Fogorvosi szemle, 2002 (95. évfolyam, 1-6. szám)

2002-08-01 / 4. szám

FOGORVOSI SZEMLE ■ 95. évf. 4. sz. 2002.

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Dr Gera I, Dr Dőri F, Dr Keglevich T, Dr Sculean A, Dr Szilágyi E, Dr Windisch P:

Clinical evaluation of ß tri-calcium phosphate (Cerasorb®) as a bone replacement graft material in human

periodontal osseous defects.

Various bone replacement graft materials have been used in attempting to restore periodontal bone structure lost as a result of periodontal inflammation. The pure ß-tricalcium phosphate has been successfully used in oral surgery for replacing lost bone but the periodontal data available are very limited. The major objective of the present clinical trial is to evaluate the regenerative-reparative potential of ß-tricalcium phosphate (CERASORB®) in the treatment of twothree-wall vertical periodontal bony defect.

21 patients with advanced intrabony defects were selected for this study. Parameters used for assessment: Bleeding on probing, Clinical Probing Depths (CPD), Clinical Attachment Loss (CAL), Clinical Gingival Recession (CGR) and Radiological evaluation on standardized periapical radiographs. Following local anesthesia, intracrevicular incisions is placed and a full thickness mucoperiosteal flap is raised vestibularly and lingually. The granulation tissue was completely removed from the defects and the roots were thoroughly scaled and planed using hand and ultrasonic instruments. Osseous recontouring was not performed. Following defect debridement, the CERASORB® bone-grafting material was carefully applied and gently condensed in the bone crater then the flaps were repositioned in a coronal position and closed with vertical or horizontal mattress sutures. Six months after surgery CPD, CAL and CGR parameters were also measured and compared to baseline data. Bone defects treated with ß-TCP bone grafting materials showed a great variation in healing tendency. The best radiological results (bone fill) were obtained in three wall defects.

Even using the most thorough suturing technique substantial part of the bone grafting material was lost during the first post-surgical week. If no sequestration occured substantial bone fill and clinical attachment gain occurred especially in the three wall defects one year after grafting. The use of biological barrier membranes are recommended.

Key words: bony defects, ß-tricalcium phosphate, bone fill, attachment gain