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Yamaki D, Fukuba S, Okada M, Takeuchi S, Hoshi S, Matsuura T, Iwata T. Octacalcium phosphate collagen composite for periodontal regeneration in a canine one-wall intrabony defect. J Periodontal Res 2024; 59:521-529. [PMID: 38356157 DOI: 10.1111/jre.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study aimed to evaluate the regenerative capacities of octacalcium phosphate collagen composite (OCP/Col) in one-wall intrabony defects in dogs. The background data discuss the present state of the field: No study has assessed the efficacy of OCP/Col for periodontal regeneration therapy despite the fact that OCP/Col has proved to be efficient for bone regeneration. METHODS In six beagle dogs, the mandibular left third premolars were extracted 12 weeks before the experimental surgery. Standardized bone defects (5 mm in height and 4 mm in width) were simulated on the distal surface of the second premolars and mesially on the fourth premolars. The defect was filled with either OCP/Col (experimental group) or left empty (control group). Histological and histomorphometric characteristics were compared 8 weeks after surgery. RESULTS No infectious or ankylotic complications were detected at any of the tested sites. The experimental group exhibited a significantly greater volume, height, and area of newly formed bone than the control group. The former also showed a greater height of the newly formed cementum than the latter, although the results were not statistically significant. The newly formed periodontal ligaments were inserted into newly formed bone and cementum in the experimental group. CONCLUSION OCP/Col demonstrated high efficacy for bone and periodontal tissue regeneration that can be successfully applied for one-wall intrabony defects.
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Affiliation(s)
- Daichi Yamaki
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Fukuba
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Munehiro Okada
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Shu Hoshi
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- Private Practice, Niigata, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, California, Los Angeles, USA
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
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Sahu SA, Panda S, Das AC, Mishra L, Rath S, Sokolowski K, Kumar M, Mohanty R, Nayak R, Satpathy A, Lapinska B. Efficacy of Sub-Gingivally Delivered Propolis Nanoparticle in Non-Surgical Management of Periodontal Pocket: A Randomized Clinical Trial. Biomolecules 2023; 13:1576. [PMID: 38002260 PMCID: PMC10669236 DOI: 10.3390/biom13111576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Naturally sourced products like propolis are commonly employed for the non-surgical treatment of periodontal pockets. The use of nanoparticle formulations of these natural remedies has the potential to improve treatment outcomes. The aim of the present study was to evaluate the efficacy of sub-gingivally delivered propolis nanoparticles in the non-surgical management of periodontal pockets. Forty patients diagnosed with periodontitis presenting at least one periodontal pocket with a probing pocket depth between 4 and 6 mm were selected. Patients were randomly assigned into the control group (n = 20), which received scaling and root planing (SRP) and saline (SRP + Saline), and the test group (n = 20), which received SRP and sub-gingivally delivered propolis nanoparticles (PRO) into the periodontal pocket (SRP + PRO). The clinical parameters recorded were plaque index (PI), gingival index (GI), relative attachment loss (RAL), probing pocket depth (PPD), and bleeding on probing (BOP). They were assessed at baseline, one month, and three months post therapy. The results indicated that there was a significant improvement in clinical parameters (p < 0.05) in the test sites compared with the control sites at the end of the study. The gingival index at one month and three months was found to be significantly better in the SRP + PRO group than the SRP + Saline group, with a p value of <0.001. The BOP, PPD, and RAL showed significant improvement with the SRP + PRO group at the end of the 3-month follow-up with p values of 0.0001, 0.001, and 0.05, respectively. The subgingival delivery of propolis nanoparticles showed promising results as an adjunct to SRP in patients with periodontitis presenting periodontal pockets.
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Affiliation(s)
- Sushree Ambika Sahu
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Abhaya Chandra Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Lora Mishra
- Department of Conservative Dentistry & Endodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India;
| | - Satchidananda Rath
- Department of Physics, School of Basic Sciences, Indian Institute of Technology, Bhubaneswar 752050, Odisha, India;
| | - Krzysztof Sokolowski
- Department of Conservative Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland;
| | - Manoj Kumar
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Rinkee Mohanty
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Rashmita Nayak
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, Odisha, India; (S.A.S.); (A.C.D.); (M.K.); (R.M.); (R.N.); (A.S.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
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Sarafidou K, Lazaridi I, Gotsis S, Kirmanidou Y, Vasilaki D, Hirayama H, Michalakis K. Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies. J Prosthodont 2022; 31:e87-e99. [PMID: 35794083 DOI: 10.1111/jopr.13560] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this systematic review was to identify studies with a minimum of 5-years follow-up, reporting on the management of periodontally compromised teeth with either extraction and subsequent implant placement or teeth preservation with conventional periodontal treatment and application of regenerative procedures. The outcomes of these two approaches, based on clinical and radiographic data and the incidence of tooth- and implant-loss, were also investigated. MATERIAL AND METHODS A systematic search for studies reporting on clinical and radiographic outcomes of periodontal treatment or replacement of periodontally compromised teeth with implants was conducted in 3 electronic databases, followed by a hand-search in 8 journals. Only randomized controlled trials (RCTs), cohort studies, and case series with prospective design were included. RESULTS The initial search resulted in 1080 papers. After the first two screenings, 24 publications were selected for inclusion in this systematic review. The treatment protocols for the teeth preservation group contained nonsurgical and/or surgical periodontal treatment with or without regeneration procedures. The implant studies included extraction of periodontally involved teeth and implant placement with or without bone and soft tissue augmentation, followed by restoration with fixed dental prostheses (FDPs). Survival rates ranged between 81.8% and 100% in the tooth retention group, and between 94.8% and 100% in the implant group. In the extraction group, no complications were reported for 76.09% of the implants. Similarly, no complications were reported for 86.83% of the tooth retention group. The lack of standardized comparable studies prohibited conduction of a metaanalysis. CONCLUSION Both treatment approaches, treatment of periodontally compromised teeth, or tooth extraction followed by implant placement, present high survival rates. The application of bone regeneration techniques improves the long-term prognosis of periodontally involved teeth. Hence, treatment of periodontally involved teeth with subsequent application of a rigorous maintenance protocol can be a viable alternative for a number of years, before proceeding to extraction and replacement with dental implants. More well-designed randomized controlled trials are needed in order to draw definite conclusions on the subject.
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Affiliation(s)
- Katia Sarafidou
- Department of Prosthodontics, Aristotle University of Thessaloniki, Faculty of Health Sciences, School of Dentistry, Thessaloniki, Greece
| | - Ioanna Lazaridi
- Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Sotirios Gotsis
- Graduate and Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Yvoni Kirmanidou
- Private Practice limited to Prosthodontics, Thessaloniki, Greece
| | - Dimitra Vasilaki
- Private Practice limited to Prosthodontics, Thessaloniki, Greece
| | - Hiroshi Hirayama
- Department of Restorative Sciences and Biomaterials, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA
| | - Konstantinos Michalakis
- Department of Restorative Sciences and Biomaterials, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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Predictability and Clinical Stability of Barrier Membranes in Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12104835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The adjunctive use of GTR membranes helps us to achieve predictable periodontal regeneration. The aim of this systematic review was to evaluate and compare the treatment efficacy of resorbable versus non-resorbable barrier membranes used in guided tissue regeneration in the treatment of intrabony defects in chronic periodontitis patients. The following databases were searched: Medline, the Cochrane Central Register of Controlled Trails (CENTRAL), SCOPUS, EMBASE. Randomized clinical trials (RCTs) published in English languages over the past 25 years were included. The primary outcomes assessed were: change of probing pocket depth (PD), change in clinical attachment level (CAL) and gingival recession coverage (GRC), and intrabony defect fill (IBDF). A total of eight RCTs were included for systematic review. The outcome of GR at a six-month interval revealed a significant difference in treatment effect with a mean difference of 0.42, 95% CI [0.02, 0.81]; Z = 2.09, (p = 0.04) favouring the resorbable membrane group. The intrabony defect depth fill at a 12-month interval revealed a significant difference in treatment effect with MD of 0.79, p = 0.00001; favoring the resorbable membrane group. The resorbable membrane showed a significant improvement in gingival recession coverage and intrabony defect fill, owing to its advantage of avoiding the second surgical intervention.
