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J Periodontol ; 74(1): 10-24, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12593591

RESUMO

BACKGROUND: In an effort to regenerate periodontal intrabony defects, the healing potential of the defect should determine what therapeutic modalities and materials are employed. The purpose of this study was to compare regenerative outcomes in baboon intrabony defects that were contained versus non-contained, using various regenerative therapies. METHODS: Nine adult baboons (Papio anubis) in good health were treated. Eighty-six interproximal, intrabony defects were surgically created: 43 contained by 3 walls of bone; 43 non-contained with a missing buccal wall. Chronicity and plaque accumulation were encouraged with wire ligature placement for 8 weeks. After ligature removal, scaling, and a 2- to 4-week healing period, the defects were treated with the following therapies: collagen membrane (GTR), human demineralized freeze-dried bone (DFDB) grafting (BG), combined therapy (GTR + BG) and a DFDB-glycoprotein sponge matrix (MAT). Clinical healing responses were evaluated in 58 sites by changes in soft tissue (recession, probing, clinical attachment) and hard tissue (resorption, defect fill) parameters 6 months post-treatment. Histologic evaluation (defect regeneration, connective tissue attachment, epithelial migration) was done on 26 sites. RESULTS: For contained defects, no real significant clinical (ANOVA) or histologic differences existed among treatments. However, for non-contained defects, combined therapy (GTR + BG) demonstrated clinically significant (P < or = 0.05, ANOVA) and histologically superior healing results over the other therapies tested. CONCLUSION: These results confirm a defect morphology directed rationale for periodontal intrabony therapy.


Assuntos
Perda do Osso Alveolar/cirurgia , Regeneração Tecidual Guiada Periodontal/métodos , Perda do Osso Alveolar/classificação , Análise de Variância , Animais , Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea/fisiologia , Reabsorção Óssea/classificação , Reabsorção Óssea/cirurgia , Transplante Ósseo , Doença Crônica , Colágeno , Tecido Conjuntivo/patologia , Placa Dentária/complicações , Raspagem Dentária , Modelos Animais de Doenças , Inserção Epitelial/patologia , Retração Gengival/classificação , Retração Gengival/cirurgia , Glicoproteínas/uso terapêutico , Humanos , Membranas Artificiais , Papio , Perda da Inserção Periodontal/classificação , Perda da Inserção Periodontal/cirurgia , Preservação de Tecido , Transplante Heterólogo , Resultado do Tratamento , Cicatrização/fisiologia
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