Autogenous periosteal barrier membranes and bone grafts in the treatment of periodontal intrabony defects of single-rooted teeth: a 12-month reentry randomized controlled clinical trial.
BACKGROUND: This randomized clinical trial compares the outcomes of combination
treatment by autogenous periosteal membranes and bone graft versus guided tissue
regeneration (GTR) with collagen membranes or open-flap debridement (OFD) only in
the treatment of intraosseous defects.
METHODS: Forty-two patients affected by moderate to severe chronic periodontitis
were enrolled. Each patient had one deep intrabony defect (≥6 mm). They were
randomly assigned into three groups: patients treated with 1) an OFD procedure
alone (OFD group); 2) a GTR procedure with collagen membranes (GTR group); and 3)
a combined treatment procedure by autogenous periosteal membranes and autogenous
bone chips (aCPRT group). Clinical and intrasurgical examinations including
probing depth (PD), clinical attachment level (CAL), gingival recession (GR), and
defect bone level (DBL) were performed at baseline and after 1 year.
RESULTS: After 1 year, all of the evaluated clinical parameters showed
statistically significant changes from baseline within each group (P <0.01). The
GTR and aCPRT groups had significantly greater PD reductions (5.2 and 4.4 mm,
respectively) and CAL (3.2 and 3.9 mm) and DBL gains (2.4 and 3.1 mm) compared to
the OFD group (PD, 2.9 mm; CAL, 1.6 mm; DBL, 1.5 mm); moreover, the aCPRT group
showed a significantly smaller GR increase (0.5 mm) and a greater DBL gain (3.1
mm) compared to the GTR group (2 and 2.4 mm, respectively; P <0.05).
CONCLUSIONS: Both the GTR and aCPRT treatments produce additional clinical
benefits over OFD alone. Moreover, the aCPRT technique can minimize post-surgical
GR and produce better defect bone-level improvement.