[Treatment of periodontal infrabony defects with alloplastic implantation materials]

The implantation of alloplastic materials in infrabony defects is controversely discussed. Only calcium phosphate ceramics have been proven as implantation materials for clinical use. All of the materials not being inert they undergo biodegradation. The extent of biodegradation is most pronounced with tricalciumphosphate (TCP). It had been shown in clinical studies that reduction of probing depth and gain of probing attachment level increased with implantation when compared to surgery only. Formation of new attachment however, can only be verified by histological analysis. Block sections of human teeth demonstrated different results in terms of gain of attachment when porous hydroxyapatite (HA) was implanted. Histometric analysis of a study in dogs showed significant gain of attachment by implanting porous HA and TCP in infrabony defects. Using solid HA or a modified Widman flap healing occurred only by reparation forming a long junctional epithelium. In conclusion, it can be stated that regeneration of periodontal tissues may be achieved by means of implantation of porous HA and TCP. However, long term results are not available and the clinical parameters to obtain predictable results still have to be defined.