Collagen/hydroxyapatite/chondroitin sulphate implant in the treatment of deep intrabony defects

AIM OF THE STUDY: This study was designed to evaluate clinical effectiveness of a equine Type I collagen/synthetic hydroxyapatite/chondroitin-4-sulphate implant (Biostite®, Vebas s.r.l., S.Giuliano M., Milan, Italy) following reconstructive surgery in deep intrabony defects, as compared to a bovine hydroxyapatite implant (Bio-Oss®, Geistlich AG, Wolhusen, Switzerland). MATERIAL AND METHODS: Selection criteria were 1) systemically healthy conditions with no contraindications to periodontal surgery; 2) presence of at least one interproximal deep intrabony defect (intrabony component ≥ 4 mm). Prior to surgery, patients had received oral hygiene instruction and multiple scaling and root planing sessions. Surgical procedure was performed when full-mouth plaque score was ≤ 20%. Surgical therapy included full-split thickness flap elevation and thorough defect debridement. Intrabony defects were randomly grafted with Biostite® or Bio-Oss® implant. Flap was passively adapted and sutured to completely cover the implant. Postsurgery plaque control regimen consisted of a 0.12% chlorhexidine mouthwash prescription (twice daily for 4 weeks) and a monthly recall program (supragingival scaling and oral hygiene reinforcement for 6 months). The following clinical parameters were recorded (in mm) immediately before surgery (baseline) and 6 months postsurgery at the deepest location of the selected interproximal site: 1) probing pocket depth (PPD), from the gingival margin to the bottom of the pocket; 2) clinical attachment level (CAL), from the cemento-enamel junction (CEJ) to the bottom of the pocket; 3) recession depth (RD), from the CEJ to the gingival margin. The following defect morphology parameters were recorded (in mm) after debridement of the defect: 1) distance from the CEJ to the bottom of the defect (CEJ-BD); 2) distance from the most coronal extension of the interproximal bone crest to the bottom of the defect, i.e. the intrabony component of the defect (INFRA). Data were expressed as means ± standard deviations. The patient was regarded as the statistical unit. Significance of differences within and between groups was analyzed using the Student t-test for paired and for independent observations, respectively. The level of significance was set at 5%. 13 defects in 13 patients (7 males, mean age: 47.5 years, 5 smokers) were grafted with Biostite®, 12 defects in 11 patients (5 males, mean age: 46.1 years, 2 smokers) were grafted with Bio-Oss®. CONCLUSIONS: 1) Biostite® resulted in significant PPD reduction and CAL gain following reconstructive treatment of deep intrabony defects; 2) no statistically significant differences were observed between Biostite® and Bio-Oss® groups in terms of PPD reduction and CAL gain. This study was partly supported by grant from Vebas s.r.l., S.Giuliano M., Milan, Italy, and grant ex 60% 1999 from University of Ferrara, Italy.