COMPARISON OF AUTOGENOUS PERIOSTEAL PEDICAL GRAFT AS A BARRIER AND BIORESORBABLE COLLAGEN MEMBRANE IN MANAGEMENT OF PERIODONTAL INTRABONY DEFECTS: A RANDOMIZED CONTROLLED CLINICAL TRIAL

Introduction: The autogenous periosteal pedicle graft (PPG) has been viewed as having regenerative potential and provides adequate blood supply rich in growth factors. It also provides a rigid barrier maintaining the patency of the periodontal intrabony defect space for regenerative cell repopulation. Thus, PPG might be an alternative to currently available barrier membranes used for guided tissue regeneration (GTR). So, the aim of this study was to evaluate the clinical and radiographic outcomes of autogenous PPG as a barrier compared to bioresorbable collagen membrane (CM) for treating periodontal intra-bony defects.
Materials and methods: Twenty chronic periodontitis patients having matched contralateral periodontal intrabony defects participated in this randomized controlled clinical trial. Using split-mouth design, defects were randomly treated with either autogenous PPG or bioresorbable CM (Bioteck®, Arcugnano VI, Italy). Clinical outcomes included; plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL). Digital periapical radiographs and linear measurements were used to calculate the radiographic outcomes; bone defect area (BDA). Measurements were taken at the time of surgery (baseline) and 6-months postoperatively. Statistical analysis was conducted using Wilcoxon’s-Signed-Rank test.
Results: At 6 months both treatments resulted in statistically significant improvement in all clinical and radiographic outcomes compared with baseline (P<0.0001). In the PPG group, the PPD (mean±SD) was reduced from 6.92±0.76 mm to 3.17±0.65 mm, the CAL (mean±SD) was improved from 6.42±0.56 mm to 3.52±0.44 mm, the reduction in BDA (mean±SD) was 3.94±4.09 mm2 and the percentage of reduction in BDA (mean±SD) was 39.47±20.77 %. In the CM group, the PPD (mean±SD) was reduced from 6.82±1.1 mm to 3.15±0.67 mm, the CAL (mean±SD) was improved from 6.15±0.98 mm to 3.6±0.57 mm, the reduction in BDA (mean±SD) was 3.54±3.44 mm2 and the percentage of reduction in BDA (mean±SD) was 34.55±26.88 %. Differences between groups were not statistically significant (P>0.05).
Conclusion: Within the limitations of this study, it can be concluded that both the autogenous PPG and the bioresorbable CM improved clinical and radiographic outcomes and were effective GTR membranes in management of intra-bony defects.