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Regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen‐enriched bovine‐derived xenograft: a 1‐year prospective study on clinical and aesthetic outcome
Author(s) -
Cosyn Jan,
Cleymaet Roberto,
Hanselaer Lore,
Bruyn Hugo
Publication year - 2012
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.2012.01924.x
Subject(s) - medicine , dentistry , gingival recession , gingival and periodontal pocket , bleeding on probing , radiography , surgery , periodontitis
Aim To evaluate the clinical and aesthetic outcome of regenerative periodontal therapy ( RPT ) using minimally invasive surgery and a collagen‐enriched bovine‐derived xenograft (1); to identify risk factors for failure (clinical attachment level ( CAL ) gain ≤1 mm) and advanced gingival recession ( REC ) increase (>1 mm) (2). Material and methods Ninety‐five non‐smoking patients, with ≤25% full‐mouth plaque and bleeding presenting ≥6 months after initial periodontal therapy with ≥1 isolated inter‐dental infrabony defect were recruited. Patients were consecutively treated by the same clinician using minimally invasive surgery and a collagen‐enriched bovine‐derived xenograft. Clinical, radiographic and aesthetic data were collected before surgery and up to 1 year. Multivariate analyses were used to identify risk factors for failure and advanced REC increase. Results Eighty‐four patients (39 men, 45 women; mean age 53) complied and demonstrated mean probing depth ( PD ) of 7.8 mm, CAL of 10.0 mm and defect depth of 5.2 mm before surgery. At 1 year, postsurgery mean PD reduction was 3.5 mm (range 0.0–8.0), CAL gain was 3.1 mm (range 0.0–7.0) and radiographic defect fill was 53% (range 0–100). Forty‐nine percentage showed ≥4 mm CAL gain, whereas 15% were considered failures. Mean inter‐dental and midfacial REC increase was 0.3 mm (range−2.0–2.0) and 0.5 mm (range−1.5–2.0) respectively. Midfacial REC increase and contour deterioration contributed most to a small, yet significant reduction in the P ink E sthetic S core from 10.06 to 9.42 ( p = 0.002). Risk factors for failure included defects with a non‐supportive anatomy ( OR : ≥10.4), plaque ( OR : 14.7) and complication(s) ( OR : 12.0). Risk factors for advanced midfacial REC increase included defects with a non‐supportive anatomy ( OR : 58.8) and a thin‐scalloped gingival biotype ( OR : 76.9). Conclusions RPT using minimally invasive surgery and a collagen‐enriched bovine‐derived xenograft demonstrated favourable clinical outcome after 1 year, even though soft tissue aesthetics could not be fully preserved. Defects with a non‐supporting anatomy may be at risk for failure and advanced midfacial recession.