Comparison of Autogenous Periosteal Pedicle Graft and Collagen Membrane in Management of Periodontal Intrabony Defects

Overview

A clinical and radiographic evaluation of autogenous periosteal pedicle graft in comparison with collagen membrane for management of periodontal intrabony defects.

Full Title of Study: “Comparison of Autogenous Periosteal Pedicle Graft and Collagen Membrane in Management of Periodontal Intrabony Defects: A Randomized Controlled Clinical Trial.”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Participant)
  • Study Primary Completion Date: April 2014

Detailed Description

Twenty patients suffering from advanced chronic periodontitis were included in this randomized controlled clinical trial. Each subject contributed matched pairs of two- or three-walled intrabony defects. Each pair of periodontal defects were randomly assigned into the experimental group; periosteal pedicle graft guided tissue membrane or the positive control group; bioresorbable collagen guided tissue regeneration membrane. Clinical and radiographic parameters were recorded at baseline and at 6 months postoperatively.

Interventions

  • Procedure: Periosteal pedicle graft
    • Autogenous pedicle graft harvested from the periosteum
  • Biological: Bioresorbable collagen membrane
    • Biocollagen is a thin equine Achilles tendon collagen barrier membrane used for guided tissue regeneration

Arms, Groups and Cohorts

  • Experimental: periosteal pedicle graft
    • autogenous marginal periosteal pedicle graft harvested by partial thickness periodontal flap.
  • Active Comparator: Bioresorbable collagen membrane
    • Equine Achilles tendon collagen barrier membrane

Clinical Trial Outcome Measures

Primary Measures

  • Clinical Attachment Level
    • Time Frame: Baseline and 6 months
    • Estimation of clinical attachment level in chronic periodontitis patients at baseline and 6 months after guided tissue regeneration

Secondary Measures

  • Pocket Depth
    • Time Frame: Baseline and 6 months
    • Estimation of pocket depth in chronic periodontitis patients at baseline and 6 months after guided tissue regeneration
  • Bone Defect Area
    • Time Frame: Baseline and 6 months
    • linear measurements collected from a digital radiography program to estimate percentage of defect fill.

Participating in This Clinical Trial

Inclusion Criteria

  • Severe chronic periodontitis patients with at least two sites with pocket depth ≥ 6 mm and clinical attachment level ≥ 5 mm, with radiographic evidence of bone loss 2- or 3-wall intrabony defect depth ranging from 3 to 6 mm as detected in periapical radiographs – The facial surface of teeth adjacent to the interproximal defect should be free of extensive recession and marginal bone loss, with at least a 4 to 5 mm band of keratinized gingiva to allow for periosteal manipulation Exclusion Criteria:

  • Pregnant women – Subjects had <22 permanent teeth – Having any given systemic disease – Taking any type of medication and/or antibiotic therapy during the 3 months before the study – Received periodontal treatment within the past 12 months – Current or former smokers

Gender Eligibility: All

Minimum Age: 35 Years

Maximum Age: 50 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Cairo University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Noha Ayman Ghallab, Associate Professor of periodontology, faculty of oral and dental medicine – Cairo University
  • Overall Official(s)
    • Noha Ghallab, M.D., Principal Investigator, Associate Professor of periodontology faulty of oral and dental medicine Cairo Unv.

Citations Reporting on Results

Singhal R, Nandlal, Kumar A, Rastogi P. Role of space provision in regeneration of localized two-wall intrabony defects using periosteal pedicle graft as an autogenous guided tissue membrane. J Periodontol. 2013 Mar;84(3):316-24. doi: 10.1902/jop.2012.110734. Epub 2012 May 21.

Gamal AY, Mailhot JM. A novel marginal periosteal pedicle graft as an autogenous guided tissue membrane for the treatment of intrabony periodontal defects. J Int Acad Periodontol. 2008 Oct;10(4):106-17.

Paolantonio M, Femminella B, Coppolino E, Sammartino G, D'Arcangelo C, Perfetti G, Perinetti G. Autogenous periosteal barrier membranes and bone grafts in the treatment of periodontal intrabony defects of single-rooted teeth: a 12-month reentry randomized controlled clinical trial. J Periodontol. 2010 Nov;81(11):1587-95. doi: 10.1902/jop.2010.100094. Epub 2010 Jun 28.

Bunyaratavej P, Wang HL. Collagen membranes: a review. J Periodontol. 2001 Feb;72(2):215-29. doi: 10.1902/jop.2001.72.2.215.

Stoecklin-Wasmer C, Rutjes AW, da Costa BR, Salvi GE, Juni P, Sculean A. Absorbable collagen membranes for periodontal regeneration: a systematic review. J Dent Res. 2013 Sep;92(9):773-81. doi: 10.1177/0022034513496428. Epub 2013 Jul 10.

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