Healing of human suprabony lesions treated with guided tissue regeneration and coronally anchored flaps. Case reports

Teflon membranes were interposed between soft tissue flaps and roots in 4 human suprabony lesions affecting the mandibular incisor teeth in 1 volunteer patient. 4 suprabony lesions affecting the mandibular incisor teeth were used as comparisons in a 2nd patient. All roots were debrided using ultrasonic and manual instruments and the most apical positioned calculus/site on the facial surface was notched. Flaps were sutured as coronally as possible using orthodontic brackets as anchors. Tissue blocks were removed 2 to 3 months after procedures and the facial aspects of all teeth were examined histologically. New attachment in the form of new "cementum with functionally oriented fibers" was seen within the calculus notch in 3 out of 4 membrane-treated sites and immediately apical to the notch at 1 site. The 4 comparison sites showed no evidence of new attachment within or adjacent to the notch. Rather, the gingival margins were located apical to the notch. Our observations suggest that guided tissue regeneration techniques improved coronal attachment responses in human suprabony lesions within the sample described.