Klinischer Vergleich einer resorbierbaren Membran und eines bioaktiven Glases zur Behandlung von infraalveolären Defekten bei Patienten mit einer fortgeschrittenen chronischen Parodontitis

Background: The aim of this study was to compare two materials (ResolutÒXT and PerioGlasÒ) in the treatment of intrabony defects. This investigation took place over a period of 24 months and evaluates the effectivenis of the applied materials. Furthermore the purpose of this research was to find additionally factors, which affected the results of the therapy. Method: 19 patients (13 female) with chronic periodontitis were attending the study. 103 vertical lesions were treated. Preoperative probing pocket depths of 5 mm and more have been considered for this study. 25 defects were treated with resorbable membrane (ResolutÒXT) and 78 defects were treated with bioglass (PerioGlasÒ). The principle of choice was done at random. The clinical parameters probing pocket depth, clinical attachment level, gingival recession, gingival index, plaque index were recorded and x-rays analyses performed and compared with the data which had been evaluated at baseline. After digitalisation of the radiographs the varity of the distance from apex to the basis of the infraalveolar defect (a1/c), from apex to cemento-enamel junction (a2/b2) and from apex to bone margin (d) were determined. The statistic analysis was done by the use of the Kolmogorov-Smirnov-Test, the Wilcoxon-Test and the U-Test by Mann-Whitney. Furthermore other factors such as smoking, clinical depth of defects, defect location (incisivi, premolar, molar), materials (ResolutÒXT/PerioGlasÒ), age, oral hygiene were included in the evaluation. Summary: In conclusion based on this 24-month study the results showed in the RXT group a pocket depth reduction (PPD) of 3,60 ± 2,59 mm (p < 0,001) and an average gain of clinical attachment (CAL) of 3,12 ± 2,89 mm (p < 0,001). The gingival recession (GR) decreased 0,05 ± 1,83 mm (p = 0,294). In the PG group the results showed a pocket depth reduction (PPD) of 3,69 ± 2,0 mm (p < 0,001) and an average gain of clinical attachment (CAL) 3,98 ± 2,60 mm (p < 0,001). The gingival recession (GR) increased 0,39 ± 1,81 mm (p = 0,294). The best results were found in defects with deep defect morphology (> 7 mm PD), which is predominantly found in 3-wall defects. Incisivi and canines demonstrated more favourable results than premolars and molars. The radiographs in the RXT group showed a gain of bone of 64 % ± 25,8 and the PG group showed a gain of bone of 69 % ± 22,5. Moreover the influence of different factors on the results were evaluated. Conclusion: Both materials are equally effective in the treatment of intrabony pockets. The results of the study show, that intrabony defects treated with the applied materials do have a significant decrease in probing depth and gain in clinical attachment level. These values can be maintained over extended time intervals and are considered to be predictable, if patients compliance exists during the recall appointments as well as an excellent oral hygiene.