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Effects of Nanofiber Scaffolds Coated with Nanoparticulate and Microparticulate Freeze Dried Bone Allograft on the Morphology, Adhesion, and Proliferation of Human Mesenchymal Stem Cells. IRANIAN BIOMEDICAL JOURNAL 2022; 26:193-201. [PMID: 35633638 PMCID: PMC9440688 DOI: 10.52547/ibj.26.3.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Freeze dried bone allograft nanoparticles on a nanofiber membrane may serve as an ideal scaffold for bone regeneration. This study aimed to assess the biological behavior of human MSCs in terms of proliferation and adhesion to nanoparticulate and microparticulate FDBA scaffolds on PLLA nanofiber membrane. Methods: In this experimental study, PLLA nanofiber scaffolds were synthesized by the electrospinning method. The FDBA nanoparticles were synthesized mechanically. The FDBA nanoparticles and microparticles were loaded on the surface of PLLA nanofiber membrane. A total of 64 scaffold samples in four groups of n-FDBA/PLLA, FDBA/PLLA, PLLA and control were placed in 24-well polystyrene tissue culture plates; 16 wells were allocated to each group. Data were analyzed using one-way ANOVA and Bonferroni test. Results: The proliferation rate of MSCs was significantly higher in the nanoparticulate group compared to the microparticulate group at five days (p = 0.034). Assessment of cell morphology at 24 hours revealed spindle-shaped cells with a higher number of appendages in the nanoparticulate group compared to other groups. Conclusion: MSCs on n-FDBA/PLLA scaffold were morphologically more active and flatter with a higher number of cellular appendages, as compared to FDBA/PLLA. It seems that the nanoparticulate scaffold is superior to the microparticulate scaffold in terms of proliferation, attachment, and morphology of MSCs in vitro.
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Connective Tissue Graft with or without Enamel Matrix Derivative for Treating Gingival Recession Defects: A Systematic Review and Meta-Analysis. J Evid Based Dent Pract 2021; 21:101635. [PMID: 34922714 DOI: 10.1016/j.jebdp.2021.101635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/25/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this systematic review is to compare the root coverage outcomes of using a connective tissue graft (CTG) with and without the application of enamel matrix derivative (EMD). METHODOLOGY An electronic search was performed up to July 2020 in 4 databases, including Ovid MEDLINE, EMBASE, Web of Science and Cochrane Central. Human clinical studies with data on comparing outcomes of root coverage using CTG with and without the application of EMD were included. Meta-analyses for the recorded parameters were performed and the weighted mean difference (WMD) between the 2 groups and 95% confidence interval (CI) were reported. RESULTS Nine clinical studies were selected for inclusion in this review. The WMD of clinical attachment level gain was 0.78 mm (95% CI of 0.23-1.34 mm, P = .005) and the WMD of recession depth reduction was 0.28 mm (95% CI of 0.06-0.51 mm, P = .01), favoring the CTG + EMD approach. However, the comparisons for the percentage of complete root coverage and mean root coverage between the 2 approaches were not statistically significant. CONCLUSION Although the use of a CTG with and without the application of EMD in root coverage procedures achieved a similar percentage of complete root coverage and mean root coverage, the addition of EMD to CTG may improve the outcome of recession depth reduction and clinical attachment level gain.
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Kumari CBN, Ramakrishnan T, Devadoss P, Vijayalakshmi R, Alzahrani KJ, Almasri MA, Al-Ahmari MM, Al Dira HS, Suhluli M, Bhati AK, Ahmad ZH, Raj AT, Bhandi S, Patil S. Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study. BIOLOGY 2021; 10:biology10121348. [PMID: 34943263 PMCID: PMC8698821 DOI: 10.3390/biology10121348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 06/01/2023]
Abstract
The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.
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Affiliation(s)
- C. Burnice Nalina Kumari
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Thiagarajan Ramakrishnan
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Pradeep Devadoss
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
| | - Rajaram Vijayalakshmi
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 11099, Saudi Arabia;
| | - Mazen A. Almasri
- Department of Oral Maxillofacial Surgery, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Manea Musa. Al-Ahmari
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Hajar Saeed Al Dira
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.S.A.D.); (M.S.)
| | - Malath Suhluli
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.S.A.D.); (M.S.)
| | - Ashok Kumar Bhati
- Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Zeeshan Heera Ahmad
- Dental College Hospital, King Saud University Medical City, Riyadh 11362, Saudi Arabia;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shilpa Bhandi
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Shankargouda Patil
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Shaikh MS, Zafar MS, Alnazzawi A, Javed F. Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis. Ann Anat 2021; 240:151877. [PMID: 34864225 DOI: 10.1016/j.aanat.2021.151877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/09/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone. MATERIALS AND METHODS The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively. RESULTS From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48). CONCLUSIONS The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan.
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, New York 14620, United States
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Pagni G, Tavelli L, Rasperini G. The Evolution of Surgical Techniques and Biomaterials for Periodontal Regeneration. Dent Clin North Am 2021; 66:75-85. [PMID: 34794555 DOI: 10.1016/j.cden.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The understanding of biological concepts in wound healing together with the evolution in biomaterials applied in periodontal regeneration allowed for improved, minimally invasive surgical techniques with a wider range of application and adapted to achieve multiple goals at the same time. Regenerating attachment was never the sole end point, but maintaining the patient's own natural dentition in health and esthetics is becoming a feasible goal even in cases considered challenging just a few years ago. In this article we report on the evolution of techniques and biomaterials and their application in esthetic and challenging cases.
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Affiliation(s)
- Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Via della Commenda 12, Milan 20122, Italy
| | - Lorenzo Tavelli
- Department of Periodontics, University of Michigan School of Dentistry, 1011 N University Avenue, Ann Arbor, MI 48109, USA; Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Via della Commenda 12, Milan 20122, Italy.
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Shaikh MS, Zafar MS, Alnazzawi A. Comparing Nanohydroxyapatite Graft and Other Bone Grafts in the Repair of Periodontal Infrabony Lesions: A Systematic Review and Meta-Analysis. Int J Mol Sci 2021; 22:12021. [PMID: 34769451 PMCID: PMC8584357 DOI: 10.3390/ijms222112021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the results of periodontal infrabony lesions treated using nanohydroxyapatite (NcHA) graft with other bone grafts (BGs). METHODS Four electronic databases were searched including PubMed (NLM), Embase (Ovid), Medline, and Dentistry and Oral Sciences (EBSCO). The inclusion criteria included randomised controlled clinical trials (RCTs) and controlled clinical trials (CCTs). The clinical results of NcHA were compared with other BGs. For clinical attachment level (CAL) gain, probing pocket depth (PPD) decrease, and gingival recession (REC) change, weighted averages and forest plots were computed. RESULTS Seven RCTs fulfilled the selection criteria that were included. When NcHA was compared to other BGs, no clinically significant differences were found in terms of each outcome assessed, except the REC change for synthetic BGs as compared to NcHA. CONCLUSIONS The use of an NcHA graft showed equivalent results compared to other types of BGs. To further validate these findings, future studies are required to compare the NcHA and various BGs over longer time periods and in furcation deficiencies.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 75510, Pakistan;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia;
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Lee IK, Choi HS, Jeong SH, Lee JT. Evaluating Change of Marginal Bone Height with Cone-Beam Computed Tomography Following Surgical Treatment with Guided Tissue Regeneration (Bone Grafting) or Access Flap Alone: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57090869. [PMID: 34577792 PMCID: PMC8472387 DOI: 10.3390/medicina57090869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/21/2021] [Accepted: 08/21/2021] [Indexed: 11/25/2022]
Abstract
Background and Objectives: This study aimed to evaluate the change of bone height following treatment of human intrabony defects with guided tissue regeneration (GTR) with bone grafting or access flap alone by cone-beam computed tomography (CBCT) scan. Materials and methods: This study was conducted as a retrospective longitudinal study. In this study, a total of 2281 teeth sites were included: the GTR group had 1210 sites, and the Flap group had 1071 sites. In the GTR group, demineralized freeze-dried bone (DFDBA) particles in combination with resorbable collagen membrane were used. No regenerative material was applied to the Flap group. CBCT images were taken twice at baseline and at least 2.5 months postoperatively. Bone heights were measured using software on CBCT images. Results: The bony change between the GTR and Flap groups was significantly different (p = 0.00001). Both males and females in the GTR group had smaller bone loss than in the Flap group. In age groups, significant differences of bony height between the GTR and Flap groups were observed in the subgroups consisting of those 29–45 and 46–53 years old. The non-smoking subjects in the GTR group had higher bone heights than those in the Flap group. In the absence of systemic disease and medicine, bone formation was higher in the GTR group than in the Flap group. In terms of oral position, the #14–17, #34–37, and #44–47 subgroups of the GTR group showed higher levels of bone heights than those of the Flap group. Conclusions. The results of this study indicated that the GTR procedure offers the additional benefit of higher bone heights than the Flap procedure does.
