Guided tissue regeneration in noncontained intrabony defect a

Guided tissue regeneration in non-contained intrabony defect: a report of three cases. 以引導組織再生術治療骨內缺損: 病例報告 Yun-Han Wang ▲ Yi-Hung Lin Chun-Tai Lu 王韻涵▲ 林益弘 盧俊泰 Department of Dentistry, Changhua Christian Hospital 彰化基督教醫院牙科部 Background Many randomized controlled studies documented that the guided tissue regeneration (GTR) have more clinical attachment level (CAL) gain and probing pocket depth (PPD) reduction in intrabony defects, when compared with open flap debridement (OFD). Especially in treating non-contained defects (1 or 2 wall), combination of two or more regenerative therapies demonstrated additional benefits than each individual technique. The case reports present three cases with non-contained intrabony defect that show clinical and radiographic improvement 2 years following GTR in combination with bone grafts. Case Report Three patients, without systemic diseases and smoking habit, presented with generalized chronic periodontitis. After completing initial periodontal therapy and re-evaluation, deep and wide non-contained intrabony defects were treated with GTR and bone grafts. The defects were accessed using modified or simplified papilla preservation flap. After removal of granulation tissue, scaling and root planing was performed. Then the defects were filled with bone grafts and a resorbable collagen membrane was placed to cover the bone grafts. All flaps were repositioned under modified vertical mattress and interrupted sutures. The sutures were removed after 14 days and wound conditions were stable. Results The patients were arranged on 3 -month-interval recall programs. At postoperative 6 months and 2 years follow-up, clinical attachment level gain and probing depth reduction were detected in three cases. The radiographic evaluation at 2 -year maintenance period showed that considerable radiographic bone level gain in three cases. Table 1 Patient General & Surgery Data Age Gender / Tooth site Defect type Case 1 48 / Female 44 2 -wall defect Case 2 41 / Male 43 Buccal dehiscence, uncontained defect Case 3 43 / Male 23 Buccal dehiscence, uncontained defect Membrane & Bone Graft FDBA (Ora. Graft®) + Collagen membrane (Bio. Gide®) FDBA (Ora. Graft®) + Collagen membrane (EZ Cure. TM) FDBA (Ora. Graft®) + Collagen membrane (Bio. Gide®) Fig 1. Case 1, Tooth 44 Fig 2. Case 2, Tooth 43 Fig 3. Case 3, Tooth 23 Conclusion The guided tissue regeneration therapy using resorbable collagen membrane and bone grafts is effective in clinical improvement of periodontal conditions of intrabony defects. Through good oral hygiene and regular maintenance care, the clinical outcomes obtained from periodontal regenerative therapy can be stably maintained on a long-term basis.