An augmented regenerative technique for severe osseous defects.

Techniques for new attachment using the principle of guided tissue regeneration with barrier membranes have become accepted as a method for treating teeth with severe osseous defects and furcation involvement. After an evaluation of existing membranes and techniques, a procedure was developed using an expanded polytetrafluoroethylene soft tissue patch, 1 mm thick (W. L. Gore and Assoc., Flagstaff, AZ), in conjunction with an alloplast hydroxylapatite bone substitute (HA-500, 40-60 mesh) (Orthomatrix, Minneapolis, MN), to maintain a space for the maturation of the blood clot. An in vitro study of microbial adherence to the soft tissue patch indicated that the number of attached Streptococcus sanguis (gordonii) G9B, and Actinomyces viscosus T14 (V) cells was significantly lower (P < .005 and P < .025, respectively) than the number of bacteria that attached to Gore-Tex Periodontal Material. Two case reports are presented to demonstrate the successful use of the soft tissue patch augmented with hydroxylapatite in patients exhibiting furcation involvement and severe vertical osseous defects.