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Radiographic Defect Depth and Width for Prognosis and Description of Periodontal Healing of Infrabony Defects
Author(s) -
Klein Filip,
Kim TiSun,
Hassfeld Stefan,
Staehle HansJörg,
Reitmeir Peter,
Holle Rolf,
Eickholz Peter
Publication year - 2001
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2001.72.12.1639
Subject(s) - medicine , radiography , dentistry , gingival and periodontal pocket , orthodontics , periodontitis , radiology
Background: The aims of the present study were to evaluate 1) defect depth and width as a prognostic factor and 2) change in defect width as a describing parameter of periodontal healing in infrabony defects treated by regenerative therapy after 6 and 24 months. Methods: In 24 patients with advanced periodontitis, 39 infrabony defects were treated by guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (ePTFE) (n = 7) or bioabsorbable barriers (n = 32). Clinical parameters were assessed and 39 standardized radiographs (in triplicate) were taken before and 6 and 24 months after surgery. Using a computer‐assisted analysis, the depth, width, and angle of the bony defects were measured. Results: Statistically significant vertical clinical attachment gains (CAL‐V: 3.15 ± 1.63 mm to 3.31 ± 1.65 mm; P <0.001) and bony fill (1.30 ± 2.53 mm; P <0.01 to 1.54 ± 2.70 mm; P <0.005) were observed 6 and 24 months postsurgically. In a multilevel regression analysis CAL‐V gain was predicted by baseline CAL‐V ( P <0.0001), actual smoking ( P <0.05), and age ( P <0.1). Bony fill could be predicted by baseline height of the infrabony component ( P <0.0001), gingival index at baseline ( P <0.05), and actual smoking ( P <0.01). In narrow (<26°) and deep (≥3 mm) infrabony defects bony fill was more pronounced than in wide and shallow defects ( P <0.05). Conclusions: Improvement achieved by guided tissue regeneration in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and to some extent clinically more favorably to GTR therapy than wide and shallow defects. However, depth of the infrabony component was a stronger prognostic parameter than defect angle. Actual smoking impairs the results of GTR therapy in infrabony defects. J Periodontol 2001;72:1639‐1646.