Clinical and histological characteristics of lyophilized allogenic dura mater in periodontal bony defects in humans

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Abstract
This clinical and histological study investigated the use of lyophilized, allogenic dura mater (Lyodura ®) as a periodontal implant material in interdental bony defects (2‐wall lesions) in humans. For 23 defects in 8 subjects a modified Widman flap was raised, curettage performed and the defects bridged with the implant. The same procedure, without Lyodura implantation, was performed on 23 contralateral teeth. By a standardized method, involving the use of a removable stent, the following clinical measurements were recorded after 24 and 48 weeks: the probing attachment level, the probing bone level, the probing pocket depth and the labial and interdental gingival recession. For the histological study 5 additional, interdental craters arid 5 control defects were treated as in the clinical study. They were block‐sectioned after 1,2,6,12 and 24 weeks and processed in the usual manner for routine examination by light and polarization microscopy. From the clinical study it could be concluded that, in absolute values, only the experimental side showed a significant gain in probing attachment level and a greater reduction of the probing pocket depth. In percentage values the labial gingival recession was significantly lower and the bone formation significantly more pronounced on the experimental side. The histological examination showed that the implant remodelled completely without rejection phenomena. It was replaced gradually, after enzymatic breakdown, by the host's own collagen through the action of invading fibroblasts. Bone formation occurred along but never in the implant. The implant material seems to act as a barrier against epithelial downgrowth and infiltration of inflammatory cells.

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