Regeneration of the Periodontal Apparatus in Aggressive Periodontitis Patients.

Zvi Artzi,Shiran Sudri,Ori Platner,Avital Kozlovsky

doi:10.3390/dj7010029

Abstract

The purpose of this study is to evaluate and compare, retrospectively, the outcome of two different periodontal regeneration procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from several intra-bony defects (IBD); that were treated by one of two periodontal regeneration techniques randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of extracted enamel matrix derivatives (EMD) combined with demineralized bone xenograft particles (DBX). Probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession were recorded. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PPD and CAL values, however, not between subject groups. CAL values decreased in all sites. At the EMD group (44 sites), CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p < 0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1–10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.

Highlights

Aggressive periodontitis (AgP) is a periodontal disease characterized by a rapid loss of periodontal tissue
Many randomized trials have shown encouraging results of periodontal therapy in Chronic periodontitis (ChP) patients, there are only a few reports that claim clinical success using either the guided tissue regeneration (GTR) technique in AgP patients [35,36,37] or the enamel matrix derivatives (EMD) application [38,39,40,41]. Most of these reports, especially those related to the later, are based on small group of patients with no clinical standardization and/or follow-up protocols. The aim of this this study is to retrospectively evaluate the efficacy via one of the surgical regenerative options, GTR or EMD w/wo biomaterial filler, among AgP patients in 1–10 years follow-up
A clinical improvement was evident as related to the periodontal indices

Summary

Introduction

Aggressive periodontitis (AgP) is a periodontal disease characterized by a rapid loss of periodontal tissue. Several features describe AgP, such as early onset, involvement of a few or multiple teeth, and a relatively rapid progression [1,2]. There are two distinguishable patterns available: the localized form that involves the first molars and the incisors and up to two additional teeth, and the generalized form with an extensive destructive pattern [2,3,4,5]. [6], the classification of the periodontal entities has been updated to stages (I–IV) and grades (A–C). The stages are based on periodontal breakdown severity, management complexity, and the extent of the disease. Grade definitions are based on the progression which in principal is related to risk factors. Most of the AgP cases would be classified as stage III grade B or C

Objectives

Methods

Results

Discussion

Conclusion