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Medical Grade Calcium Sulfate Hemihydrate Versus Expanded Polytetrafluoroethylene in the Treatment of Mandibular Class II Furcations

Background: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non‐...

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Published in:Journal of periodontology (1970) 2002-11, Vol.73 (11), p.1352-1359
Main Authors: Couri, Christopher J., Maze, Glenn I., Hinkson, David W., Collins, Byran H., Dawson, Deborah V.
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container_issue 11
container_start_page 1352
container_title Journal of periodontology (1970)
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creator Couri, Christopher J.
Maze, Glenn I.
Hinkson, David W.
Collins, Byran H.
Dawson, Deborah V.
description Background: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non‐absorbable barrier. Methods: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freezedried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re‐entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. Results: The MGCSH‐treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 ± 0.82 mm, P
doi_str_mv 10.1902/jop.2002.73.11.1352
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The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non‐absorbable barrier. Methods: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freezedried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re‐entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. Results: The MGCSH‐treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 ± 0.82 mm, P &lt;0.05) and baseline and 12 months (1.31 ± 0.85 mm, P &lt;0.05). There was no statistically significant change in probing depth in the ePTFE group at any time interval. The horizontal defect fill was significantly greater for ePTFE (36.7%) versus MGCSH (23.8%) (P &lt;0.02). Conclusions: In selected defects, improved clinical measurements were achieved with DFDBA/MGCSH as well as DFDBA/ePTFE. Both treatments obtained significant horizontal defect fill at 6 months. DFDBA/ePTFE showed a significantly greater horizontal defect fill compared to DFDBA/MGCSH. Attachment level gains achieved with MGCSH held for 12 months, whereas ePTFE attachment level gains did not. J Periodontol 2002;73:1352‐1359.</description><identifier>ISSN: 0022-3492</identifier><identifier>EISSN: 1943-3670</identifier><identifier>DOI: 10.1902/jop.2002.73.11.1352</identifier><identifier>PMID: 12479641</identifier><language>eng</language><publisher>737 N. Michigan Avenue, Suite 800, Chicago, IL 60611‐2690, USA: American Academy of Periodontology</publisher><subject>Absorbable Implants ; Adult ; Aged ; Bone Regeneration ; Bone Transplantation - methods ; Calcium Sulfate ; comparison studies ; Dentistry ; Female ; Furcation Defects - surgery ; Furcation/therapy ; guided bone regeneration ; Guided Tissue Regeneration, Periodontal - methods ; Humans ; Male ; Mandible ; Membranes, Artificial ; membranes, bioabsorbable ; membranes/barrier ; Middle Aged ; Molar ; Periodontitis - surgery ; Polytetrafluoroethylene ; polytetrafluoroethylene/therapeutic use ; Statistics, Nonparametric ; Treatment Outcome</subject><ispartof>Journal of periodontology (1970), 2002-11, Vol.73 (11), p.1352-1359</ispartof><rights>2002 American Academy of Periodontology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3512-a7a989484104ba376bd638af09e2a1f4cd9772ac4792e51364a14c0d685d223b3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12479641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Couri, Christopher J.</creatorcontrib><creatorcontrib>Maze, Glenn I.</creatorcontrib><creatorcontrib>Hinkson, David W.</creatorcontrib><creatorcontrib>Collins, Byran H.</creatorcontrib><creatorcontrib>Dawson, Deborah V.