Quality Resource Guide –

Periodontal Regeneration 3rd Edition

www.metdental.com

Page 7

with a coronally advanced flap).

However, human

histological studies have shown that healing at

the gingiva-root interface following pedicle flaps

or free soft tissue grafts generally involves a

long junctional epithelium with limited and variable

amounts of new connective tissue attachment or

bone regeneration.

Although clinically successful,

current therapeutic approaches to the treatment of

recession defects are achieved primarily by repair

rather than regeneration.

Factors Impacting Treatment

Outcome

The predictability of periodontal regeneration

appears to be influenced by multiple factors related

to the patient, defect morphology, and surgical

management,

7,19

which contribute to variability

clinical

outcomes

following

regenerative

therapy.

Patient compliance with oral hygiene

procedures and frequent periodontal maintenance

are critical for optimal regenerative outcome and

maintenance of long-term therapeutic success

following regenerative therapy. Smoking adversely

affects all regenerative outcome parameters and

increases the risk for periodontal breakdown

following treatment.

Surgical access is also

a major determinant of whether intraosseous

lesions, such as proximal furcation defects, can

be successfully treated with regenerative therapy.

Systemic antibiotics appear to provide a consistent

but modest benefit in clinical attachment level

gains following periodontal surgery;

therefore,

the selective use of antibiotics should be guided

primarily by a clinician’s assessment of need

based on a patient’s dental and physical status.

Microbiologic identification and antibiotic sensitivity

testing are generally

limited

to cases of aggressive

or refractory periodontitis. Longitudinal studies

document the stability of clinical outcomes achieved

with regenerative therapy, although insufficient

evidence is available to meaningfully compare the

long-term stability of gains in periodontal support

and tooth survival following various regenerative

treatment approaches.

References

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Shimono M, Ishikawa T, Enokiya Y, et al.

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