Periodontal Repair in Intrabony Defects Treated With a Calcium Carbonate Implant and Guided Tissue Regeneration

Clinical outcome following the concurrent use of a porous resorbable calcium carbonate (CC) implant and guided tissue regeneration (GTR) in intrabony periodontal defects was evaluated in a randomized four-treatment parallel arm study. Eighty (80) patients, each contributing one interproximal intrabony defect, were assigned to the four treatments (20 patients per treatment) including the CC implant and GTR (CC + GTR), GTR alone (GTR control), CC implant alone (CC control), and gingival flap surgery alone (GFS control). Fourteen patients treated with CC + GTR, 19 patients treated with the GTR control, 13 patients treated with the CC control, and 18 patients treated with the GFS control completed the study. Clinical healing was evaluated 6 months postsurgery and included changes in probing depth, clinical attachment level, probing bone level, and gingival recession. Postsurgery probing depth reduction was 4.5 +/- 1.7 mm (CC + GTR; P < 0.01), 4.8 +/- 1.8 mm (GTR; P < 0.01), 3.7 +/- 2.2 mm (CC; P < 0.01), and 3.3 +/- 1.6 mm (GFS; P < 0.01). Clinical attachment gain amounted to 3.3 +/- 1.4 mm (CC + GTR; P < 0.01), 4.0 +/- 2.1 mm (GTR; P < 0.01), 3.0 +/- 2.4 mm (CC; P < 0.01), and 2.0 +/- 1.7 mm (GFS; P < 0.01). The CC + GTR and GTR treatments exhibited significantly greater improvements compared to GFS (P < 0.05). Postsurgery probing bone level gain amounted to 4.0 +/- 1.7 mm (CC + GTR; P < 0.01), 4.1 +/- 1.5 mm (GTR; P < 0.01), 4.0 +/- 2.2 mm (CC; P < 0.01), and 0.5 +/- 2.0 mm (GFS; P > 0.05). The CC + GTR, GTR, and CC treatments exhibited significantly greater improvements compared to GFS (P < 0.05). Gingival recession increased significantly compared to presurgery for GTR, CC, and GFS treatments (-0.9 +/- 1.2, -0.7 +/- 0.7, and -1.2 +/- 1.4 mm, respectively; P < 0.01). The results suggest that the concurrent use of a porous resorbable CC implant and GTR has limited adjunctive effect in the treatment of intrabony periodontal defects.