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Affiliation(s)
- In-Kyung Lee
- Department of Periodontics, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea; (I.-K.L.); (H.-S.C.)
| | - Hyun-Seok Choi
- Department of Periodontics, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea; (I.-K.L.); (H.-S.C.)
| | - Sang-Heon Jeong
- Department of Radiology, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea;
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Seoul 05698, Korea
- Correspondence: ; Tel.: +82-2-2072-0054; Fax: +82-2-2072-3018
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Alloplastic Bone Substitutes for Periodontal and Bone Regeneration in Dentistry: Current Status and Prospects. MATERIALS 2021; 14:ma14051096. [PMID: 33652888 PMCID: PMC7956697 DOI: 10.3390/ma14051096] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022]
Abstract
Various bone graft products are commercially available worldwide. However, there is no clear consensus regarding the appropriate bone graft products in different clinical situations. This review is intended to summarize bone graft products, especially alloplastic bone substitutes that are available in multiple countries. It also provides dental clinicians with detailed and accurate information concerning these products. Furthermore, it discusses the prospects of alloplastic bone substitutes based on an analysis of the current market status, as well as a comparison of trends among countries. In this review, we focus on alloplastic bone substitutes approved in the United States, Japan, and Korea for use in periodontal and bone regeneration. According to the Food and Drug Administration database, 87 alloplastic bone graft products have been approved in the United States since 1996. According to the Pharmaceuticals and Medical Devices Agency database, 10 alloplastic bone graft products have been approved in Japan since 2004. According to the Ministry of Health and Welfare database, 36 alloplastic bone graft products have been approved in Korea since 1980. The approved products are mainly hydroxyapatite, β-tricalcium phosphate, and biphasic calcium phosphate. The formulations of the products differed among countries. The development of new alloplastic bone products has been remarkable. In the near future, alloplastic bone substitutes with safety and standardized quality may be the first choice instead of autologous bone; they may offer new osteoconductive and osteoinductive products with easier handling form and an adequate resorption rate, which can be used with growth factors and/or cell transplantation. Careful selection of alloplastic bone graft products is necessary to achieve predictable outcomes according to each clinical situation.
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Mlachkova A, Dosseva-Panova V, Popova C. Application of PRP (platelet-rich plasma) in surgical periodontal therapy: overview. BIOTECHNOL BIOTEC EQ 2021. [DOI: 10.1080/13102818.2021.1878932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Antoaneta Mlachkova
- Faculty of Dental Medicine, Department of Periodontology, Medical University of Sofia, Sofia, Bulgaria
| | - Velitchka Dosseva-Panova
- Faculty of Dental Medicine, Department of Periodontology, Medical University of Sofia, Sofia, Bulgaria
| | - Christina Popova
- Faculty of Dental Medicine, Department of Periodontology, Medical University of Sofia, Sofia, Bulgaria
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Shaikh MS, Husain S, Lone MA, Lone MA, Akhlaq H, Zafar MS. Clinical effectiveness of anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide grafts for regeneration of periodontal defects: a systematic review and meta-analysis. Regen Med 2020; 15:2379-2395. [PMID: 33356535 DOI: 10.2217/rme-2020-0113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: To ascertain clinical effectiveness of anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide (ABM/P-15) for regeneration of periodontal defects. Materials & methods: Electronic databases (National Library of Medicine [Medline by PubMed], Cochrane Library [Wiley], CINAHL [EBSCO] and Medline [EBSCO]) were systematically searched up to December 2019. Randomized controlled clinical trials comparing ABM/P-15 grafts to conventional surgery for intrabony and gingival recession defects were included and evaluated intrabony defects including clinical attachment level (CAL), probing depth and gingival recession. Results: A significant gain in CAL (1.37 mm), and reduction in probing depth (1.22 mm) were shown by ABM/P-15 grafts than open flap debridement (p < 0.00001). The subgroup analysis also showed better results for ABM/P-15 grafts in CAL gain for intrabony defects. For furcation and gingival recession defects, no significant difference was seen. Conclusion: The adjunct use of ABM/P-15 grafts in conventional periodontal surgery is useful for periodontal regeneration of intrabony defects.
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Affiliation(s)
- Muhammad S Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Shehriar Husain
- Department of Dental Materials Science, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Mohid A Lone
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muneeb A Lone
- Department of Prosthodontics, Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Humera Akhlaq
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina Al Munawwarra, 41311, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan
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15
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Clinical and Radiographic Evaluation of Nanohydroxyapatite Powder in Combination with Polylactic Acid/Polyglycolic Acid Copolymer as Bone Replacement Graft in the Surgical Treatment of Intrabony Periodontal Defects: A Retrospective Case Series Study. MATERIALS 2020; 13:ma13020269. [PMID: 31936143 PMCID: PMC7014298 DOI: 10.3390/ma13020269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/25/2023]
Abstract
The aim of this retrospective case series was to evaluate the clinical efficacy of nanohydroxyapatite powder (NHA) in combination with polylactic acid/polyglycolic acid copolymer (PLGA) as a bone replacement graft in the surgical treatment of intrabony periodontal defects. Medical charts were screened following inclusion and exclusion criteria. Periodontal parameters and periapical radiographs taken before surgery and at 12-month follow-up were collected. Intra-group comparisons were performed using a two-tailed Wilcoxon signed-rank test. Twenty-five patients (13 males, 12 females, mean age 55.1 ± 10.5 years) were included in the final analysis. Mean probing depth (PD) and clinical attachment level (CAL) at baseline were 8.32 ± 1.41 mm and 9.96 ± 1.69 mm, respectively. Twelve months after surgery, mean PD was 4.04 ± 0.84 mm and CAL was 6.24 ± 1.71 mm. Both PD and CAL variations gave statistically significant results (p < 0.00001). The mean radiographic defect depth was 5.54 ± 1.55 mm and 1.48 ± 1.38 mm at baseline and at 12-month follow-up, respectively (p < 0.0001). This case series, with the limitations inherent in the study design, showed that the combination of NHA and PLGA, used as bone replacement graft in intrabony periodontal defects, may give significant improvements of periodontal parameters at 12-month follow-up.
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Interests of Exosomes in Bone and Periodontal Regeneration: A Systematic Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1341:67-87. [PMID: 33159304 DOI: 10.1007/5584_2020_593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Periodontitis is an infectious inflammatory disease characterized by clinical attachment loss and tooth supporting tissue destruction. As exosomes demonstrated pro-regenerative ability, their use in periodontal treatment has been suggested. The aim of this systematic review is to gather and summarize the most recent data regarding exosomes to determine their potential impact in bone and periodontal regeneration. Electronic databases (Pubmed, Web of Science) were searched up to February 2020. Studies assessing the impact of exosomes administration in experimental bone and periodontal defects have been identified according to PRISMA guidelines. Among the 183 identified articles, 16 met the inclusion criteria and were included in this systematic review. Experimental bone defects were mainly surgically induced with a dental bur or distraction tools. All studies considered bone healing after exosomes administration as the primary outcome. Results showed that mesenchymal stem cells derived exosomes administration promoted bone healing and neovascularization. Nevertheless, a dose-effect relationship was observed. Exosomes administration appears to promote significantly the bone healing and periodontal regeneration. However, only a limited number of studies have been carried out so far and the optimized protocols in this context need to be evaluated.
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17
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Sallum EA, Ribeiro FV, Ruiz KS, Sallum AW. Experimental and clinical studies on regenerative periodontal therapy. Periodontol 2000 2019; 79:22-55. [PMID: 30892759 DOI: 10.1111/prd.12246] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The recognition of a periodontal therapy as a regenerative procedure requires the demonstration of new cementum, periodontal ligament, and bone coronal to the base of the defect. A diversity of regenerative strategies has been evaluated, including root surface conditioning, bone grafts and bone substitute materials, guided tissue regeneration, enamel matrix proteins, growth/differentiation factors, combined therapies and, more recently, tissue-engineering approaches. The aim of this chapter of Periodontology 2000 is to review the research carried out in Latin America in the field of periodontal regeneration, focusing mainly on studies using preclinical models (animal models) and randomized controlled clinical trials. This review may help clinicians and researchers to evaluate the current status of the therapies available and to discuss the challenges that must be faced in order to achieve predictable periodontal regeneration in clinical practice.
