Abstract

Background: A similar long-term stable clinical attachment level (CAL) of infrabony defects (IBDs) after regenerative treatment compared to control teeth would indicate a high level of stability resulting from the regenerative approach. Methods: Patients with a regeneratively treated IBD were screened 120 ± 12 months postoperatively for eligibility for study participation, and were included if complete baseline and 12-month examinations (plaque (PlI), periodontal probing depth (PPD), CAL) were available and a respective control tooth could be identified. Re-examination included clinical examination (PPD, CAL, PlI/GI, bleeding on probing, plaque control record, gingival bleeding index). Results: A total of 27 patients (16 females; age (median; lower/upper quartile): 57.0; 44.0/60.0 years; 6 smokers) contributed 27 IBDs (test), for each of which a control tooth was identified. Five test teeth (18.5%) were lost between 12 and 120 months. The remaining 22 test teeth revealed a significant CAL gain after 1 (2.5 mm; 1.0/4.0 mm, p < 0.0001) and 10 (2.5 mm; 0.5/3.5 mm, p < 0.0001) years, whereas control teeth were stable (1 year: 0.0 mm; 0.0/1.0 mm, p = 0.396; 10 years: 0.0 mm; −1.0/1.5 mm, p = 0.215). The study did not detect any significant CAL change between 1 and 10 years for test (−0.5 mm; −1.0/0.5 mm, p = 0.414) and control teeth (0.0 mm; −1.0/1.0 mm, p = 0.739). In 15 patients, test and control teeth revealed stable CAL values between 12 and 120 months. Conclusion: Regenerative treatment of IBDs exhibited stability comparable to non-surgically treated, periodontally reduced sites over a 10-year period.

Highlights

  • Introduction iationsEarly pioneering studies provided histological evidence that it is possible to regenerate lost periodontal attachment [1]

  • Since histology plays a subordinate role in everyday clinical practice, numerous studies and systematic reviews followed, showing that regenerative therapy for infrabony defects (IBDs) is superior to conventional open-flap debridement (OFD) [2,3,4,5,6,7,8]

  • The present study was able to show for regeneratively treated teeth that there are significant gains in clinical attachment 1 year after surgery, which can be kept stable for 10 years as in teeth that have not received any surgical treatment

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Summary

Introduction

Introduction iationsEarly pioneering studies provided histological evidence that it is possible to regenerate lost periodontal attachment [1]. Since histology plays a subordinate role in everyday clinical practice, numerous studies and systematic reviews followed, showing that regenerative therapy for infrabony defects (IBDs) is superior to conventional open-flap debridement (OFD) [2,3,4,5,6,7,8]. Not least for this reason, the treatment of IBDs of more than 3 mm was approved with a strong recommendation in the EFP (European Federation of Periodontology) S3 level clinical practice guidelines [9]. The remaining 22 test teeth revealed a significant CAL gain after 1 (2.5 mm; 1.0/4.0 mm, p < 0.0001) and 10 (2.5 mm; 0.5/3.5 mm, p < 0.0001)

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