Table 6.
Treatment characteristics and early wound healing assessment
| Author, year of publication | Treatment prior to intervention | Intervention | Specific EMD treatment | Specific GTR treatment | Suture (material/time remotion) | Post-surgical medication | Periodontal parameters assessed | Maintenance | Parameters for early wound healing assessment |
|---|---|---|---|---|---|---|---|---|---|
| A.Sculean et al. 1999a [56] | 3 mo bs: OhI + FM supra- and subgingival Sc |
lA, intracrevicular incisions, full flap, GrTr, ScRp | 2 min 24% EDTA gel, EMD | BM | NA 14 days |
Amox (375 mg TID) Metro (275 mg TID) for 10 days |
GI, BOP, PD, GR, CAL |
0.12% CHX (TID) first 6 w. Tooth brushing resumed. Rv each 2 w (2 mo) and once a month afterwards |
Allergic reactions, suppuration, abscess formation, swelling (1w). Membrane exposure (3w) |
| A.Sculean et al. 1999b [60] | 3 mo bs: OhI + FM supra- and subgingival Sc |
lA, intracrevicular incisions, full flap, GrTr, ScRp | 2 min 24% EDTA gel, EMD | BM | Non-r e-PTFE sutures 14 days |
Amox (1 g/d) for 1 w | PD, GR, CAL | 0.12% CHX (BID) first 6 w. Tooth brushing resumed. Rv (professional tooth cleaning) each 2 w (6 mo) | Allergic reactions, suppuration abscess formation, membrane exposure |
| N. Donos et al. 2004 [62] | 3 mo bs: OhI, ScRp |
lA, intracrevicular incisions, full flap, GrTr, ScRp | 2 min 24% EDTA gel, EMD (4 sites) |
BM alone or BM + EMD | Non-r e-PTFE sutures 14 days |
Metro (250 mg TID) for 1 w | BOP, PAL-V, PAL-H | 0.2% CHX (BID) for 1 min first 6 w. Rv each 1 w (6 w): tooth polishing and Li 0.2% CHX. Tooth brushing resumed. Supragingival tooth polishing + OhI once a mo afterwards | Allergic reaction, abscess formation, membrane exposure (first 2 w) |
| P. Cortellini et al. 2005 [57] | Motivation, OhI, ScRp, Flap surgery in the remaining portions of the dentition | lA, SPPF, MPPT, crestal incision, full flap, GrTr, ScRp | EMD | e-PTFE TrM or BM or BM + BG | 5–0, 6–0 and 7–0 Non–r e-PTFE sutures 7 days | Doxycycline (100 mg BID) for 1 week. | FMPS, FMBS, BOP, PD, GR, CAL, Rx defect angle | 0.12% CHX (TID) and weekly prophylaxis for 6 w. Resumption oral hygiene:2 to 4 w after M removal or when BM were fully resorbed, after 4–5 w EMD group Rv monthly for 1 year |
Primary closure recorded weekly for 6 w |
| A. Crea et al. 2008 [61] | 3 mo bs: non-surgical periodontal therapy | lA, SPPF, full flap, periosteal releasing, GrTr, ScRp | 2 min 24% EDTA gel, EMD | e-PTFE M | 4–0 Non-r e-PTFE sutures 10 days |
One day prior to surgery, Amox (500 mg BID) for 6 days | PD, CAL, GR, BOP, PI Is: IC, Rs-BC, CEJ-BD, CEJ-BC RMDD, RVBG |
1% CHX gel (TID) (4 w) Rv each 1 w (first 6 w). Rv every 3 mo. At each visit: supra-gingival debridement teeth polish, OhI, BOP, PI assessment |
Wound dehiscence, pain or discomfort, abscess formation, swelling, allergic reactions (5–6 days) |
| V. Iorio-Siciliano et al. 2011 [58] | Non-surgical mechanical debridement | lA, MPPT or SPPF,full flap, GrTr, ScRp | 2 min 24% EDTA gel, EMD | e-PTFE TrM | 5–0 Non-r sutures 7–10 days | 600 mg Ibuprofen immediately before the surgery and after 4 h | FMPS, FMBS, PD, REC, CAL, Is: IVLD: CEJ-BD, VLD: BC-BD, HLD: Rs-BC, Rx defect angle |
0.12% CHX (first 2 w) Modified oral hygiene procedures (4 w). Professional maintenance care after 2 and 4 w and after 3,6,9,12 mo |
Early wound healing complications, membrane exposure after 1 w |
| V. Iorio-Siciliano et al. 2014 [59] | Non-surgical mechanical debridement | lA, MPPT or SPPF, full flap, GrTr, scaling and root planing | 2 min 24% EDTA gel + DBBM particles (0.25 to 1.0 mm) + EMD | DBBM + BM | 5–0 Non-r sutures 7–10 days |
600 mg Ibuprofen immediately before surgery and after 4 h or 500 mg Acetaminophen immediately before and after 6 h | FMPS, FMBS, PD, REC, CAL, Is: CEJ-BD, VLD: BC-BD HLD: Rs-BC |
0.12% CHX (first 2 w) Modified oral hygiene procedures (4 w). Professioal maintenace care after 2 and 4 w and after 3,6,9,12 mo |
Early wound healing complications, membrane exposure after 1 w |
Amox amoxicillin (systemic administration); BC bone crest, BD bottom of the defect, BG bone graft, BID twice times a day, BM bioabsorbable membrane, BOP bleeding on probing, Bs before surgery, CAL clinical attachment level, CEJ cemento-enamel junction, CHX chlorhexidine, DBBM deproteinized bovine bone mineral, EDTA Ethylenediaminetetraacetic acid, EMD enamel matrix derivative, e-PTFE expanded polytetrafluoroethylene, FM full mouth, FMBS full mouth bleeding score, FMPS full mouth plaque score, GI gingival index, GR gingival recession, GrTr granulation tissue remotion, GTR guided tissue regeneration, HLD horizontal linear distance, IC intrabony component of the defect, Is intrasurgical, IVLD intrasurgical vertical linear distance, La local anesthesia, Li local irrigation, M membrane, mo months, min minutes, Metro metronidazole, MPPT modified papilla preservation technique, NA not available, Non-r non resorbable, OhI oral hygiene instructions, PAL-H probing attachment level (mm) in the horizontal direction, PAL-V probing attachment level (mm) in the vertical direction, PD probing depth, PI plaque index, RMDD radiographic measurement of defect depth, RVBG radiographic vertical bone gain, Rs root surface, Rv recall visitis, Rx radiographical, Sc scaling, ScRp scaling and root planning, SPPF simplified papilla preservation flap, VLD vertical linear distance, TID three times a day, TrM titanium reinforced membrane, w weeks