Treatment of inter-radicular lesions with demineralised freeze dried bone allografts (DFDBA) and guided tissue regeneration (GTR) : an histological study

Aim of the study

The aim of this study was to evaluate human histological sections to ascertain if it is possible to obtain regeneration in interradicular lesions caused by periodontitis.

Materials and methods

Three Class II interradicular mandibular molar lesions in a 47 years old female patient who was due to receive an immediate complete prosthesis were treated in one appointment with demineralised freeze dried bone allografts (DFDBA) covered with a resorbable membrane. A notch was created in the interradicular calculus which served as a reference point in the histological study. Six months post-operatively, the teeth were extracted with a small quantity of interradicular tissue and were processed for histology.

Results

Clinical parameters showed gains of attachment of 1, 1 and 2,5 mm. One lesion became Class I and the other two remained Class II. The histological study showed bone regeneration in one molar with the new bone formation being coronal to the reference notch. One other molar showed signs of repair with epithelium at the level of the notch and regeneration apically. There was no regeneration around the remaining molar.

Conclusion

Regeneration in human interradicular lesions using DFDBA under a resorbable membrane is possible but the quantity of regenerated tissue is variable. For teeth with a better prognosis than this clinical case, it is reasonable to assume that regeneration can occur.

Commentary

This study is one of the few histological studies in human subjects treated by bone grafting in association with a membrane. The histological illustrations are clearly labelled. At the end of the article, the author poses several unanswered questions ; how, and what are the factors which improve the predictability of complete regeneration in interradicular lesions ?