January 2012

Objective: The aim of the present study was to clinically and histologically examine the effects of a marginal periosteal pedicle graft as a biologic guided tissue membrane. Material and methods: Fifteen patients with severe chronic periodontitis participated in this prospective, controlled, blind trial. Each paired periodontal defect was clinically evaluated for nine months. Nine months following therapy at re-entry, samples of the newly formed tissue were harvested from all test and control sites. Hopeless teeth of test and control samples were extracted for histologic evaluation of root surfaces exposed to the pocket environment. Results: At nine months, the experimental group showed a significant improvement in pocket depth reduction, clinical attachment level gain and intrabony defect reduction when compared to the open flap debridement control (p < 0.01). Histologic evaluation of test samples revealed coarse-fibered woven bone filling the defect nine months following therapy in three of the 10 examined newly formed tissue samples. Apical root notches of such samples showed a homogenous layer of cementum-like tissue deposition. Conclusion: Placement of a vascularized marginal periosteal pedicle graft as a barrier membrane significantly improved clinical and histologic parameters of deep periodontal intrabony defects.