

Abstract

To evaluate the stability of attachment achieved in infrabony defects by regenerative treatment over 60±12months compared to control teeth. Patients treated regeneratively in at least one infrabony defect between 2004 and 2010 were screened for this retrospective cohort study. Complete examinations available for baseline, 12 and 60±12months after surgery, and a respective control tooth without treatment, provided eligibility for analysis. Twenty-seven patients (age 58±11.7years; 12 females, five smokers) were included, each contributing one infrabony defect and one control tooth. Regenerative therapy resulted in significant attachment gain (2.7±1.6mm; p<0.001) after 1 and (3.0±2.2mm; p<0.001) 5years. Control teeth were stable (vertical probing attachment level [PAL-V] change: 1year: 0±0.8mm; 5years: -0.2±1.2mm). The study did not detect any significant change of PAL-V from 1 to 5years after surgery for regenerative (-0.3±2.4mm) and control teeth (-0.2±1.4mm). Multivariate analysis associated smoking and generalized recurrence of periodontitis (amount of sites with PPD>5mm) with attachment loss. PAL-V achieved by regenerative therapy in infrabony defects is as stable over 5years as periodontally reduced but gingivally healthy or gingivitis sites. Smoking and periodontitis recurrence are associated with attachment loss.