Guided Tissue Regeneration using an Equine Bio-absorbable Collagen Membrane with or without Equine Bone Graft in the Treatment of Intrabony Defects in Patients with Aggressive Periodontitis Results of 18 month

Background: Successful periodontal regeneration is considered a gold standard for periodontists. Several GTR materials and bone grafts have been attempted but showed variable success rates. Objective: The present randomized clinical and radiographic study was undertaken to compare the effectiveness of guided tissue regeneration (GTR) by using equine bioabsorbable collagen membrane with or without equine bone graft in the treatment of periodontal intrabony defects affected by aggressive periodontitis. Materials and Methods: Ten systemically healthy patients with 20 periodontal intrabony defects were enrolled as a split mouth design. These defects were affected with aggressive periodontitis. The recorded measurements included plaque index, gingival bleeding index, gingival recession, PPD, clinical attachment level, radiographic defect depth and radiographic density. The defects were randomly distributed either as a control group (equine bioabsorbable collagen membrane alone) or a test group (equine bioabsorbable collagen membrane combined with equine bone graft). Results: The inter& intra-group comparison showed no significant differences between studied groups nor within each group for these clinical parameters (PI, BI & GR), except only gingival recession within group 1. On contrary, the inter& intra-group comparison showed significant differences between studied groups and within each one for these parameters (PPD, CAL, RDD & RD). At 18-month examination, PPD reduction was significantly greater in GTR + bone graft group (3.80±1.33 mm) compared with GTR group (2.60±1.57 mm), and clinical attachment level gain were 3.60±1.15 and 2.20±1.26 respectively. Radiographic DD reduction was similarly greater in GTR + bone graft group (3.30 ± 0.84 mm) compared with GTR group (2.40±1.09 mm). Also, the change in the radiographic density indicated a significant greater gain of mean gray level as (19.90 ± 16.00) in group 2 whereas 7.10±10.65 in group 1. Conclusion: Use of GTR bioresorbable membrane with bone graft showed significant improved outcomes when compared to use of bioresorbable membrane in treating aggressive periodontitis. However, the studied groups showed significant improvement within each group when baseline & 18 month data were compared.