Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12months.

Abstract

The aim of this study was to compare clinical outcomes between guided tissue regeneration (GTR) and access flap (AF) surgery in patients with aggressive periodontitis (AgP). Eighteen AgP patients with similar bilateral intrabony defects were treated in this split-mouth, single-blinded, randomised, controlled clinical trial. All patients presented with ≥3mm intrabony defects and ≥5mm periodontal pocket depths (PPD). In each patient, one defect was treated with a polyglycolide membrane according to the GTR principle, whereas the contralateral side was treated with AF. For both sides, a simplified papilla preservation flap was used. At baseline, 6 and 12months post-surgery, the clinical attachment levels (CAL) and PPD were evaluated. At 6 and 12months, at the GTR sites, the mean [95% CI] CAL gain was 1.7mm [1.1, 2.3] and 1.6mm [0.9, 2.1], respectively, while the mean [95% CI] PPD reduction was 2.3mm [1.9, 2.8] and 2.4mm [1.9, 2.8], respectively. Similar CAL (1.6mm [1.0, 2.2] and 2.1mm [1.4, 2.7]) and PPD (2.0mm [1.5, 2.4] and 2.5mm [2.0, 3.0]) outcomes were observed at the control sites at 6 and 12months, respectively. Notably, at the GTR-treated sites, 13 subjects presented with various degrees of membrane exposure. Both therapies were effective in the treatment of intrabony defects in AgP patients, and no statistically significant differences between them could be demonstrated, possibly as a result of the differing degrees of membrane exposure at the GTR sites. Both periodontal regeneration and conventional periodontal surgery are effective treatments for AgP patients.