(31) Guided Tissue Regeneration- Retrospective Review With Up To Four Year Follow-Up Of Clinical Success

Introduction: Guided Tissue Regeneration has the potential to optimize the outcome of pocket reduction procedures without sacrificing healthy periodontium. However, many factors should be considered to enhance tissue regeneration, such as thorough case selection and materials or techniques. Traditionally, GTR requires the barrier membrane to exclude the epithelium that grows into the defect. There are evolving developments in regeneration procedures, such as biologics that aim to mimick, induce, and regulate the activity of the natural events in the healing, which lead to the promotion of tissue regeneration. Also, combination therapy has demonstrated significantly more periodontal regeneration than each individual component. The aim of this study is to evaluate the clinical outcomes and survival of teeth treated via guided tissue regeneration

Methods: This retrospective study included participants who had undergone regenerative treatment to address periodontal defects between 2016 and 2021 in the dental school setting and private specialty practice. All electronic records, including radiographs, were carefully analyzed. Due to the study’s retrospective design, data on missing and unresponsive cases were excluded. A total of 163 patients were thoroughly assessed. A rigorous analysis of each chart was performed. All relevant periodontal charting, radiographs, periodontal maintenance frequency, and clinician notes were reviewed. The use of a barrier membrane or biologic was also considered, as well as whether a bone graft was utilized in the treatment. Demographics such as age, gender, and medical history were evaluated.

Results: This study found that of the qualified cases, there was a 77% reduction in probing depths, in which the PD measured 5 mm or less. Only 6% of the cases were deemed as a failure and ultimately the tooth was extracted. The 2+ year survival rate was 94%. Of particular interest is the use of biologics, in which no membrane was used, and it was observed that there was a 100% success rate for all cases evaluated that utilized a biologic. 34% of the observed cases used an enamel matrix derivative (EMD), and 17% used platelet-derived growth factor (PDGF). 21% of cases used a porcine-derived collagen membrane, and 6% used a bovine-derived collagen membrane. Regarding bone graft materials, 57% of cases used FDBA, the most frequently used. The average follow-up time was 6 ± 2 months, with 32% of patients having greater than two year follow-up. Additionally, 95% of the included patients underwent periodontal maintenance 6 ± 3 months.

Conclusions: Within the study’s limitations, this data suggests that treatment of periodontal defects via a combination of materials provide viable long-term success when considering all clinical and radiographic parameters. This study provides further evidence of the long-term success of guided tissue regeneration.

Lead Author’s Contributions to the Research Project: As lead author, I was responsible for all chart review, data collection, and analysis, as well as preparing the abstract.