120 Infrabony Defects Treated With Regenerative Therapy : Long Term Results

Background: The aim of this study is to evaluate the long-term benefits of regenerative therapy and which factors (smoking, oral hygiene (OH), radiographic angle, tooth, clinical center, bio-material) influence the results. Methods: One hundred-twenty infrabony defects were treated with Guided Tissue Regeneration (GTR), using resorbable and non-resorbable membranes with graft, or enamel matrix derivative proteins (EMD). At the baseline smoking, x-ray angle, pocket depth (PPD), recession and clinical attachment (CAL) were recorded. CAL was measured 1 year after surgery and every 2 years for up to 16 years. Patients' participation in the OH protocols was recorded. Results: Baseline CAL was 8.5 ± 2.3 mm, PPD 7.8 ± 2.1 mm and x-ray angle 31.8 ± 8.9 °. One year after CAL gain was 4.1 ± 2.1 mm. EMD was used in 47 defects, resorbable membranes with deprotenized bovine bone in 41 cases, non-resorbable membranes in 7, resorbable membranes and autogenous bone in 5 and combination in 20 defects. 10% were smokers and 20% didn't participate in the OH program. Average follow up was 9 years. 90% of teeth survival was achieved at 13 years and the CAL gained was maintained at 82% for 11 years. Statistical analysis demonstrated that both smoking and OH maintenance influences long-term outcomes. X-ray angle, tooth, clinical center and bio-materials didn't influenced the results. Conclusions: Regenerative therapy provides a high percentage of long-term success. Smoking and non-participation in OH maintenance negatively influence the prognosis, while other factors didn't affect long term results.