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Affiliation(s)
- Enilson A Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Karina S Ruiz
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Antonio W Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
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18
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Struillou X, Fruchet A, Rakic M, Badran Z, Rethore G, Sourice S, Fellah BH, LE Guehennec L, Gauthier O, Weiss P, Soueidan A. Evaluation of a hydrogel membrane on bone regeneration in furcation periodontal defects in dogs. Dent Mater J 2018; 37:825-834. [PMID: 29925730 DOI: 10.4012/dmj.2017-238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the study was to evaluate bone regeneration using a canine model with surgically created periodontal defects filled for 12 weeks using a stratified biomaterial consisting in a biphasic calcium phosphate (BCP) covered with a crosslinking hydrogel acting as polymer membrane of silated hydroxypropyl methylcellulose (Si-HPMC) as the tested new concept. Bilateral, critical-sized, defects were surgically created at the mandibular premolar teeth of six adult beagle dogs. The defects were randomly allocated and: (i) left empty for spontaneous healing or filled with: (ii) BCP and a collagen membrane; (iii) BCP and hydrogel Si-HPMC membrane. At 12 weeks, the experimental conditions resulted in significantly enhanced bone regeneration in the test BCP/Si-HPMC group. Within the limits of this study, we suggest that the hydrogel Si-HPMC may act as an occlusive barrier to protect bone area from soft connective tissue invasion and then effectively contribute to enhance bone regeneration.
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Affiliation(s)
- Xavier Struillou
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Aurélien Fruchet
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Mia Rakic
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Institute for Biological Research "Sinisa Stankovic", University of Belgrade
| | - Zahi Badran
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Faculty of Dentistry, Mcgill University
| | - Gildas Rethore
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Sophie Sourice
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes
| | | | - Laurent LE Guehennec
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Olivier Gauthier
- ONIRIS, College of Veterinary Medicine, Department of Small Animal Surgery
| | - Pierre Weiss
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
| | - Assem Soueidan
- INSERM, UMR-S 1229, RMeS, Faculty of Dental Surgery, University of Nantes.,Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Nantes University Hospital, UIC Odontology
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19
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Siaili M, Chatzopoulou D, Gillam D. An overview of periodontal regenerative procedures for the general dental practitioner. Saudi Dent J 2018; 30:26-37. [PMID: 30166868 PMCID: PMC6112342 DOI: 10.1016/j.sdentj.2017.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 10/26/2017] [Accepted: 11/07/2017] [Indexed: 01/09/2023] Open
Abstract
The complete regeneration of the periodontal tissues following periodontal disease remains an unmet challenge, and has presented clinicians with a remarkably difficult clinical challenge to solve given the extensive research in this area and our current understanding of the biology of the periodontal tissues. In particular as clinicians we look for treatments that will improve the predictability of the procedure, improve the magnitude of the effect of treatment, and perhaps most importantly in the long term would extend the indications for treatment beyond the need for single enclosed bony defects to allow for suprabony regeneration, preferably with beneficial effects on the gingival soft tissues. A rapid development in both innovative methods and products for the correction of periodontal deficiencies have been reported during the last three decades. For example, guided tissue regeneration with or without the use of bone supplements has been a well-proven treatment modality for the reconstruction of bony defects prior to the tissue engineering era. Active biomaterials have been subsequently introduced to the periodontal community with supporting dental literature suggesting that certain factors should be taken into consideration when undertaking periodontal regenerative procedures. These factors as well as a number of other translational research issues will need to be addressed, and ultimately it is vital that we do not extrapolate results from pre-clinical and animal studies without conducting extensive randomized clinical trials to substantiate outcomes from these procedures. Whatever the outcomes, the pursuit of regeneration of the periodontal tissues remains a goal worth pursuing for our patients. The aim of the review, therefore is to update clinicians on the recent advances in both materials and techniques in periodontal regenerative procedures and to highlight the importance of both patient factors and the technical aspects of regenerative procedures.
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Affiliation(s)
| | | | - D.G. Gillam
- Centre for Adult Oral Health, Barts and the London School of Medicine and Dentistry QMUL, London, United Kingdom
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20
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Jalaluddin M, Singh DK, Jayanti I, Kulkarni P, Faizuddin M, Tarannum F. Use of Platelet Rich Plasma in the Management of Periodontal Intra-Osseous Defects: A Clinical Study. J Int Soc Prev Community Dent 2017; 7:105-115. [PMID: 28462179 PMCID: PMC5390574 DOI: 10.4103/jispcd.jispcd_28_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/07/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment, and alveolar bone around the affected tooth. Alveolar bone support and attachment apparatus regeneration has been achieved through various processes and have given elusive results. An expedient and cost-effective approach to obtain autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-β is the use of platelet-rich plasma (PRP). PRP is obtained by sequestrating and concentrating platelets by gradient density centrifugation. Aims: The current study was aimed at evaluating the regenerative potential of platelet-rich plasma in comparison with open flap debridement. Settings and Designs: This study was a randomized controlled clinical trial conducted in the Department of Periodontics and Oral Implantology, KIDS, Bhubaneswar, Odisha. Materials and Methods: Twenty periodontal infrabony defects in 10 patients; 6 males and 4 females of age between 25–45 years were included in this study and were followed up for a period of 6 months. Statistical Analysis: Both the groups showed a mean plaque index of 2.10 and 2.50 at baseline, 1.75 and 2.05 at 3 months, and 1.28 and 1.53 at the end of 6 months. The mean reduction of 0.35 and 0.45 at three months and 0.82 and 0.97 at six months was achieved, which was statistically significant. (P < 0.001). When comparison was done between the two groups it was not found to be statistically significant (P < 0.05). In each of the group there was definitive reduction in plaque score over a period of time. Results and Conclusion: There was no statistically significant difference in the treatment outcome between open flap debridement and PRP alone. Platelet-rich plasma application holds promise and needs further exploration.
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Affiliation(s)
- Md Jalaluddin
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Dhirendra K Singh
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Ipsita Jayanti
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Prasad Kulkarni
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Mohamed Faizuddin
- Department of Periodontics, V.S. Dental College, Bengaluru, Karnataka, India
| | - Fouzia Tarannum
- Department of Periodontics, MRADC, Bengaluru, Karnataka, India
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21
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Mrunal DM, Jaypal JS, Wilson RS, Chatterjee A. Whale's tail technique: A case series. J Indian Soc Periodontol 2017; 20:460-463. [PMID: 28298831 PMCID: PMC5341324 DOI: 10.4103/0972-124x.188333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The Whale's tail technique performed to obtain maximum interdental papilla fill in the anterior region after placement of bone grafts. This study aims to assess the clinical efficacy of this new technique. This report describes a series of three cases with a probing depth of 6–7 mm in the maxillary anterior teeth and their treatment with Whale's tail technique to obtain regeneration and maximum papilla preservation. The cases in this report showed a pocket depth reduction of 3-4mm and a clinical attachment gain of 3-4mm. The application of the “Whale's tail” flap leads to clinically significant improvement of hard and soft tissue conditions and allows regeneration of wide intrabony defects involving the maxillary anterior teeth with notable interdental diastemas, maintaining interproximal tissue to recreate a functional attachment with esthetic results.
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Affiliation(s)
- Deshpande Milind Mrunal
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Jarde Samiksha Jaypal
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Rohan Srinivasan Wilson
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
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22
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Kattimani VS, Kondaka S, Lingamaneni KP. Hydroxyapatite–-Past, Present, and Future in Bone Regeneration. ACTA ACUST UNITED AC 2016. [DOI: 10.4137/btri.s36138] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hydroxyapatite (HA) is an essential element required for bone regeneration. Different forms of HA have been used for a long time. The essence of bone regeneration always revolves around the healthy underlying bone or it may be the surroundings that give enough strength. HA is well known for bone regeneration through conduction or by acting as a scaffold for filling of defects from ancient times, but emerging trends of osteoinductive property of HA are much promising for new bone regeneration. Emerging technology has made the dreams of clinicians to realize the use of HA in different forms for various regenerative purposes both in vivo and in vitro. The nanostructured calcium apatite plays an important role in the construction of calcified tissues. The nanostructured material has the ability to attach biological molecules such as proteins, which can be used as functional materials in many aspects, and the capability of synthesizing controlled structures of apatite to simulate the basic structure of bone and other calcified tissues. The process of regeneration requires a biomimetic and biocompatible nanostructured novel material. The nanostructured bioceramic particles are of interest in synthetic bone grafts and bone cements both injectable and controlled setting, so that such composites will reinforce the strength of bioceramics. Extensive research is being carried out for bone regeneration using nanotechnology. Artificial bone formation is not far from now. Nanotechnology has made many dreams come true. This paper gives comprehensive insights into the history and evolution with changing trends in the use of HA for various regenerative purposes.
