Bioresorbierbare Membran und bioaktives Glas in der Behandlung von Furkationsdefekten Grad II und III bei Patienten mit generalisierter aggressiver Parodontitis.

Das Ziel dieser Prospektivstudie war der klinische und radiologische Vergleich der Langzeitstabilität von Zähnen mit Furkationsbefall II. und III. Grades über einen Zeitraum von 5 Jahren, nach der Behandlung mit zwei regenerativen Materialien. Insgesamt nahmen 12 Patienten (8 weiblich) im Alter zwis...

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Bibliographic Details
Main Author: Schreiber, Nicole
Contributors: Flores-de-Jacoby, Lavinia (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2008
Online Access:PDF Full Text
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The purpose of this prospective study was to compare clinically and radiographically the effectiveness of guided tissue regeneration (GTR), using a bioabsorbable barrier (Gore Resolut® XT) and bioactive glass particulate (PerioGlas™Bioglass® Synthetic Bone Graft Particulate ) in the treatment of degree II and III furcation involvements. 12 patients (8 female) aged 29 to 57 with generalized aggressive periodontitis were enrolled in this study. 32 furcation defects, 19 degree II. and 13 degree III, were treated, 13 furcations with the membrane (RXT group) and 19 with the bioactive glass (PG group). Preliminary treatment was completed 8 weeks prior to surgery. Clinical measurements as plaque index (Pll), gingival index, probing pocket depths (PPD), bleeding on probing (BOP), gingival recession (REC), clinical attachment levels (CAL), furcation depth (FD) and tooth mobility were carried out before and after surgery every 6 month over a period of 5 years. Radiographic examinations were taken immediately before the operation as well as every 12 months using standardized parallel long tubus technique. After image digitalization the linear distances from the alveolar crest (xAC) to the base of the defect (xBD) and from the cemento-enamel junction (xCEJ) to the xAC were compared. The results were statistically analyzed by non-parametric tests. Normal distribution of the data was tested by means of the Shapiro-Wilk- test. Paired data were compared using the Wilcoxon sign-rank test and unpaired data by Mann-Whitney U-test. Correlations between the parameters were determined via Spearman rank correlation test. For both group there was a mean probing depth reduction of 3,4 ± 3,8 mm (RXT) and 3,3 ± 1,8 mm (PG) and a clinical attachmentlevel gain of 3,9 ± 4,0 mm (RXT) and 3 ± 2,3 mm (PG) respectively. 25% (2) of the initial dass II furcations treated with the barrier were considered to be clinically completly closed and 50% (4) partially closed (class l). From the furcation defects class III were 0% (0) closed. From the class III defects also treated with the barrier were 40% (2) partially closed (class l). After the treatment with the bioactive glass, 9,1% (1) degree II furcations were completly closed and 18,2% (2) partially closed (class l). Of the defects with a degree III involvement 50% (4) (2 class I) were partially and 12,5% (1) completely closed. No significant differences were found when the clinical results of the two materials were compared. No statistical differences were observed between the two groups. There was no possible statistic investigation because of the small number of usable radiographic pictures. Degree II defects responded better to therapy than class III defects, but a statistical significance is missing due to a small number of cases.