1
|
Bertl K, Pandis N, Stopfer N, Haririan H, Bruckmann C, Stavropoulos A. The impact of a "successfully treated stable periodontitis patient status" on patient-related outcome parameters during long-term supportive periodontal care. J Clin Periodontol 2021; 49:101-110. [PMID: 34866227 DOI: 10.1111/jcpe.13582] [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: 08/04/2021] [Revised: 10/14/2021] [Accepted: 11/20/2021] [Indexed: 01/22/2023]
Abstract
AIM To assess the importance of achieving a successfully treated stable periodontitis patient status (PPS) during long-term supportive periodontal care (SPC). MATERIALS AND METHODS This retrospective cohort study included 100 periodontitis patients, who continued for ≥7.5 years after active periodontal treatment with SPC and were judged as overall adherent. The effect of various predictors on three patient-related outcome parameters was assessed: (1) number of diseased teeth at last SPC, (2) number of teeth lost due to periodontitis, and (3) number of teeth lost due to any reason. RESULTS One-fifth of the patients were classified as stable after active periodontal treatment. After a mean follow-up of 10.77 years, 24 patients lost 38 teeth due to periodontitis. An unstable PPS and a higher number of diseased teeth per patient at first SPC, and inadequate oral hygiene levels over time, significantly increased the risk for a higher number of diseased teeth per patient at last SPC and for more lost teeth due to periodontitis. However, high adherence to SPC appeared to mitigate the negative effect of an unstable PPS, especially regarding tooth loss due to periodontitis. Further, tooth loss due to any reason was about 3 times higher than tooth loss due to periodontitis and was affected by a larger number of predictors. CONCLUSIONS Successfully treated patients with a stable PPS maintained a small number of diseased teeth and barely lost any teeth during long-term SPC compared to patients who did not achieve a stable PPS after active periodontal therapy.
Collapse
Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikolaus Stopfer
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Hady Haririan
- Department of Periodontology, Medical Faculty, Sigmund Freud University Vienna, Vienna, Austria
| | - Corinna Bruckmann
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
| |
Collapse
|
2
|
Liu X, Zhang W, Wang Y, Chen Y, Xie J, Su J, Huang C. One-step treatment of periodontitis based on a core-shell micelle-in-nanofiber membrane with time-programmed drug release. J Control Release 2020; 320:201-213. [PMID: 31982437 DOI: 10.1016/j.jconrel.2020.01.045] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 02/06/2023]
Abstract
As a chronic inflammatory disease, periodontitis is responsible for irreversible soft tissue damage and severe alveolar bone resorption. However, curative effects of current therapies are largely confined by the difficulty to simultaneously achieve anti-inflammation and bone regeneration. Also, the dynamic environment in oral cavity easily causes the drugs swallowed or rinsed away by saliva. We report here a one-step treatment based on a core-shell nanofiber membrane fabricated by coaxial electrospinning. Polymeric micelles containing SP600125 were distributed in the shell, while BMP-2 was incorporated in the core. After crosslinking, the nanofiber membrane displayed a prolonged degradation and release period up to 4 weeks. The release of SP600125 was detected at beginning, whereas BMP-2 was not released until day 12. Such a time-programmed release behavior was proved desirable for suppressing the expression of pro-inflammatory factors and enhancing the osteogenic induction in vitro. Further in vivo investigation confirmed that, by simply covering the periodontitis site with our nanofiber membrane, alveolar destruction was largely avoided and bone defects recovered within 2 month. Taken together, we believe that the use of our membrane with sequential release of SP600125 and BMP-2 may become a convenient and highly comprehensive therapy for periodontitis.
Collapse
Affiliation(s)
- Xiaochen Liu
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai 200072, China
| | - Wenxin Zhang
- Key Laboratory of Textile Science & Technology of Ministry of Education, College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China
| | - Yabing Wang
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai 200072, China
| | - Yunong Chen
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai 200072, China
| | - Jian Xie
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai 200072, China
| | - Jiansheng Su
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, 399 Middle Yanchang Road, Shanghai 200072, China.
| | - Chen Huang
- Key Laboratory of Textile Science & Technology of Ministry of Education, College of Textiles, Donghua University, 2999 North Renmin Road, Shanghai 201620, China.
| |
Collapse
|
3
|
|
4
|
Lee JS, Wikesjö UME, Park JC, Jang YJ, Pippig SD, Bastone P, Choi SH, Kim CK. Maturation of periodontal tissues following implantation of rhGDF-5/β-TCP in one-wall intra-bony defects in dogs: 24-week histological observations. J Clin Periodontol 2012; 39:466-74. [DOI: 10.1111/j.1600-051x.2012.01862.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ulf M. E. Wikesjö
- Departments of Periodontics and Oral Biology; Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Health Sciences University College of Dental Medicine; Augusta; GA; USA
| | | | | | | | | | | | | |
Collapse
|
5
|
Struillou X, Boutigny H, Soueidan A, Layrolle P. Experimental animal models in periodontology: a review. Open Dent J 2010; 4:37-47. [PMID: 20556202 PMCID: PMC2885595 DOI: 10.2174/1874210601004010037] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 01/19/2010] [Accepted: 02/03/2010] [Indexed: 01/19/2023] Open
Abstract
In periodontal research, animal studies are complementary to in vitro experiments prior to testing new treatments. Animal models should make possible the validation of hypotheses and prove the safety and efficacy of new regenerating approaches using biomaterials, growth factors or stem cells. A review of the literature was carried out by using electronic databases (PubMed, ISI Web of Science). Numerous animal models in different species such as rats, hamsters, rabbits, ferrets, canines and primates have been used for modeling human periodontal diseases and treatments. However, both the anatomy and physiopathology of animals are different from those of humans, making difficult the evaluation of new therapies. Experimental models have been developed in order to reproduce major periodontal diseases (gingivitis, periodontitis), their pathogenesis and to investigate new surgical techniques. The aim of this review is to define the most pertinent animal models for periodontal research depending on the hypothesis and expected results.
