For the first time a 5-year prospective study from Belgium has investigated the clinical and radiographic outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and Geistlich Bio-Oss® Collagen to treat at least one interdental infrabony defect.1
RPT has been proposed as a viable treatment concept for infrabony defects.2 Histological studies have demonstrated the regeneration potential for Guided Tissue Regeneration (GTR),3 allograft,4 xenograft,5 and enamel matrix derivative.6 Since a prerequisite for broad application of RPT is procedural simplicity, EMD may be considered more favorably than GTR. However, EMD may not be ideal for treating wide defects, especially those with a non-supportive anatomy, which could instead benefit from a treatment with Geistlich Bio-Oss® Collagen.
Select highly compliant and plaque-free patients
Before surgery, mean probing depth (PD) was 7.8 mm, mean clinical attachment level (CAL) was 10.0 mm, and mean defect depth was 5.2 mm. A total of 71 patients could be evaluated at five years. Mean PD reduction was 3.3 mm, mean CAL gain was 3.0 mm, and mean radiographic bone gain was 57%. No significant difference was observed in any of these parameters between one and five years, which demonstrates stable results.
RPT succeeded in 76% of the cases (≥ 1 mm CAL gain) and regression analyses showed superior outcomes in highly compliant and plaque-free patients. The predictability of RPT can therefore be improved by very stringent case selection: only patients with perfect oral hygiene and excellent compliance should be considered.