Clinical and Histologic Evidence Documenting the Long-Term Success of Regenerative Therapy Using an...

Area of Science:

• Periodontology
• Regenerative Dentistry
• Biomaterials Science

Background:

• Periodontal defects, particularly furcation involvements, present significant treatment challenges.
• Regenerative therapies aim to restore lost periodontal tissues, including bone and cementum.
• Graft materials combined with growth factors and biomimetic agents show promise for periodontal regeneration.

Purpose of the Study:

• To document the long-term outcome of using a mineralized allograft combined with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and enamel matrix derivative (EMD) for buccal furcation regeneration.
• To histologically evaluate the regenerated tissue and assess the fate of the graft material over 12 years.
• To explore the potential of this combination therapy in guided tissue regeneration (GTR).

Main Methods:

• Retrospective case report involving two adjacent maxillary molars with buccal furcation defects.
• Treatment involved a mineralized allograft hydrated with rhPDGF-BB and EMD.
• Long-term follow-up (12 years) included clinical assessment and, upon tooth extraction, visual and histological evaluation of the regenerated furcation.

Main Results:

• Complete bone fill was observed in both furcations 12 years post-treatment.
• A resorptive lesion developed near the furcation of the second molar, necessitating its extraction.
• Histological evaluation confirmed complete furcation fill with bone and showed that the graft material did not fully resorb into host bone.

Conclusions:

• The combination of mineralized allograft, rhPDGF-BB, and EMD can lead to stable, long-term bone regeneration in molar furcations.
• The graft-biologic combination may contribute to a stable new attachment apparatus.
• Understanding the long-term fate of the graft material is crucial for optimizing GTR strategies.