</creatorcontrib><title>Medical Grade Calcium Sulfate Hemihydrate Versus Expanded Polytetrafluoroethylene in the Treatment of Mandibular Class II Furcations</title><title>Journal of periodontology (1970)</title><addtitle>J Periodontol</addtitle><description>Background: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non‐absorbable barrier. Methods: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freezedried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re‐entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. Results: The MGCSH‐treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 ± 0.82 mm, P &lt;0.05) and baseline and 12 months (1.31 ± 0.85 mm, P &lt;0.05). There was no statistically significant change in probing depth in the ePTFE group at any time interval. The horizontal defect fill was significantly greater for ePTFE (36.7%) versus MGCSH (23.8%) (P &lt;0.02). Conclusions: In selected defects, improved clinical measurements were achieved with DFDBA/MGCSH as well as DFDBA/ePTFE. Both treatments obtained significant horizontal defect fill at 6 months. DFDBA/ePTFE showed a significantly greater horizontal defect fill compared to DFDBA/MGCSH. Attachment level gains achieved with MGCSH held for 12 months, whereas ePTFE attachment level gains did not. J Periodontol 2002;73:1352‐1359.</description><subject>Absorbable Implants</subject><subject>Adult</subject><subject>Aged</subject><subject>Bone Regeneration</subject><subject>Bone Transplantation - methods</subject><subject>Calcium Sulfate</subject><subject>comparison studies</subject><subject>Dentistry</subject><subject>Female</subject><subject>Furcation Defects - surgery</subject><subject>Furcation/therapy</subject><subject>guided bone regeneration</subject><subject>Guided Tissue Regeneration, Periodontal - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Mandible</subject><subject>Membranes, Artificial</subject><subject>membranes, bioabsorbable</subject><subject>membranes/barrier</subject><subject>Middle Aged</subject><subject>Molar</subject><subject>Periodontitis - surgery</subject><subject>Polytetrafluoroethylene</subject><subject>polytetrafluoroethylene/therapeutic use</subject><subject>Statistics, Nonparametric</subject><subject>Treatment Outcome</subject><issn>0022-3492</issn><issn>1943-3670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNqNkE1v1DAQhi0EotvCL0BCPnFL8NfGmyNabdutWrWCwtWaxBOtKydZ_CHIvT-8WXYlrj2NR37fR5qHkE-clbxm4uvTuC8FY6LUsuS85HIp3pAFr5UsZKXZW7KYP0UhVS3OyHmMT_PKlWTvyRkXSteV4gvyfIfWteDpVQCLdA2-dbmnP7LvICG9xt7tJhsO718YYo5083cPg0VLH0Y_JUwBOp_HMGLaTR4HpG6gaYf0MSCkHodEx47ezRXXZA-Brj3ESLdbeplDC8mNQ_xA3nXgI348zQvy83LzuL4ubu-vtutvt0Url1wUoKFe1WqlOFMNSF01tpIr6FiNAninWltrLaCdbxO45LJSwFXLbLVaWiFkIy_IlyN3H8bfGWMyvYsteg8DjjkaLXTFWSXnoDwG2zDGGLAz--B6CJPhzBzkm1m-Ocg3WhrOzUH-3Pp8wuemR_u_c7I9B-pj4I_zOL2GaW4eNt__wV8AKvWTZw</recordid><startdate>200211</startdate><enddate>200211</enddate><creator>Couri, Christopher J.</creator><creator>Maze, Glenn I.</creator><creator>Hinkson, David W.</creator><creator>Collins, Byran H.</creator><creator>Dawson, Deborah V.</creator><general>American Academy of Periodontology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200211</creationdate><title>Medical Grade Calcium Sulfate Hemihydrate Versus Expanded Polytetrafluoroethylene in the Treatment of Mandibular Class II Furcations</title><author>Couri, Christopher J. ; Maze, Glenn I. ; Hinkson, David W. ; Collins, Byran H. ; Dawson, Deborah V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3512-a7a989484104ba376bd638af09e2a1f4cd9772ac4792e51364a14c0d685d223b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Absorbable Implants</topic><topic>Adult</topic><topic>Aged</topic><topic>Bone Regeneration</topic><topic>Bone Transplantation - methods</topic><topic>Calcium Sulfate</topic><topic>comparison studies</topic><topic>Dentistry</topic><topic>Female</topic><topic>Furcation Defects - surgery</topic><topic>Furcation/therapy</topic><topic>guided bone regeneration</topic><topic>Guided Tissue Regeneration, Periodontal - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Mandible</topic><topic>Membranes, Artificial</topic><topic>membranes, bioabsorbable</topic><topic>membranes/barrier</topic><topic>Middle Aged</topic><topic>Molar</topic><topic>Periodontitis - surgery</topic><topic>Polytetrafluoroethylene</topic><topic>polytetrafluoroethylene/therapeutic use</topic><topic>Statistics, Nonparametric</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Couri, Christopher J.