FisiograftTM as a bone material in the treatment of periodontal vertical defects and its clinical and radiological evaluation: clinical study / FisiograftTM como material de enxerto ósseo no tratamento de defeitos periodontais verticais e sua avaliação clínica e radiográfica: um estudo clínico

Objectives: The purpose of this clinical study is to determine the efficacy of Fisiograft™ as a bone graft materialin the treatment of three wall vertical defects in generalized chronic periodontitis patients and theirclinical and radiological evaluation. Materials and methods: Twenty patients (with 30 defects) diagnosedwith generalized chronic periodontitis having two or more three wall vertical defects were selected for thisstudy. Clinical parameters like plaque index, gingival index, probing pocket depth and clinical attachmentlevels were recorded at different points of time over six months. Radiographic evaluation included the depthof the bone defect and the percentage of bone defect fill, and was carried out for both the groups at baseline,three months and six months. After recording clinical parameters and administering phase-1 therapy, thesites were randomly treated either with Fisiograft™ or open flap debridement only. Results: At the end of sixmonths there was a significant reduction in the plaque and gingival scores in both test and control groups.There was 64% decrease in probing pocket depth for the test site as compared to 55% decrease seen for thecontrol group. Similarly there was an 85% gain in clinical attachment level from the baseline to six monthspost operatively for the experimental group in comparison to 69% gain for the control group. Furthermore,44% bone fill was observed for the experimental site whereas only 18% of bone fill was evident in the controlsite. Conclusion: Fisiograft™ improves healing outcomes, leads to a reduction of probing depth, a resolutionof osseous defects and a gain in clinical attachment, compared with open flap debridement by itself.

Objetivo: O objetivo do presente estudo clínico foi determinar a eficácia do Fisiograft®, como material de enxerto ósseo, no tratamento de defeitos ósseos verticais de três paredes em pacientes com periodontite crônica,bem como avaliações clínica e radiográfica. Materiais e métodos: Vinte pacientes (com 30 defeitos)diagnosticados com periodontite crônica generalizada, portando dois ou mais defeitos ósseos verticais detrês paredes foram selecionados para o estudo. Parâmetros clínicos como índice de placa, índice gengival,profundidade de bolsa à sondagem e níveis clínicos de inserção foram registrados em diferentes intervalos de tempo até seis meses. Avaliações radiográficas incluíram a profundidade do defeito ósseo e a porcentagem de preenchimento do defeito ósseo, sendo realizadas em ambos os grupos imediatamente (baseline),em três meses e seis meses. Após registrar os parâmetros clínicos e administrar a terapia de fase-1, os locais foram tratados aleatoriamente com Fisiograft® ou retalho de espessura total somente. Resultados: Ao fim do período de seis meses houve redução significativa nos índices de placa e gengival em ambos os grupos,controle e experimental. Houve redução de 64% na profundidade de bolsa à sondagem para os locais de teste comparado, 55% de redução no grupo controle. Similarmente, houve ganho de 85% no nível clínico de inserção do baseline para o período de seis meses de pós-operatório para o grupo experimental em comparação ao ganho de 69% para o grupo controle. Adicionalmente, um preenchimento ósseo de 44% foi observado para os locais experimentais, enquanto somente 18% de preenchimento foi evidente nos locais de controle.Conclusão: O Fisiograft® melhora os resultados de cicatrização, promove redução na profundidade de sondagem,constitui uma resolução para os defeitos ósseos e aumento na inserção clínica, comparado ao retalho de espessura total somente.

Prevalence And Distribution of Vertical Osseous Defects In Patients Being Treated For Chronic Periodontitis.

Background: The aim of the study was to determine the prevalence and distribution of vertical osseous defects in patients who underwent open flap debridement. Methods: A total of 83 subjects were examined for prevalence of vertical defects using direct observation during periodontal surgery. All patients required periodontal surgery in one or more segments. The diagnosis of periodontitis was made after clinical and radiographic examination. Periodontal surgery was performed on each patient and full thickness mucoperiosteal flaps were elevated to gain access to root and osseous structures. The vertical osseous defects were explored surgically using mouth mirror, explorer and a periodontal probe. Results: A total of 141 vertical osseous defects were detected in the 677 teeth assessed during surgical exposure. Of these 81 vertical defects were found in the maxilla and 60 vertical defects were found in the mandible. Craters accounted for almost 44% of the total defects. The posterior maxilla had the highest percentage of teeth with vertical defects (26.23%) while the mandibular anterior segment had the lowest percentage of vertical defects. Conclusion: The posterior maxilla had the highest percentage of vertical osseous defects which can be explained by the fact that greater thickness of supporting bone allows formation of a greater number of infrabony defects. Craters were found to be the most common defect.