Comparison of Bioactive Glass Synthetic Bone Graft Particles and Open Debridement in the Treatment of Human Periodontal Defects. A Clinical Study Stuart J. Froum,*' Mea A. Weinberg,' and Dennis Tarnow*^ THE PURPOSE OF THIS STUDY was to compare the repair response of bioactive glass synthetic bone graft particles and open debridement in the treatment of human peri- odontal osseous defects. Fifty-nine delects in 16 healthy adults were selected. Each patient had at least 2 sites with attachment loss of at least 6 mm with clinical and radiographic evidence of intrabony or furcation defects. One to 3 months after cause- related therapy (oral hygiene instructions, scaling and root planing), the following measurements were recorded prior to surgery: probing depths, clinical attachment lev- el, and gingival recession. Each defect was surgically exposed and measurements made of the alveolar crest height and base of osseous defect. The test defects were implanted with bioactive glass. The other sites served as unimplanted controls. Flaps were su- tured at or close to the presurgical level. Radiographs and soft tissue presurgical mea- surements were repeated at 6, 9, and 12 months. At 12 months all sites were surgically re-entered to record osseous measurements. At the 12-month evaluation, significantly greater mean probing depth reduction was noted in the bioactive glass group compared to the controls (4.26 mm versus 3.44 mm; P = 0,028). Clinical attachment level gain was significantly improved (P = O.(XX)4) in the bioactive glass sites {2.96 mm) com- pared to the control sites (1.54 mm). There was significantly less gingival recession in the bioactive glass sites (1.29 mm) compared to the control sites (1.87 mm). Defect fill was significantly greater in the bioactive glass sites (3.28 mm) compared to the control sites (1.45 mm). Defect depth reduction was significantly greater in the bioac- tive glass sites (4.36 mm) compared to the control sites (3.15 mm). In conclusion, bioactive glass showed significant improvement in clinical parameters compared to open flap debridement. J Pcriodontol 1998:69:698-709. Key Words: Grafts, bone; bone regeneration; periodontal diseases/surgery; periodon- tal diseases/therapy; glass, bioactive; surgical flaps. Periodontal surgical procedures have focused on the elim- ination of hard and soft tissue defects (i.e., probing depths and osseous defects) by regenerating new attachment. This new attachment ideally consists of new bone, ce- nientum. and attached periodontal ligament to replace that which was lost due to periodontal disease. Toward these ends a variety of materials and regenerative procedures have been utilized.' Many of these procedures include the use of bone grafts and bone replacement materials. A re- *New York University. Department of Implant Dentistry, New York. NY. Departmcn! of Surgical Sciences (Periodontics). cent review focused on the clinical and histological results following the use of bone autografts and allografts. : In their conclusions, the authors state that " . . . conclusive evidence now exists that some regeneration occurs after regenerative procedures in which bone grafts are used." Although the use of intraoral autogenous bone grafts is well accepted in the periodontal community, drawbacks such as limited availability of donor sites, requirement for an additional surgical procedure to obtain the graft ma- terial, and elimination of potential sites for the placement of dental implants are recognized limitations with this material.