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Affiliation(s)
| | - Sudheer Kondaka
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Krishna Prasad Lingamaneni
- Department of Oral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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23
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Salem D, Natto Z, Elangovan S, Karimbux N. Usage of Bone Replacement Grafts in Periodontics and Oral Implantology and Their Current Levels of Clinical Evidence — A Systematic Assessment. J Periodontol 2016; 87:872-9. [DOI: 10.1902/jop.2016.150512] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Sukumar S, Dřízhal I, Paulusová V, Bukač J. Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta-Tricalcium Phosphate: Clinical Observations Two Years Post-Surgery. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016. [DOI: 10.14712/18059694.2016.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The study was designed to evaluate the clinical outcome of a composite material, beta-tricalcium phosphate in combination with calcium sulphate, in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. A total of 47 teeth with intrabony defects in 26 periodontitis patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK). Clinical parameters were evaluated which included changes in probing depth, clinical attachment level/loss and gingival recession at the baseline and 2 years postoperatively. The mean differences in measurements between the baseline and 2 years postoperatively were a reduction of 2.07±1.14 mm (p=0.000) in case of probing depth and a gain of 1.93±1.36 mm (p=0.000) in clinical attachment level; but an increase of 0.14±0.73 mm (p=0.571) in gingival recession. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects 2 years after the surgery.
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25
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Evaluation of 660 nm LED light irradiation on the strategies for treating experimental periodontal intrabony defects. Lasers Med Sci 2016; 31:1113-21. [DOI: 10.1007/s10103-016-1958-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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26
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Pradeep AR, Garg V, Kanoriya D, Singhal S. 1.2% Rosuvastatin Versus 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Placebo-Controlled Clinical Trial. J Periodontol 2016; 87:756-62. [PMID: 26878748 DOI: 10.1902/jop.2016.150706] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are an important group of hypolipidemic drugs that are able to modulate inflammation and alveolar bone loss. Rosuvastatin (RSV) and atorvastatin (ATV) are known to inhibit osteoclastic bone resorption and have been proposed to have osteostimulative properties. The aim of this study is to evaluate and compare the efficacy of 1.2% RSV and 1.2% ATV gel local drug delivery (LDD) and redelivery systems, in addition to scaling and root planing (SRP), for the treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP). METHODS A total of 90 individuals with 90 IBDs was randomly allocated to treatment with SRP followed by LDD of 1.2% RSV, 1.2% ATV, or placebo gel. Clinical and radiographic parameters, including plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and IBD depth, were recorded at baseline and 6 and 9 months. RESULTS All three groups showed significant reduction in PI and mSBI at all intervals. Mean mSBI and PD reductions, CAL gain, and IBD depth reduction with statin drugs were significantly greater than with placebo gel LDD. Improvements in these parameters were significantly greater with RSV LDD than ATV or placebo gels at 6 and 9 months. CONCLUSION LDD of 1.2% RSV results in significantly greater clinico-radiographic improvement than 1.2% ATV or placebo gels as adjunct to mechanical periodontal therapy.
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Affiliation(s)
- A R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Vibhuti Garg
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Dharmendra Kanoriya
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sandeep Singhal
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
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Zanatta FB, de Souza FG, Pinto TMP, Antoniazzi RP, Rösing CK. Do the clinical effects of enamel matrix derivatives in infrabony defects decrease overtime? A systematic review and meta-analysis. Braz Dent J 2015; 24:446-55. [PMID: 24474283 DOI: 10.1590/0103-6440201302192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 09/13/2013] [Indexed: 11/22/2022] Open
Abstract
Previous systematic reviews have demonstrated better results with enamel matrix derivative proteins (EMDP) as compared with open flap debridement (OFD) for the management of infrabony periodontal defects (IPD). The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies. Cochrane Central Register of Controlled Trials, Medline/PubMed, Lilacs, Embase and Web of Science electronic databases were searched up to August 2013 for randomized clinical trials.Eligible outcomes were changes in probing depth (PD), clinical attachment level (CAL),gingival recession (GR) and bone changes (BC). Studies with follow-up of 12 months showed differences of 0.97 mm (CI95% 0.52 - 1.43) and 1.19 mm (CI95% 0.77 - 1.60) for PD and CAL, respectively, favorable for EMDP. Studies with follow-up ≥ 24 months presented advantages of 1.11 mm (CI95% 0.74 -1.48) for CAL and 0.83 mm (CI95% 0.19 -1.48) for PD,with use of EMDP. Considering the quality of studies, those with low risk of bias showed lower difference between groups, presenting 0.8 mm (CI95% 0.24-1.36) for CAL, favorable for EMDP and without differences for PS (0.51 mm, CI95% -0.21 - 1.23). In conclusion, follow-up time (< or > 2 years) and the risk of bias influence the results of treatment with EMDP in IPD.
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Agarwal A, Gupta ND. Combination of bone allograft, barrier membrane and doxycycline in the treatment of infrabony periodontal defects: A comparative trial. Saudi Dent J 2015; 27:155-60. [PMID: 26236130 PMCID: PMC4501465 DOI: 10.1016/j.sdentj.2015.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 12/04/2014] [Accepted: 01/26/2015] [Indexed: 11/14/2022] Open
Abstract
Aim The purpose of the present study was to compare the regenerative potential of noncontained periodontal infrabony defects treated with decalcified freeze-dried bone allograft (DFDBA) and barrier membrane with or without local doxycycline. Methods This study included 48 one- or two-wall infrabony defects from 24 patients (age: 30–65 years) seeking treatment for chronic periodontitis. Defects were randomly divided into two groups and were treated with a combination of DFDBA and barrier membrane, either alone (combined treatment group) or with local doxycycline (combined treatment + doxycycline group). At baseline (before surgery) and 3 and 6 months after surgery, the pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF), and alveolar height reduction (AHR) were recorded. Analysis of variance and the Newman–Keuls post hoc test were used for statistical analysis. A two-tailed p-value of less than 0.05 was considered to be statistically significant. Results In the combined treatment group, the PPD reduction was 2.00 ± 0.38 mm (32%), CAL gain was 1.25 ± 0.31 mm (17.9%), and RBF was 0.75 ± 0.31 mm (20.7%) after 6 months. In the combined treatment + doxycycline group, these values were 2.75 ± 0.37 mm (44%), 1.5 ± 0.27 mm (21.1%), and 1.13 ± 0.23 mm (28.1%), respectively. AHR values for the groups without and with doxycycline were 12.5% and 9.4%, respectively. Conclusion There was no significant difference in the regeneration of noncontained periodontal infrabony defects between groups treated with DFDBA and barrier membrane with or without doxycycline.
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Affiliation(s)
- Ashish Agarwal
- Department of Periodontics, Institute of Dental Sciences, Bareilly, India
| | - N D Gupta
- Department of Periodontics, DR. Z.A. Dental College, Aligarh Muslim University, Aligarh, India
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Cortellini P, Tonetti MS. Clinical concepts for regenerative therapy in intrabony defects. Periodontol 2000 2015; 68:282-307. [DOI: 10.1111/prd.12048] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/14/2022]
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Comparative study of indigenously prepared and imported, demineralized, freeze-dried, irradiated bone allograft in the treatment of periodontal infrabony defects. Cell Tissue Bank 2014; 16:371-9. [DOI: 10.1007/s10561-014-9481-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/28/2014] [Indexed: 11/25/2022]
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Saimbi CS, Gautam A, Khan MA, Nandlal. Periosteum as a barrier membrane in the treatment of intrabony defect: A new technique. J Indian Soc Periodontol 2014; 18:331-5. [PMID: 25024547 PMCID: PMC4095626 DOI: 10.4103/0972-124x.134571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 11/21/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The purpose of the study was to evaluate the clinical effectiveness of periosteum as a barrier membrane for the treatment of intrabony defects. MATERIALS AND METHODS The study was conducted in patients having bilateral intrabony defects. A total of 20 intrabony defects in 10 patients were treated, out of which 10 defects received periosteal barrier and the other 10 defects received conventional open flap debridement procedure. The efficacy of the treatment was assessed using clinical parameters and dentascan. RESULTS Statistically significant gain in clinical attachment level (CAL) was found in the test group (2.00 ± 0.26 mm) as compared to the control group (0.60 ± 0.22 mm). In both the treatment modalities (test and control groups), a significant decrease in probing pocket depth of 3.90 ± 0.35 mm and 2.90 ± 0.31 mm was observed, respectively. The difference between the two groups was not statistically significant. Bone defect fill was 1.40 ± 0.16 mm for the test group and 0.90 ± 0.18 mm for the control group, but the difference observed was not statistically significant. CONCLUSION The results of this study show that periosteal barrier membrane can be a better alternative of barrier membranes for the treatment of intrabony defects.
