Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Conservadores da Densidade Óssea/administração & dosagem , Difosfonatos/administração & dosagem , Imidazóis/administração & dosagem , Doenças Mandibulares/induzido quimicamente , Doenças Maxilares/induzido quimicamente , Osteoporose Pós-Menopausa/tratamento farmacológico , Idoso , Alendronato/uso terapêutico , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Doenças Ósseas Metabólicas/tratamento farmacológico , Difosfonatos/efeitos adversos , Difosfonatos/uso terapêutico , Ácido Etidrônico/análogos & derivados , Ácido Etidrônico/uso terapêutico , Feminino , Seguimentos , Humanos , Ácido Ibandrônico , Imidazóis/efeitos adversos , Infusões Intravenosas , Pessoa de Meia-Idade , Ácido Risedrônico , Extração Dentária/efeitos adversos , Alvéolo Dental/patologia , Ácido ZoledrônicoRESUMO
BACKGROUND: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non-absorbable barrier. METHODS: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freeze-dried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re-entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. RESULTS: The MGCSH-treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 +/- 0.82 mm, P<0.05) and baseline and 12 months (1.31 +/- 0.85 mm, P<0.05). There was no statistically significant change in probing depth in the ePTFE group at any time interval. The horizontal defect fill was significantly greater for ePTFE (36.7%) versus MGCSH (23.8%) (P<0.02). CONCLUSIONS: In selected defects, improved clinical measurements were achieved with DFDBA/MGCSH as well as DFDBA/ePTFE. Both treatments obtained significant horizontal defect fill at 6 months. DFDBA/ePTFE showed a significantly greater horizontal defect fill compared to DFDBA/MGCSH. Attachment level gains achieved with MGCSH held for 12 months, whereas ePTFE attachment level gains did not.
