"Bio-oss in Treatment of Furcation Class II Deffects and Comparison with Coronally Positioned Flap "

Abstract

Statement of Problem: Among periodontal defects, the furcation involvement represents one of the most chalenging scenarios due to the difficulty of achieving a predictable improvement regardless of the type of periodontal therapy. Moreover, the presence of furcation involvement has been demonstrated to considerably affect tooth prognosis. Thus, treatment of furcation defects is a challenge in clinical periodontics. The aim of periodontal treatment is not only to control infection but also to regenerate periodontal tissues lost as a consequence of periodontal disease. Purpose: The purpose of this study was to compare Bio-oss (Bo), an anorganic bovine bone Xenograft, in combination with coronally positioned flap to open flap debridment surgery with coronally positiond flap alone in human mandibular class II furcation defects. Materials and Methods: In this clinical trial and interventional study 24 furcations, which provided 12 pairs of similar periodontal defects were evaluated. Each defect was randomly assigned to treatment with Bio-Oss in combination coronally positioned flap or open flap debridment and coronally positioned flap alone. Following basic therapy, baseline measurements were recorded including probing depth (PDD), clinical attachment level (CAL), gingival recession (REC), keratinized gingiva (KG) and closed horizontal probing depth (CHPD). After 6 months, all sites were re-entered and hard tissue measurements were recorded. Hard tissue measurements were performed during surgery to determine open horizontal probing depth (OHPD) and open vertical probing depth (OVPD). The data was analyzed using t-test paired sample. Results: Vertical probing depth reduction of 3.17±1.32 mm and horizontal probing depth reduction of 4.42±1.02 mm were noted for the BO group, with 2.87±0.83 mm and 2.31±0.49 mm reductions, respectively, noted for CPF alone. Both surgical procedures resulted in statistically significant probing depth reduction and gain clinical attachment levels, with no significant difference between groups. Recession didn't have significant differences between groups. Hard tissue measurements (after Re-entry) showed 4.17±1.66 mm of vertical furcation bone fill (OVPD) for test group (BO) and 0.83±0.72 mm for CPF alone. The test (BO) group had 3.87±0.88mm of horizontal furcation bone fill (OHPD), and the CPF group had 1.21±0.8mm. Conclusion: There was a statistically significant difference between test (BO) group and CPF group in all soft and hard tissue measurements with the exception of attachment level, recession, and keratinized gingiva. The use of Bio-oss improved horizontal and vertical defect resolution in mandibular class II furcation defects.