Improving the Prognosis of Periodontally Involved Teeth at the Time of Extraction of Adjacent Teeth With an Amnion-Chorion Barrier and Bioactive Dentin Graft.

With increased awareness, both in the dental literature and by the general public, of peri-implant disease, a growing trend in dentistry is to save teeth with a "questionable" periodontal prognosis. This prospective study involving such patients was designed to evaluate the effects of combining a bioactive barrier and graft, not on the socket but to augment adjacent periodontal conditions on teeth with severe periodontal bone loss at the time of extraction of an adjacent tooth. Fifteen patients were selected; teeth were extracted, ground, prepared with a pH 11 cleanser, partially demineralized, and made into a graft. This mixture was used to augment socket volume and perform periodontal regenerative surgery. The graft was covered with a bioactive amnion-chorion barrier membrane. Bioactive membranes can stimulate host cells in the surrounding gingival and periosteal tissues to accelerate site closure and healing, simultaneously exerting positive effects on the underlying bone and graft material not observed to the same extent with other membranes. This can improve healing and site regeneration as shown clinically and radiographically in this report. Use of these bioactive barrier membrane and dentin graft materials may have additive effects and provide stimulus for conversion to host bone after site healing. The combination of an amnion-chorion membrane with autologous dentin graft appears to maximize the benefits of the individual materials, improving guided tissue regeneration results and the prognoses of periodontally involved teeth.