The effect of flap management and bioresorbable occlusive devices in GTR treatment of degree III furcation defects

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  • An experimental study in dogs

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<jats:p><jats:bold>Abstract</jats:bold> The present experiment on guided tissue regeneration had 2 objectives namely: (i) to study if an improved anchorage of the soft tissue flaps during the initial healing period after membrane placement would reduce the tendency for soft tissue recession and allow for healing of also large furcation defects; (ii) to determine if the use of biodegradable membranes in GTR procedures may promote new attachment formation in degree III furcation defects. 2 experiments were performed which included 5 and 8 dogs each. In each animal, the 3rd pre‐molar of the left or right side of the mandible was selected as test site using the contralateral tooth as control. 2 months prior to the start of the experiment, the 2nd and 4th premolars in each side of the mandible were extracted. The extractions were performed to create a large edentulous space mesial and distal to the 3rd premolar. During GTR therapy the incisions prepared in this edentulous region were used to allow proper suture retention and flap stability during the initial phase of healing. In study 1, furcation defects (degree III) were prepared and subsequently treated according to GTR using e‐PTFE membranes in the test and no membrane in the control site. In study 2, a bioresorbable membrane (Resolut®) was installed in the test and an e‐PTFE membrane in the control sites. The non‐resorbable membranes were removed after 30 days. The animals were sacrificed 5 months after reconstructive surgery, biopsies were harvested, sectioned and analyzed histologically for new connective tissue attachment and bone. The results demonstrated that comparatively large furcation defects can be successfully regenerated by GTR therapy provided the membrane‐covering soft tissue flaps are prevented from receding apical of the furcation fornix during healing. Our findings also disclosed that a biodegradable membrane provides a barrier which is equally effective as a non‐degradable teflon membrane in a GTR procedure.</jats:p>

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