Infrabony defects 20 years after open flap debridement and guided tissue regeneration.

Abstract

Evaluation of 20-year results after open flap debridement (OFD) and guided tissue regeneration (GTR) of infrabony defects in a randomized controlled trial. In originally 16 periodontitis patients (baseline examination), periodontal surgery was performed in 44 infrabony defects. Polylactide acetyltributyl citrate barriers were randomly assigned to 23 out of these 44 defects (parallel). Ten of these patients (GTR) exhibited a second, contra-lateral defect (OFD) each (split-mouth). At baseline, 12, 120 and 240±12months after surgery probing depths, attachment level, bleeding on probing as well was Plaque Index, Gingival Bleeding Index and plaque control record were obtained. Twelve patients contributing 38 defects were available at 240months. At 12, 120 and 240±12months, both groups showed significant (p<0.01) attachment gain (split-mouth: OFD: 12months: 4.15±2.93mm; 120months: 3.35±2.37mm, 240months: 3.60±2.55mm; GTR: 12months: 3.50±2.47mm; 120months: 3.90±2.76mm, 240months: 3.80±2.69mm; parallel: OFD: 12months: 3.53±2.04mm; 120months: 3.59±2.54mm, 240months: 3.53±2.50mm; GTR: 12months: 4.07±2.88mm; 120months: 3.13±2.22mm, 240months: 3.13±2.22mm). Seven teeth (3 OFD, 4 GTR) were lost. Only 1 patient out of 12 was kept in regular supportive periodontal therapy (SPT) over 20years. The study failed to show significant attachment gain differences between both groups after 240months. Twenty years after OFD and GTR in infrabony defects in a population with lack of regular SPT attachment gains at 12months after surgery were stable. About 82% of the initially included teeth were still in place.