Abstract
Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.
Highlights
Aggressive periodontitis (AgP) affects a minority of periodontal patients but it is highly significant since it is characterized by severe destruction of the supporting structure of the teeth
AgP can occur at any age and is frequently characterized by a clinical manifestation at an early age, which indicates that the etiologic agents are able to cause clinically detectable levels of the disease within a relatively short time [1]
It was observed that in 93.16% of the baseline defects in the anorganic bone grafting material (ABM)/P-15 group there was gain in radiographic density, while in the guided tissue regeneration (GTR) group this improvement was observed in 62.03% of the defects
Summary
Aggressive periodontitis (AgP) affects a minority of periodontal patients but it is highly significant since it is characterized by severe destruction of the supporting structure of the teeth. AgP can occur at any age and is frequently characterized by a clinical manifestation at an early age, which indicates that the etiologic agents are able to cause clinically detectable levels of the disease within a relatively short time [1]. Because of its less common occurrence, few studies have evaluated different treatment protocols for this condition. The treatment of the infection should be the most important goal of periodontal therapy in patients with AgP. Once the periodontal lesions have occurred, the aim of therapy should be the attempt to restore the tissues destroyed by periodontal disease [2]
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