Abstract
Molars with a furcation involvement (FI) exceeding grade 1 according to Hamp's classification are at approximately doubled risk of tooth loss. Guided tissue regeneration (GTR) is a regenerative approach in the treatment of periodontal defects and is aimed at achieving new clinical attachment formation. The aim of this case series was to assess the efficacy of a newly reintroduced polylactic acid (PLA) matrix barrier and to evaluate the feasibility of the surgical approach. 11 patients with an average age of 58.7 years were treated with GTR using a PLA matrix barrier. Patients were instructed not to brush and chew on the treated side for 4 weeks. A gentle clinical probing was performed after 6 months for the first time after surgery. The patients were included into individual maintenance program at three months' interval. The clinical improvement was expressed by reduced horizontal penetration of the probe accompanied by vast resolution of the vertical defect component. The change from grade II to grade I or complete resolution of the FI could be seen in 8 from 11 sites included. The newly reintroduced PLA matrix barrier showed promising results after a 12-month observation period with clinical attachment gain.
Highlights
Periodontal attachment loss in the furcation area plays a pivotal role in the long-term prognosis of molars in both the mandible and the maxilla
Several systematic reviews have shown greater probing depth reduction, clinical attachment gain, and gain in hard tissue with Guided tissue regeneration (GTR) compared with open flap debridement in both intrabony and furcation involvement (FI) grade II defects [9] [10]
The clinical improvement was expressed by reduced horizontal penetration of the probe (Figures 8(a) and 8(c)) accompanied by vast resolution of the vertical defect component (Table 1) (Figures 8(b) and 8(d)), which often could be followed radiographically (Figures 8(e) and 8(f))
Summary
Periodontal attachment loss in the furcation area plays a pivotal role in the long-term prognosis of molars in both the mandible and the maxilla. Several systematic reviews have shown greater probing depth reduction, clinical attachment gain, and gain in hard tissue with GTR compared with open flap debridement in both intrabony and FI grade II defects [9] [10] In this context, despite the observation that a complete furcation closure may rarely occur, the evidence points to the fact that GTR may often convert grade II furcation defects to grade I, which improves the long-term tooth prognosis [11]. The long-term stability achieved with the GTR technique using the PLA barrier has been reported for a period of 6 to 7 years previously [19] In this case series, the authors report the outcomes in 11 consecutively treated patients by applying the Guidor matrix barrier using the MPPT protocol. The results obtained clinically and radiographically at 12 months are summarized
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