Evaluation of bioabsorbable elastin-fibrin matrix as a barrier in surgical periodontal treatment

The purpose of this investigation was to test clinically the efficiency of a recently described bioabsorbable matrix as a guided tissue regeneration membrane. This matrix was prepared from an original reaction between elastin and fibrin monomers and is now extensively used in several domains of surgery. The study group was composed of 26 patients, with a total of 35 lesions (22 intrabony defects, 8 Class II furcations and 5 Class III furcations) presenting moderate to advanced adult periodontitis. After initial therapy, measurements were made with a calibrated periodontal probe. Probing depth (PD) and gingival margin location (GM) measurements were taken twice: immediately before surgery and after 6 months before re-entry. Clinical attachment level (CAL), vertical osseous level (VOL) and alveolar crest location (AC) measurements were taken during surgery and after 6 months with re-entry procedures for all the patients. Color change of the gingival margin was only observed in 4 defects and device exposure occurred in the proportion of 2 out of the 35 defects. No foreign body reaction was observed in any case. At the intrabony defects mean PD reduction was 5 mm (P < 0.001), and mean gain of CAL was 4 mm (P < 0.001). Mean VOL was 4.3 mm (P < 0.001), mean gingival recession was 0.9 mm (P < 0.05) and mean AC was 0.2 mm (NS). At the Class II furcation defects the mean PD reduction was 4.5 mm (P < 0.001), mean gain CAL vertical was 3.2 mm and CAL horizontal was 4.5 mm (P < 0.001). Gingival recession averaged 1 mm (NS). A complete closure was observed in 2 out of the 8 defects. At the Class III furcation defects the mean PD reduction was 3.6 mm (P < 0.05) and mean CAL-V gain was 1.5 mm (P < 0.02). However the 5 sites showed no horizontal attachment gain and none were unchanged. A very low gingival recession, gingival reaction, crestal bone loss, and device exposure occurred during this study. This preliminary study suggests that the use of a biosynthetic barrier may have beneficial effects in the treatment of intrabony defects and Class II furcation defects. Randomized controlled trials are necessary to evaluate the efficacy and safety of this bioabsorbable membrane in periodontal therapy.