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Affiliation(s)
- Charanjeet Singh Saimbi
- Department of Periodontics, Carrier Postgraduate Institute of Dental Sciences and Hospital, Ghaila, Sitapur-Hardoi Bypass, IIM Road, Lucknow, Uttar Pradesh, India
| | - Anju Gautam
- Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Mohd. Akhlak Khan
- Department of Periodontics, Faculty of Dental Sciences, C. S. M. Medical University, Lucknow, Uttar Pradesh, India
| | - Nandlal
- Department of Periodontics, Faculty of Dental Sciences, C. S. M. Medical University, Lucknow, Uttar Pradesh, India
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Xiong Y, Ren C, Zhang B, Yang H, Lang Y, Min L, Zhang W, Pei F, Yan Y, Li H, Mo A, Tu C, Duan H. Analyzing the behavior of a porous nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite for healing of bone defects. Int J Nanomedicine 2014; 9:485-94. [PMID: 24531621 PMCID: PMC3894953 DOI: 10.2147/ijn.s52990] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to analyze the behavior of the porous nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite grafted for bone defect repair through a series of biological safety experiments, animal experiments, and a more than 5-year long clinical follow-up. The biological safety experiments, carried out in accordance with the Chinese Guo Biao and Tolerancing (GB/T)16886 and GB/T16175, revealed that porous n-HA/PA66 composite had no cytotoxicity, no sensitization effect, no pyrogenic reaction, and that its hemolysis rate was 0.59% (less than 5%). Rabbit models of tibia defects with grafted porous n-HA/PA66 composite were established. After 2 weeks, the experiment showed that osteogenesis was detected in the porous n-HA/PA66 composite; the density of new bone formation was similar to the surrounding host bone at 12 weeks. After 26 weeks, the artificial bone rebuilt to lamellar bone completely. In the clinical study, a retrospective review was carried out for 21 patients who underwent serial radiographic assessment after treatment with porous n-HA/PA66 composite grafts following bone tumor resection. All wounds healed to grade A. No postoperative infections, delayed deep infection, nonspecific inflammation, rejection, or fractures were encountered. At a mean follow-up of 5.3 years, the mean Musculoskeletal Tumor Society's (MSTS) 93 score was 29.3 points (range: 28-30 points) and mean radiopaque density ratio was 0.77±0.10. The radiologic analysis showed that porous n-HA/PA66 composite had been completely incorporated with the host bone about 1.5 years later. In conclusion, this study indicated that the porous n-HA/PA66 composite had biological safety, and good biocompatibility, osteoinduction, and osseointegration. Thus, the porous n-HA/PA66 composite is an ideal artificial bone substitute and worthy of promotion in the field.
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Affiliation(s)
- Yan Xiong
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Cheng Ren
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Bin Zhang
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Hongsheng Yang
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Yun Lang
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Li Min
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Wenli Zhang
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Fuxing Pei
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Yonggang Yan
- School of Physical Science and Technology, Chengdu, People's Republic of China
| | - Hong Li
- School of Physical Science and Technology, Chengdu, People's Republic of China
| | - Anchun Mo
- Department of Oral Implant, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
| | - Hong Duan
- Department of Orthopedics, West China Hospital, Chengdu, People's Republic of China
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Preferences of UK-Based Dentists When Undertaking Root Coverage and Regenerative Procedures: A Pilot Questionnaire Study. Int J Dent 2014; 2014:548519. [PMID: 24616737 PMCID: PMC3927746 DOI: 10.1155/2014/548519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 11/08/2013] [Accepted: 12/05/2013] [Indexed: 11/17/2022] Open
Abstract
Objectives. The purpose of the present study was to evaluate the awareness and preferences of registered United Kingdom (UK) dentists specialising or with an interest in periodontics in root coverage and regenerative procedures. Methods. A cross-sectional postal survey of 366 dentists was conducted. The questionnaire was divided in two sections and most of the questions were giving the option of multiple answers. Frequencies and associations between the demographic profiles of the participants with their answers were evaluated. Results. 63% of dentists with an interest in periodontics and 32% of specialists returned the questionnaire. Guided tissue regeneration procedures and the use of enamel matrix derivatives were recommended for the reconstruction of bony defects and both subepithelial connective tissue graft and coronally advanced flap with or without enamel matrix derivatives were the most popular choices for root coverage. Smoking was considered a contraindication by most of the participants and conflicting responses were given regarding the use of antibiotics as part of the care following regenerative procedures. Conclusions. The participants incorporated both traditional and “novel” techniques and products in reconstructive procedures and appeared to be up to date with the evidence from the dental literature. However, it was evident that there was confusion regarding the role of antibiotics in regenerative procedures.
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Agarwal A, Bhattacharya HS, Srikanth G, Singh A. Comparative evaluation of decalcified freeze dried bone allograft with and without local doxycycline in non-contained human periodontal infrabony defects. J Indian Soc Periodontol 2013; 17:490-4. [PMID: 24174730 PMCID: PMC3800413 DOI: 10.4103/0972-124x.118322] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/11/2013] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Doxycycline has been advocated as useful adjuncts in periodontal therapy not only due to their antimicrobial actions, but also to their recently recognized anti-collagenolytic, anti-inflammatory, osteoclast inhibitory and fibroblast stimulating property. The purpose of the present cohort study was to evaluate the regenerative outcomes of bone graft with or without local doxycycline in non-contained infrabony periodontal defects. MATERIALS AND METHODS 16 one or two wall infrabony defects, in 11 patients suffering from moderate to severe chronic periodontitis, aged 35-60 years, were randomly divided for bone graft, alone (control) and with doxycycline (test) for the study. At baseline, after 3 months and after 6 months of post-operative period, pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF) and alveolar height reduction were recorded. Analysis of variance and Newman-Keuls post-hoc test were used or statistical analysis. A two-tailed probability (P) value P < 0.05 was considered to be statistically significant. RESULTS For the control group PPD reduction 2.00 ± 0.18 mm, CAL gain 1.38 ± 0.17 mm, RBF 0.63 ± 0.27 mm (18.0%) was observed while in the test group PPD reduction 2.00 ± 0.38 mm, CAL gain 1.25 ± 0.31 mm, RBF 0.75 ± 0.31 mm (20.7%) was evaluated. While alveolar height reduction for the control group and test group was 13% and 12.5% respectively. CONCLUSION The study confirmed no added benefits of local doxycycline, as compared with bone graft alone, for regeneration of non-contained human periodontal infrabony defects.
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Affiliation(s)
- Ashish Agarwal
- Department of Periodontology, Institute of Dental Sciences, Bareilly, India
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Hsu YT, Wang HL. How to Select Replacement Grafts for Various Periodontal and Implant Indications. Clin Adv Periodontics 2013. [DOI: 10.1902/cap.2012.120031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Uraz A, Gultekin SE, Senguven B, Karaduman B, Sofuoglu IP, Pehlivan S, Capan Y, Eren K. Histologic and histomorphometric assessment of eggshell-derived bone graft substitutes on bone healing in rats. J Clin Exp Dent 2013; 5:e23-9. [PMID: 24455047 PMCID: PMC3892234 DOI: 10.4317/jced.50968] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 10/20/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The objective of this study was to histologically and histomorphometrically evaluate the efficacy of the new formulations of eggshell-derived calcium carbonate in rats. STUDY DESIGN The study was conducted on 30 adult male rats. Four standardized and circular intrabony defects were created in the both maxilla and mandibula of each animal. Three different graft materials were prepared as follows: 1) Material A: Eggshell-derived calcium carbonate combined with carrageenan gel, 2) Material B: Eggshell-derived calcium carbonate combined with xanthan gum gel, and 3) Material C: Eggshell-derived calcium carbonate powder. The right mandibular defect sites were grafted with Material A in all animals, and defects on the left were grafted with Material B. Defects on the right side of maxilla were received Material C in all animals, and all left maxillary defects were remained untreated as controls. The animals were sacrificed either postoperatively on the 15th day, postoperatively on the 30th day or postoperatively on the 45th day. Histomorphometric measurements were made of the areas of newly formed bone, necrotic bone, fibrous tissue and residual graft material. RESULTS Material A exhibited the highest level of osteoid formation followed by Material B and Material C on the 45th day. In terms of osteoid formation, statistically significant differences were observed between graft materials and controls at 45th day compared to 15th and 30th day (p<0.05). CONCLUSIONS Eggshell-derived graft substitutes in both gel and powder forms are biocompatible materials which may have the potential to enhance the new bone formation. Key words:Bone graft material, bone defects, eggshell, histopathological evaluation, rat.
