DT News - Latin America - Predictability of the regenerative therapy in class II furcation defects

Prof. Arthur Belém Novaes Junior, Brasil

jue. 2 septiembre 2010

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The predictability of regeneration of class II furcation defects is considered by many as the most challenging periodontal defect to treat. The main aspect to be considered in the regenerative therapy of class II furcation defect is the large number of factors that can influence the response to such sites. The clinician must be aware of the amount of negative factors present in a given situation, always seeking to minimise them.

Many of such factors are well described in the literature and will be discussed during our FDI presentation along with factors that have been studied by our group, in the School of Dentistry of Ribeirão Preto of the University of São Paulo, Brazil. Our periodontal group has dedicated many decades to studying the wound healing of several techniques including Guided Tissue Regeneration. In these studies, several factors not described well in the literature were reported.

Furthermore, one should keep in mind that regeneration techniques have shown very favourable results when they are well indicated, being highly sensitive to issues that can interfere with host responses, both locally and systemically.

Factors that have been published by our group include the influence of concavities of the root trunk on the regeneration of furcations. Results of animal and human studies will be presented.

Membrane removal with 4 to 6 weeks is the current approach but this has not been proven scientifically but based on the wound healing of other periodontal surgical techniques. We will demonstrate the results, again, of animal and human studies, where membranes were removed at different time intervals to try to identify the shortest period for membrane removal. The longest the membrane remains in place, higher is the possibility of membrane exposure and contamination, factors that will decrease attachment and bone gain.

The association of membranes with grafting materials could also be important in improving our results as well as the association with different grafting materials.
Regeneration of class II furcations without the use of membranes will also be discussed at the FDI. Many materials have been studied with this purpose, and perhaps here lies the future, especially enamel matrix derivative. This product has also been focused in our studies and has the potential for connective tissue attachment but not bone formation on a predictive manner.

Attempts to improve the predictability of bone formation with this material will be described.

Prof. Arthur Belém Novaes Junior presented a session “Biological Basis for Periodontal Surgery” as part of the FDI AWDC’s Specialist Clinical Session programme.

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