</creatorcontrib><creatorcontrib>Maze, Glenn I.</creatorcontrib><creatorcontrib>Hinkson, David W.</creatorcontrib><creatorcontrib>Collins, Byran H.</creatorcontrib><creatorcontrib>Dawson, Deborah V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of periodontology (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Couri, Christopher J.</au><au>Maze, Glenn I.</au><au>Hinkson, David W.</au><au>Collins, Byran H.</au><au>Dawson, Deborah V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medical Grade Calcium Sulfate Hemihydrate Versus Expanded Polytetrafluoroethylene in the Treatment of Mandibular Class II Furcations</atitle><jtitle>Journal of periodontology (1970)</jtitle><addtitle>J Periodontol</addtitle><date>2002-11</date><risdate>2002</risdate><volume>73</volume><issue>11</issue><spage>1352</spage><epage>1359</epage><pages>1352-1359</pages><issn>0022-3492</issn><eissn>1943-3670</eissn><abstract>Background: Guided tissue regeneration (GTR) techniques have been reported to enhance bone regeneration of molar furcation defects. The current trends in therapy encourage the use of a bioabsorbable barrier. The efficacy of the bioabsorbable barrier needs to be equal to, if not better than, the non‐absorbable barrier. Methods: This clinical study compared the bone regeneration capacity of a commonly used GTR procedure (demineralized freezedried bone allograft [DFDBA] and an expanded polytetrafluoroethylene [ePTFE] membrane) to DFDBA and an exclusion barrier of medical grade calcium sulfate hemihydrate [MGCSH]). Thirteen pairs of mandibular molar Class II furcation defects were evaluated in 13 patients. Clinical measurements of keratinized gingival width, probing depth, and recession were recorded prior to treatment. Following flap elevation and furcation defect debridement, an occlusal reference stent and periodontal probes were used to measure vertical, horizontal, and intrabony defect dimensions to the nearest millimeter. Paired defects were randomly assigned to receive either DFDBA/ePTFE or DFDBA/MGCSH. At 6 months, study sites were surgically re‐entered and the treated furcations were debrided to a firm bone surface. Intraoperative measurements were repeated. Clinical measurements were repeated at 12 months. Results: The MGCSH‐treated furcations demonstrated mean probing depth reduction between baseline and 6 months (1.00 ± 0.82 mm, P &lt;0.05) and baseline and 12 months (1.31 ± 0.85 mm, P &lt;0.05). There was no statistically significant change in probing depth in the ePTFE group at any time interval. The horizontal defect fill was significantly greater for ePTFE (36.7%) versus MGCSH (23.8%) (P &lt;0.02). Conclusions: In selected defects, improved clinical measurements were achieved with DFDBA/MGCSH as well as DFDBA/ePTFE. Both treatments obtained significant horizontal defect fill at 6 months. DFDBA/ePTFE showed a significantly greater horizontal defect fill compared to DFDBA/MGCSH. Attachment level gains achieved with MGCSH held for 12 months, whereas ePTFE attachment level gains did not. J Periodontol 2002;73:1352‐1359.</abstract><cop>737 N. Michigan Avenue, Suite 800, Chicago, IL 60611‐2690, USA</cop><pub>American Academy of Periodontology</pub><pmid>12479641</pmid><doi>10.1902/jop.2002.73.11.1352</doi><tpages>8</tpages></addata></record>
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subjects Absorbable Implants
Adult
Aged
Bone Regeneration
Bone Transplantation - methods
Calcium Sulfate
comparison studies
Dentistry
Female
Furcation Defects - surgery
Furcation/therapy
guided bone regeneration
Guided Tissue Regeneration, Periodontal - methods
Humans
Male
Mandible
Membranes, Artificial
membranes, bioabsorbable
membranes/barrier
Middle Aged
Molar
Periodontitis - surgery
Polytetrafluoroethylene
polytetrafluoroethylene/therapeutic use
Statistics, Nonparametric
Treatment Outcome
title Medical Grade Calcium Sulfate Hemihydrate Versus Expanded Polytetrafluoroethylene in the Treatment of Mandibular Class II Furcations
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