Use of periosteal membrane as a barrier membrane for the treatment of buccal Grade II furcation defects in lower molars: a novel technique.

OBJECTIVE To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. MATERIALS AND METHODS This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane) was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL), and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. RESULTS Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. CONCLUSION This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.