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Affiliation(s)
- Ahu Uraz
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Sibel E Gultekin
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Burcu Senguven
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Burcu Karaduman
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Ilke P Sofuoglu
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Selcen Pehlivan
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Yilmaz Capan
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Kaya Eren
- Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
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Bongio M, van den Beucken JJJP, Leeuwenburgh SCG, Jansen JA. Preclinical evaluation of injectable bone substitute materials. J Tissue Eng Regen Med 2012; 9:191-209. [DOI: 10.1002/term.1637] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 07/25/2012] [Accepted: 09/27/2012] [Indexed: 12/15/2022]
Affiliation(s)
- Matilde Bongio
- Department of Biomaterials; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | | | | | - John A. Jansen
- Department of Biomaterials; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
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Lee MJ, Kim BO, Yu SJ. Clinical evaluation of a biphasic calcium phosphate grafting material in the treatment of human periodontal intrabony defects. J Periodontal Implant Sci 2012; 42:127-35. [PMID: 22977742 PMCID: PMC3439524 DOI: 10.5051/jpis.2012.42.4.127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/03/2012] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs). Methods The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component≥4 mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period. Results In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of 3.7±1.2 mm and a mean CAL gain of 3.0±1.1 mm compared to the baseline. Corresponding values for the patients treated with OFD were 2.5±0.8 mm and 1.4±1.0 mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group. Conclusions The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.
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Affiliation(s)
- Min-Jae Lee
- Department of Periodontology, Chosun University School of Dentistry, Gwangju, Korea
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Shirakata Y, Taniyama K, Yoshimoto T, Takeuchi N, Noguchi K. Effect of bone swaging with calcium phosphate bone cement on periodontal regeneration in dogs. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:35-42. [DOI: 10.1016/j.tripleo.2011.05.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 04/27/2011] [Accepted: 05/28/2011] [Indexed: 10/17/2022]
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Zhang W, Wang W, Chen QY, Lin ZQ, Cheng SW, Kou DQ, Ying XZ, Shen Y, Cheng XJ, Nie PF, Li XC, Rompis FA, Huang H, Zhang H, Mu ZL, Peng L. Effect of calcium citrate on bone integration in a rabbit femur defect model. ASIAN PAC J TROP MED 2012; 5:310-4. [PMID: 22449524 DOI: 10.1016/s1995-7645(12)60045-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 02/15/2012] [Accepted: 03/15/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To explore effect of calcium citrate on bone integration in a rabbit femur defect model, and to compare the bone formation with different sizes by radiological and histological study. METHODS Twenty-four male Japanese white rabbits were randomly divided into three groups (Group A, B, C) in this study. Under anesthesia, defects of four sizes (1.2, 1.5, 2.0 and 2.5 mm) were created in each of the rabbits. Commercially pure calcium citrate powder was placed inside the medullary compartment of the femur (Experimental), while in the contralateral femur (Control) nothing was implanted. The defects were analyzed using radiography and histological analysis by using Imagepro-Plus 6.0 software after animal was sacrificed at 4th(Group A), 6th(Group B) and 8th(Group C) weeks postoperatively. Four samples were analyzed for each size of defect and each healing period. RESULTS The histological and the radiologic evaluation were performed after sacrification of all rabbits on postoperative 4th and 6th weeks, It showed significant difference between the experimental group and the control group when these defects were less than or equal to 2.0 mm. No statistical difference was observed when these defects were larger than 2.0 mm at all healing periods except at the 4th week. CONCLUSIONS Calcium citrate affects the early periods of bone defects healing mechanism in Japanese white rabbits positively, especially when the defect is not too large. We suggest further studies on calcium citrate to determine the effects of various dosages, administration ways and the experimental time on the bone defects.
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Affiliation(s)
- Wei Zhang
- Department of Orthopaedic Surgery, the Second Affiliated Hospital of Wenzhou Medical College,109 Xue Yuan Xi Road, Wenzhou 325000, China
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Mitri F, Alves G, Fernandes G, König B, Rossi AJ, Granjeiro J. Cytocompatibility of Porous Biphasic Calcium Phosphate Granules With Human Mesenchymal Cells by a Multiparametric Assay. Artif Organs 2012; 36:535-42. [DOI: 10.1111/j.1525-1594.2011.01409.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ozdemir B, Okte E. Treatment of intrabony defects with beta-tricalciumphosphate alone and in combination with platelet-rich plasma. J Biomed Mater Res B Appl Biomater 2012; 100:976-83. [PMID: 22287494 DOI: 10.1002/jbm.b.32660] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 11/07/2011] [Accepted: 11/22/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND The therapeutic efficacy of platelet-rich plasma (PRP) still remains controversial. This study aimed to compare the efficacy of a beta-tricalcium phosphate (β-TCP) and PRP/β-TCP combination both clinically and radiographically. METHODS Fourteen chronic periodontitis patients with at least two similar three-walled defects were included in the study. Each patient was randomly treated with both β-TCP (n = 14) and PRP/β-TCP (n = 14) in the same session. Baseline and 6-month evaluations of plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), bleeding on probing, and radiographic intrabony defect depth (RIDD) were assessed statistically. RESULTS At 6 months, statistically significant reductions of GI, PPD, BOP, and RIDD were observed in both groups. The median values of CAL decreased from 7.0 to 6.0 mm in the β-TCP group (p = 0.002), and 7.5 to 5.0 mm in the PRP/β-TCP group (p < 0.001). No statistically significant difference was detected between the two groups for all clinical indices. CONCLUSION After a 6-month healing period, both β-TCP and PRP/β-TCP were found effective in the treatment of three-walled intrabony defects and no additional statistically significant benefits were found with PRP.
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Affiliation(s)
- Burcu Ozdemir
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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Mandlik V, Roy S, Jha A. Comparative evaluation of bioglass with calcium sulphate β-hemihydrate for the treatment of intraosseous defects-a clinico-radiological study. Med J Armed Forces India 2012; 68:42-7. [PMID: 24669038 PMCID: PMC3862611 DOI: 10.1016/s0377-1237(11)60126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 09/06/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of the present clinical and radiological study was to compare bioglass and calcium sulphate β-hemihydrate in the treatment of intraosseous defect in chronic periodontitis. METHOD A total of 50 subjects with bilaterally symmetrical periodontal osseous defects with probing pocket depth = 5 mm and intraosseous defects ≥ 3 mm as seen on the radiographs were undertaken for the study. In one site (group A) bioactive glass was placed in defect and in contralateral site (group B) calcium sulphate β-hemihydrate was used in the defect site. RESULTS Clinical improvement was noted in all patients at the end of study. Both the groups showed reduction in probing pocket depth, increase in clinical attachment level, and reduction in osseous defect. Both materials were effective in achieving osseous gain. CONCLUSION The osseous gain in group A subjects was 58.93%, whereas in group B subjects it was 48.56%. Calcium sulphate β-hemihydrates showed promising results and were cost effective.
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Affiliation(s)
- Vb Mandlik
- Commanding Officer & Corps Dental Advisor, 15 Corps Dental Unit, C/o 56 APO, Pin - 903515
| | - Subrato Roy
- Commanding Officer & Corps Dental Advisor, 14 Corps Dental Unit, 56 APO, Namkum
| | - Ak Jha
- Officer Commanding, MDC, Namkum
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Özdemir B, Kurtiş B, Tüter G, Sengüven B, Tokman B, Pınar-Özdemir S, Demirel İ, Özcan G. Double-application of platelet-rich plasma on bone healing in rabbits. Med Oral Patol Oral Cir Bucal 2012; 17:e171-7. [PMID: 22157673 PMCID: PMC3448207 DOI: 10.4317/medoral.17336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 01/01/2011] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Platelet-rich plasma (PRP) is considered to enhance bone formation especially at early stages of wound healing, depending on the limited and short life-span of platelets and growth factors. The aim of this study was to evaluate efficacy of double-application of PRP (DA-PRP) on bone healing in a rabbit calvarial defect model. STUDY DESIGN Twenty-eight rabbits, each had two surgically prepared calvarial bone defects (10mm diameter), were included in this study and randomly divided into six groups. Defects (n=56) were treated with single-application of PRP (SA-PRP)(n=10), SA-PRP and beta-tricalciumphosphate (SA-PRP+TCP)(n=10), DA-PRP (n=8), DA-PRP and beta-tricalciumphosphate (DA-PRP+TCP)(n=8), beta-tricalciumphosphate (TCP)(n=10) or left empty (Control)(n=10). Animals were sacrificed at 30 days postoperatively. RESULTS The new bone (NB%) and defect fill (DF%) percentages were calculated from histological slides by image-analyzer software and statistically analysed. All test groups showed higher NB% than control, but differences among all groups were insignificant. The TCP treated groups had significantly higher DF% than groups treated without TCP, however the DF% differences between control, SA-PRP and DA-PRP or TCP, SA-PRP+TCP or DA-PRP+TCP were insignificant. CONCLUSION Although new bone formation was histomorphologically remarkable at double-application PRP groups, statistical analyses of the histomorphometric data revealed no significant difference.
