Guided Tissue Regeneration Treatment Yields Better Results in Class II Furcations in the Mandible Than in the Maxilla: A Retrospective Study

Abstract

Absorbable porcine collagen membrane with a bovine bone graft can be considered for regenerative treatment in periodontal class II furcation defects. We evaluated the clinical efficacy of guided tissue regeneration (GTR) treatment with bovine bone xenograft and a porcine collagen membrane in molars with class II furcations. Probing depth (PD), clinical attachment level (CAL), and bone level (BL) were recorded at baseline and at 3, 6, and 9 months postoperatively. Thirty class II furcation defects from the lower and upper molars were assessed. Significant improvements in PD and CAL were observed from baseline to 9 months in all groups (p < 0.01). BL improved in all groups except group A in the upper molars in radiographic assessment (p < 0.05). The lower and upper molars showed PD reduction of 50.5% ± 7.44% and 46.2% ± 11.2%, respectively, at 9 months (p = 0.044). In furcations of 1-3 mm, the lower and upper molars showed PD reductions of 51.2% ± 4.49% and 36.5% ± 16.14%, respectively (p = 0.035). The lower and upper molars showed a CAL gain of 51.1% ± 4.64% and 33.6% ± 18.8%, respectively (p = 0.037). Thus, GTR with bovine bone graft and porcine collagen membrane yielded good results in class II furcations, with better results in the lower than in the upper molars.

Keywords: collagen membrane; furcation involvement; guided tissue regeneration; lower jaw; upper jaw.

Figure 1

Study timeline (months).

Figure 2

Surgical procedure for regenerative therapy with collagen membrane. (A) Mandibular molar class II furcation defects. (B) Sulcular incision and full-thickness elevation. (C) Collagen membrane preparation. (D) Placement of collagen membrane. (E) Sling suture technique.

Figure 3

Radiographic parameters of the upper and lower jaws (Group A: 1–3 mm; B: 4–6 mm; and C: >6 mm). * p < 0.05 and ** p < 0.01 *** p < 0.001, respectively.

Figure 4

(A,B) Radiograph of the upper right molar. (C,D) Radiograph of the lower left molar. (A–C). Before GTR treatment. (B–D). 9 months after treatment with bovine bone xenograft and a porcine collagen membrane.

Figure 5

Comparison of hard and soft tissue levels between the upper and lower jaws at baseline and 9 months postoperatively. (A) Probing depth, (B) clinical attachment level, and (C) bone level.

Figure 6

PD reduction and CAL gain at 9 months postoperatively in the upper and lower jaws (%). (A): PD reduction at 9 months and (B): CAL gain at 9 months. * p < 0.05.

Figure 7

PD reduction and CAL gain at 9 months post-treatment in group A (%). (A): PD reduction at 9 months in group A and (B): CAL gain at 9 months in group A. * p < 0.05.