Effects of cementum-impregnated gelatine membrane on early healing following periodontal flap surgery.

The purpose of this study was to investigate the initial healing response of surgically flapped periodontal tissues in the presence of gelatine membrane compounded with particles of cementum. Four monkeys with no periodontal disease were used in this experiment. Full thickness flaps were raised and recession type defects were created on the buccal side of the maxillary lateral incisors and second premolars. Exposed root surfaces were thoroughly curetted, and composite cementum-impregnated membranes placed directly onto planed root surfaces. Flaps were then sutured back to the original position. Animals were sacrificed at 2, 4, 7 and 10 post-surgical days, and block specimens including the tooth, gingiva and bone were subsequently processed for light and electron microscopy. The resultant analysis revealed that gelatine membranes were partially resorbed at 2 days post-surgery and completely resorbed by 10 postoperative days. In the early stages of gelatine resorption, most liberated cementum particles accumulated on planed dentin surface but some became demineralized within the surgical wound. Cementoblast-like cells with well-developed rough endoplasmic reticulum appeared on the root surface 7 days following surgery. Newly synthesized collagen fibrils aligned parallel to the root surface were seen at 10 post-surgical days. The results suggest that the newly developed composite membrane enhances the formation of new periodontal attachment.