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Affiliation(s)
- Burcu Özdemir
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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Nevins M, Nevins ML, Karimbux N, Kim SW, Schupbach P, Kim DM. The combination of purified recombinant human platelet-derived growth factor-BB and equine particulate bone graft for periodontal regeneration. J Periodontol 2011; 83:565-73. [PMID: 22014175 DOI: 10.1902/jop.2011.110298] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The objective of this study is to evaluate the potential for periodontal regeneration of a critical-sized defect with the application of recombinant human platelet-derived growth factor (rhPDGF-BB) combined with either a particulate equine or a β-tricalcium phosphate (β-TCP) matrix. METHODS Critical-sized intrabony 2-wall defects were created bilaterally on the distal surface of the second premolar and the mesial surface of the first molar in nine hounds. Twelve defects received rhPDGF-BB/equine treatment, 12 defects received rhPDGF-BB/β-TCP treatment, and the remaining 12 sites served as sham-surgery controls. The animals were sacrificed after a 10-week healing period. RESULTS Clinical healing was uneventful without obvious signs of overt gingival inflammation. Histologic and histomorphometric analyses revealed statistically that there were differences among the three groups in terms of new bone formation (P <0.001). The amount of test material for both rhPDGF-BB/equine and rhPDGF-BB/β-TCP groups was comparable, but the amount of newly formed bone was significantly higher (P <0.01) in favor of the rhPDGF-BB/equine group. The amount of new cementum formed for the rhPDGF-BB/equine group (4.8 ± 1.3 mm) was significantly higher (P =0.001) than the sham-surgery control group (1.7 ± 1.9 mm). CONCLUSION Both rhPDGF-BB/equine and rhPDGF-BB/β-TCP have the potential to support the regeneration of the periodontal attachment apparatus.
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Affiliation(s)
- Myron Nevins
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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Siciliano VI, Andreuccetti G, Siciliano AI, Blasi A, Sculean A, Salvi GE. Clinical Outcomes After Treatment of Non-Contained Intrabony Defects With Enamel Matrix Derivative or Guided Tissue Regeneration: A 12-Month Randomized Controlled Clinical Trial. J Periodontol 2011; 82:62-71. [DOI: 10.1902/jop.2010.100144] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kim SH, Hong KS. Histologic evaluation of low-intensity pulsed ultrasound effects on bone regeneration in sinus lift. J Periodontal Implant Sci 2010; 40:271-5. [PMID: 21246017 PMCID: PMC3021167 DOI: 10.5051/jpis.2010.40.6.271] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 10/27/2010] [Indexed: 11/13/2022] Open
Abstract
Purpose Many techniques have been described for achieving vertical augmentation of the maxillary sinus. The aim of this study is to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) to enhance bone regeneration after sinus floor elevation. Methods The sinus lifting technique was performed through a lateral approach on 8 different sites of 5 patients (3 males and 2 females) and their mean age was 45.7 years old. The sites were randomly assigned to the control or test groups. The control group had 4 sites that received lateral sinus lifting procedure only, while the test group had 4 sites that received LIPUS application after the lateral sinus lifting procedure. 24-32 weeks (an average of 29 weeks) postoperatively, new bone formation in the augmented sinus sites was evaluated through histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. Results In the test group, the mean percentage of newly formed bone was 19.0±2.8%. In the control group, the mean percentage of newly formed bone was 15.2±3.1%. The percentage of newly formed bone was approximately 4% higher in those cases where the sinus was treated by LIPUS than the percentage in those cases where it was not used. The difference was statistically significant. Conclusions Within the scope of this study, low-intensity pulsed ultrasound application after sinus lifting appeared to have a significant effect on the development of new bone formation.
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Affiliation(s)
- Sang Hun Kim
- Department of Periodontology, Dankook University School of Dentistry, Cheonan, Korea
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Choi JY, Jung UW, Lee IS, Kim CS, Lee YK, Choi SH. Resolution of surgically created three-wall intrabony defects in implants using three different biomaterials: an in vivo study. Clin Oral Implants Res 2010; 22:343-8. [DOI: 10.1111/j.1600-0501.2010.01978.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nygaard-Østby P, Bakke V, Nesdal O, Susin C, Wikesjö UME. Periodontal healing following reconstructive surgery: effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous bone grafting. A randomized-controlled trial 10-year follow-up. J Clin Periodontol 2010; 37:366-73. [PMID: 20447260 DOI: 10.1111/j.1600-051x.2010.01532.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of this 10-year randomized-controlled trial follow-up was to evaluate the stability of treatment outcomes following the implantation of autogenous bone graft with or without guided tissue regeneration (GTR) in the treatment of deep intra-bony periodontal defects. MATERIALS AND METHODS Forty patients exhibiting deep intra-bony periodontal defects were included in a randomized-controlled trial evaluating the adjunctive effect of GTR to autogenous bone graft. Twenty-six of 39 patients completing the original study were available for follow-up 10 years post-treatment. The patients had been included in a structured maintenance programme and were evaluated using the criteria of the original study by the same investigators. RESULTS Significant improvements in the probing depth and clinical attachment level were observed for both groups between baseline and 9 months. Whereas the autogenous bone graft+GTR group showed significant improvements in probing bone levels and increased gingival recession at 9 months, no significant differences were observed for the autogenous bone graft group. Nine-month within-group results were maintained throughout the 10-year follow-up. Nevertheless, between-group comparisons at 10 years showed that the autogenous bone graft+GTR group exhibited significantly greater probing depth reduction (mean +/- SE: 4.2 +/- 0.5 versus 2.7 +/- 0.5 mm, p=0.023) and probing bone-level gain (3.9 +/- 0.8 versus 1.3 +/- 0.9 mm, p=0.034) than the autogenous bone graft group. Borderline significant differences between the autogenous bone graft+GTR and the autogenous bone graft groups were observed for clinical attachment level gain at 10 years (3.8 +/- 0.5 versus 2.2 +/- 0.7 mm, p=0.067), whereas no significant differences were observed for gingival recession (0.7 +/- 0.3 versus 0.6 +/- 0.5 mm, p>0.05). CONCLUSIONS The results of this randomized study suggest that statistically significant differences were found with the adjunct use of GTR to an autogenous bone graft at 10 years. Nevertheless, these results should be interpreted with caution in light of its clinical relevance and biological rationale. Importantly, resolution of deep intra-bony periodontal defects can be maintained in the presence of a structured maintenance programme emphasizing high oral hygiene standards.
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Affiliation(s)
- Per Nygaard-Østby
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Geitmyrsveien 71, 0458 Oslo, Norway.
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[The use of beta-tricalcium phosphate and bovine bone matrix in the guided tissue regeneration treatment of deep infra-bony defects]. SRP ARK CELOK LEK 2010; 137:607-12. [PMID: 20069916 DOI: 10.2298/sarh0912607l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The primary goal of bone regeneration procedures with application of various regenerative biologic agents and biomaterials is to facilitate the formation of periodontal tissues lost as a result of periodontitis. OBJECTIVE The aim of the study was to compare clinical outcome of the guided tissue regeneration (GTR) treatment with the use of beta-tricalcium phosphate and with bovine bone matrix in human deep intra-osseous defects. METHODS Twenty-one systemically healthy subjects with moderate to advanced periodontitis, between 30 and 56 years of age, 11 females and 10 males, were selected. Patients having two similar inter-proximal defects with pocket probing depths following initial therapy greater than 5 mm were recruited for the study. Experimental sites were grafted with pure beta-tricalcium phosphate biomaterial (Cerasorb) and a biomembrane, while control sites were treated with bovine-bone hydroxiapatite xenograft (Bio-oss) and a biomembrane. Immediately before surgery and 12 months after surgery, pocket probing depth (PPD), epithelial attachment level (EAL) and gingival recession (GR) were evaluated. RESULTS In the experimental group PPD amounted to 6.76 +/- 0.83 mm before surgery, and decreased significantly to 2.67 +/- 0.48 mm 12 months following surgery, while in the control group PPD significantly decreased from 7.14 +/- 0.65 mm presurgically to 2.85 +/- 0.57 mm postsurgically. After one year, EAL gain was 2.76 +/- 0.99 mm in the experimental group, and 3.24 +/- 0.16 mm in the control group. After twelve months postoperatively GR amounted to 1.33 +/- 0.79 mm in the experimental group and to 1.05 +/- 0.80 mm in the control group. No statistically significant differences for PPD reduction, EAL gain and GR increase were detected between the groups. CONCLUSION Results from the present study indicate that GTR treatment of deep intra-osseous defects with Bio-oss and Cerasorb resulted in clinically and statistically significant improvement of EAL gain and PPD reduction. A GR was slightly increased, with no statistical significance.
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