COMPARATIVE EVALUATION OF HUMAN PERIODONTAL OSSEOUS DEFECTS TREATED WITH AUTOGENOUS BONE GRAFTS AND LYOPHILISED IRRADIATED AMNIOTIC MEMBRANE: A CLINICO-RADIOGRAPHIC STUDY

Abstract

Background and Aims: Periodontal regeneration is a complicated process involving a number of different cell types and cell-stromal interaction resulting from the ability of cementoblasts, periodontal ligament cells, and osteoblasts to form a new periodontium. Improved understanding of the ability of various growth factors to regulate these cell types may lead to significant improvements in our ability to regenerate the periodontium. Among the graft materials to date, only autogenous bone of extra-oral and intra-oral sources is considered as the ‘gold standard’ because it provides the three elements required for bone regeneration – osteogenesis, osteoconduction and osteoinduction. The amniotic membrane has gained importance specifically because of various factors. The purpose of this study was to evaluate the efficacy of Autogenous graft and lyophilised irradiated Amniotic membrane versus Autogenous graft in the treatment of intrabony defects.

Material and Methods: Twenty-four intra-bony defects (15 patients) following open flap debridement were treated by Autogenous graft and lyophilised irradiated Amniotic membrane or Autogenous graft alone. Clinical parameters such as plaque index (PI), gingival index (GI), gingival bleeding Index (GBI), probing pocket depth (PPD), clinical attachment level (CAL) and gingival marginal position (GMP) were recorded at baseline, 3 months, 6 months and 9 months post-operatively. In both the groups radiographic assessment was done for each site at baseline, 3 months, 6 months and 9 months post-operatively using IOPA paralleling technique and analyzed using COREL DRAW 7 software.

Results: The results showed significant reduction of clinical parameters (PI, GI, GBI, PPD) and radiographic parameters (amount and percentage of bone fill) and significant gain in CAL in both treatment groups which were statistically non-significant on inter group comparison. The mean pocket reduction was statistically significant at baseline and 9 months and non-significant on inter group comparison. The percentage of original defect filled, and percentage of original defect resolved at baseline and 9 months were statistically not significant, whereas the percentage change in alveolar crest was highly significant.

Interpretation and Conclusion: Within the limits of the present study, there was greater reduction in PPD, more CAL gain and greater intra-bony defect fill at sites treated with Autogenous graft and lyophilised irradiated Amniotic membrane than with Autogenous graft alone. Thus, Autogenous graft and lyophilised irradiated Amniotic membrane can be considered as an effective alternative for the treatment of periodontal osseous defects.