TREATMENT OF MANDIBULAR 3-WALL INTRABONY DEFECTS BY FLAP DEBRIDEMENT AND EXPANDED POLYTETRAFLUOROETHYLENE BARRIER MEMBRANES - LONG-TERM EVALUATION OF 32 TREATED PATIENTS

THE PURPOSE OF THIS STUDY was to evaluate the healing potential of deep, primarily 3-wall intrabony defects which were treated by flap debridement and expanded polytetrafluoroethylene (ePTFE) membranes and followed for extended time periods. All of the treated defects were in the mandibular arch. Thirty-two patients were treated and reexamined at an average of 3 years 5 months. Twenty-four of these patients had re-entry procedures at the second examination. Sixteen of these patients were examined a third time at an average of 4 years 3 months. The patients were evaluated for changes in probing depth (PD), clinical attachment level (CAL), recession, changes in crestal resorption, and defect bone fill. The paired t-test for related samples was used to test for differences between examinations. Between Exams 1 and 2 there was a statistically significant reduction of pocket depth (3.8 mm), gain in clinical attachment level (4.2 mm), and an increase in recession (- 1.2 mm). For the 24 patients who had re-entry procedures there was an average defect fill of 4.3 mm (P < 0.0001) and 0.33 mm of crestal resorption (P < 0.0001). The 16 patients who were examined 3 times sustained decreases in PD, gains in CAL, and recession recorded at the second examination. These changes were statistically significant at Exam 3. The results of this study demonstrate that deep, 3-wall intrabony defects treated by debridement and ePTFE barrier membranes will have significant decreases in PD, gains in CAL, recession, decreases in crestal resorption, and gains in bone fill. These gains can be maintained over extended time intervals and are considered to be predictable.