Bacterial colonization of barrier material and periodontal regeneration

The objective of this study was to evaluate the relationship between the presence of bacteria on the tooth-facing surface of ePTFE barriers and the clinical outcome of membrane supported reconstructive periodontal surgery. 20 systemically healthy subjects affected by chronic periodontitis were enrolled. One tooth site per patient, associated with an angular bony defect and a probing attachment loss of > 4 mm, was selected to be treated by means of a guided tissue regeneration procedure using an ePTFE barrier membrane. Antibiotics (Augmentin 1 g/day) for 2 weeks were prescribed. In addition to the use of chlorhexidine for post-surgical plaque control, all patients were recalled once a week for professional tooth cleaning. The barrier material was harvested for SEM analysis after 4-6 weeks. Professional tooth cleaning and reinforcement of sel-performed oral hygiene measures were given at 1 mouth intervals after membrane removal. For each treated site, the difference in probing attachment loss between baseline examination and a follow-up examination after 6 months of healing was calculated. The results of the SEM-analysis revealed that bacterial colonization was evident in the collar area of all the retrieved membranes. In the mid part of the membranes 30 out of 60 microscopic fields (50%) demonstrated microbial colonization, and in the most apical part 9 out of 60 fields (15%). Regression analysis indicated that gain in probing attachment level was positively correlated to initial attachement loss and negatively correlated to microbial colonization of the mid part of the membranes. It was concluded that bacterial colonization in the mid part of the ePTFE membrane reduced the potential gain in probing attachment following GTR-therapy with almost 50%.