Platelet-Derived Growth Factor-Modulated Guided Tissue Regeneration with a Bioresorbable Membrane in Class III Furcation Defects: A Histometric Study in the Monkey.

Dietmar Weng,Lina Stapf,Ralf-Joachim Kohal,Matthias Kern

doi:10.3390/ma14092420

Abstract

It was the aim of this study to histometrically evaluate guided tissue regeneration (bioresorbable membrane plus bone mineral) (GTR) with or without platelet-derived growth factor (PDGF) in two different types of class III furcation defects (small keyhole defects and horizonal defects) in monkeys. In six cynomolgus monkeys, two types of class III furcation defects were created and allowed to chronify for 5 months in mandibular first and second molars. After a hygiene program the molars were assigned to GTR group (collagen membrane plus bovine bone mineral), PDGF group (collagen membrane plus bovine bone mineral plus PDGF), or negative control group (flap reposition only). Histologic sections were made after 7 months of healing and descriptive statistics were provided from the histometric parameters. Postoperative healing was uneventful despite marginal membrane exposures in the GTR and PDGF group. Bone regeneration of 23–35% of the original defect area was found in the two treatment groups. In none of the evaluated key parameters (formation of bone, root cementum, connective tissue, or epithelium) differences were detected between GTR and PDGF groups. However, the negative control teeth exhibited better bone regeneration than the treatment groups. The type of class III defect did not influence the regenerative outcome. Within the limits of this study PDGF was not able to enhance the histologic regeneration of class III furcation areas in monkeys compared to bone mineral enhanced GTR treatment regardless of the defect configuration. Membrane exposure during early healing might have influenced these outcomes.

Highlights

The treatment outcome of class III furcation defects has always been compromised due to its limited and unpredictable success
It was the aim of this study to histometrically evaluate guided tissue regeneration (GTR) with or without platelet-derived growth factor (PDGF) in two different types of class III furcation defects in monkeys
After a hygiene program the molars were assigned to GTR group, PDGF group, or negative control group

Summary

Introduction

The treatment outcome of class III furcation defects has always been compromised due to its limited and unpredictable success. Whereas class I and II furcations can be handled reliably in most cases with a non-surgical [1] or surgical approach [2,3,4], the anatomy of the furcation area in general [5] and the architecture of a class III furcation defect involve unfavorable conditions for guided tissue regeneration (GTR) [6]. The big distance between the areas to be regenerated and the remaining periodontal ligament cells as well as the associated exposure of the furcation entrance caused by soft tissue recession seem to be the main problems for successful GTR in class III furcations [7]. Various single and combined treatment modalities have been considered to regenerate class III furcations. None of them provided satisfying or predictable results for a closure of the class III furcation defects

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Discussion

Conclusion