Guided tissue regeneration using a bioabsorbable membrane: A 21-case series

Background: The purpose of this paper is to demonstrate how a bioabsorbable membrane in the treatment of intrabony defects, combined with appropriate case selection, produces a significant improvement in the clinical assessment of affected teeth. This study demonstrates success in 21 successive cases. Methods: Consecutiue patients presenting advanced intrabony defects (8 to 15 mm) meeting the predetermined criteria were treated by guided tissue regeneration (GTR) with flap debridement and placement of a bioabsorbable copolymer membrane. To evaluate treatment predictability in a variety of patients, only one defect per patient was included in the study. Twenty-one patients completed the study, which included baseline measurement and subsequent surgical reentry of the treated site 9 to 18 months postoperatively. Selection of lesions was made following debridement of the defect; i.e., a membrane was placed only after determining that a lesion was a proper candidate for this procedure. Measurements from the cemento-enamel junction (CEJ) to the deepest apical aspect of the defects were made and documented with photographs. At the time of reentry, defect depths were again measured from the CEJ to the deepest apical point along with measurements of the residual 3-walled component of the defect, and photographs were taken. The re-entry procedure involved an apically positioned and occasionally minor osteoplasty to reduce residual probing depth, when present. Radiographs were taken at baseline and reentry. Results: The initial mean defect depth, as measured from the CEJ to the base of the lesion, was 10.2 mm. The mean defect depth at the time of reentry was 5 mm. The mean gain in vertical bone fill was 5.2 mm. Perhaps more significantly, in 20 of 21 cases, there was vertical fill to within I mm of the 3-walled component of the residual defect. Conclusion: When appropriate case selection and management are applied, the use of bioabsorbable membranes does provide for consistent and predictable bone fill, producing clinically relevant reduction in vertical defect depth.