ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Resorbable Membranes are Clinically Superior to Non-resorbable Membranes in the Treatment of Class II Furcation Defects Using Guided Tissue Reneneration (GTR)
Clinical Question In patients requiring GTR therapy for class II furcation invasions, does the use of a resorbable or non-resorbable membrane provide better clinical results?
Clinical Bottom Line Both membranes provide clinically acceptable results, but resorbable membranes were statistically superior with fewer complications.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21091347Kinaia/201188 pts in 13 trialsSystematic Review/Meta Analysis
Key resultsResorbable membranes demonstrated statistically better results with respect to vertical bone fill than non-resorbable membranes by 0.77mm +/- 0.33mm (95% CI 0.13-1.41mm).
#2) 12410941Pruthi/200217 pts, each with two class II furcation invasionsRCT - split mouth design
Key resultsResorbable membranes demonstrated significantly greater bone fill (0.80mm vs -1.00mm, p<0.05), fewer membrane exposures during healing, and better handling characteristics than non-resorbable membranes.
Evidence Search Search 1: "Guided Tissue Regeneration"[Mesh]) AND "Furcation Defects"[Mesh] resorbable membrane Search 2: "Furcation Defects"[Mesh] bioabsorbable membrane
Comments on
The Evidence
While the only statistically significant difference between the membranes was in vertical bone fill, the resorbable membrane was also found to be slightly superior in vertical pocket reduction, clinical attachment gain, and horizontal bone fill. Additionally, the use of resorbable membranes was associated with fewer post-operative complications, e.g. membrane exposure, more ease in handling, and did not require a second stage surgery.
Applicability Because of its slight superiority in clinical results, decrease in complications, decrease in the number of required surgeries, and better handling characteristics, resorbable membranes should be considered the membranes of choice for GTR procedures. However, non-resorbable membranes still offer clinically acceptable results and can be used successfully.
Specialty/Discipline (Periodontics)
Keywords Guided Tissue Regeneration, Resorbable Membrane, Non-resorbable Membrane, Furcation invasion
ID# 2315
Date of submission: 08/07/2012spacer
E-mail degroot@uthscsa.edu
Author Bradley DeGroot
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Guy Huynh-Ba, DDS
Faculty mentor/Co-author e-mail huynhba@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
by Bradley DeGroot (San Antonio, TX) on 09/17/2012
Intrabony defects can sometimes be treated with regenerative therapy. To accomplish this, the defect is accessed, debrided, the principles of guided tissue regeneration (GTR) are applied, and the defect is then allowed to heal. If not excluded from the defect, periodontal epithelial cells migrate rapidly into the wound during healing and the site will heal with a long functional epithelium which is representative of a repair type of healing. Therefore, the use of a membrane is warranted to exclude epithelial cells from the wound healing process which, in turn, allows for re-population of the defect by periodontal ligament and bone cells, allowing true regeneration.
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