The Use of Autogenous Periosteal Grafts as Barriers for the Treatment of Class II Furcation Involvements in Lower Molars

Abstract

This study clinically analyzed the efficacy of a connective tissue graft including the periosteum used as a barrier to enhance new attachment and osseous regeneration. Fifteen patients, with no systemic diseases, and adult periodontitis including 2 Class II furcation involvements in lower molars comprised the study group. After completion of the initial phase of therapy, all patients were treated with full-thickness periodontal flaps, using sulcular incisions, and thorough scaling and root planing. One furca, selected at random, had a connective tissue graft, obtained from the palate and including the periosteum, placed over the furca with the flap sutured over the top of this graft. Control furcas received no graft and the flap was sutured in its original position. Both molars were treated in the same session. The following presurgical measurements were made: probing pocket depth, attachment level, gingival recession, sulcular bleeding index, and plaque index. The horizontal and vertical dimensions of the osseous defects were recorded after flap elevation and debridement. Six months later all clinical parameters were again measured and reentry flaps were performed to measure the bony defects. No statistically significant differences were found preoperatively between control and experimental molars with respect to soft tissue and osseous measurements. Six months after surgery, the experimental molars showed, in comparison to the controls, significant reduction in pocket depth and gain in attachment level as well as in vertical and horizontal measurements of the inter-radicular osseous defect.