Collapse
Affiliation(s)
- Xavier Struillou
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | | | | | | |
Collapse
|
6
|
Park JC, Um YJ, Jung UW, Kim CS, Choi SH, Kim CK. Histological characteristics of newly formed cementum in surgically created one-wall intrabony defects in a canine model. J Periodontal Implant Sci 2010; 40:3-10. [PMID: 20498753 PMCID: PMC2872805 DOI: 10.5051/jpis.2010.40.1.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 01/20/2010] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Periodontal regenerative therapies for defects created by severe periodontitis are mainly focused on bone regeneration. Although cementum regeneration needs to be better understood, it is believed to play an important role in periodontal regeneration. The first step toward a full understanding of cementum regeneration is to compare repaired cementum to pristine cementum. This study, which used histological techniques, was designed to focus on cementum regeneration and to compare pristine cementum to repaired cementum after surgical procedures with 8 and 24 week healing periods in a canine model. METHODS Buccal and lingual mucoperiosteal flaps of 10 beagle dogs were surgically reflected to create critical-sized defects. Intrabony one-wall defects, of which dimension is 4 mm width and 5 mm depth, were made at the distal aspect of mandibular second premolars and the mesial aspect of mandibular fourth premolars in the right and left jaw quadrants. Animals were sacrificed after 8 and 24 weeks post-surgery for histological specimen preparation and histometric analysis. RESULTS The repaired cementum was composed mostly of acellular cementum and cellular mixed fiber cementum and was thicker in the apical area than in the coronal area. The acellular cementum of the supracrestal area appeared to be amorphous. The newly formed cellular cementum was partially detached from the underlying circumpulpal dentin, which implied a weak attachment between new cementum and dentin, and this split was observed to a lesser extent in the 24 week group than in the 8 week group. The vertical height of the repaired cementum was greater in the 24 week group than in the 8 week group. CONCLUSIONS Within the limitations of this study, we can conclude that repaired cementum after root planing was mainly acellular cementum and cementum tissue that matured to a shape similar to pristine cementum as the healing progressed from 8 to 24 weeks.
Collapse
Affiliation(s)
- Jung-Chul Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Yoo-Jung Um
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Chong-Kwan Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
7
|
Pellegrini G, Seol YJ, Gruber R, Giannobile WV. Pre-clinical models for oral and periodontal reconstructive therapies. J Dent Res 2009; 88:1065-76. [PMID: 19887682 DOI: 10.1177/0022034509349748] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The development of new medical formulations (NMF) for reconstructive therapies has considerably improved the available treatment options for individuals requiring periodontal repair or oral implant rehabilitation. Progress in tissue engineering and regenerative medicine modalities strongly depends on validated pre-clinical research. Pre-clinical testing has contributed to the recent approval of NMF such as GEM 21S and INFUSE bone grafts for periodontal and oral regenerative therapies. However, the selection of a suitable pre-clinical model for evaluation of the safety and efficacy of a NMF remains a challenge. This review is designed to serve as a primer to choose the appropriate pre-clinical models for the evaluation of NMF in situations requiring periodontal or oral reconstruction. Here, we summarize commonly used pre-clinical models and provide examples of screening and functional studies of NMF that can be translated into clinical use.
Collapse
Affiliation(s)
- G Pellegrini
- Department Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48106, USA
| | | | | | | |
Collapse
|
8
|
Gonçalves PF, Gurgel BCV, Pimentel SP, Sallum EA, Sallum AW, Casati MZ, Nociti FH. Effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration: a histomorphometric study in dogs. J Periodontal Res 2007; 41:535-40. [PMID: 17076778 DOI: 10.1111/j.1600-0765.2006.00902.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of the present study was to evaluate comparatively the effect of two different approaches for root decontamination on new cementum formation following guided tissue regeneration (GTR). MATERIAL AND METHODS Nine mongrel dogs were used to obtain bilateral chronic class III furcation defects by placing cotton ligatures around both third mandibular premolars. The teeth were randomly assigned to receive one of the following treatments: scaling and root planing, by means of hand and rotatory instruments, in order to remove soft and hard deposits as well as all root cementum (group A); or removal of only soft microbial deposits, by polishing the root surface with rubber cups and polishing paste, aiming for maximum root cementum preservation (group B). Both groups were treated with GTR, with the use of resorbable polyglycolic-lactic acid membranes (RESOLUT XT). RESULTS Four months later, data analysis showed that a superior length (mm) (3.59 +/- 1.67 and 6.20 +/- 2.26 for groups A and B, respectively; p = 0.004) and a thicker layer (microm) (18.89 +/- 9.47 and 52.29 +/- 22.48 for groups A and B, respectively; p = 0.001) of new cementum was achieved by keeping the root cementum in place during root decontamination (group B). Regardless of the treatment modality, the new cementum was predominantly of a reparative, cellular extrinsic and intrinsic fiber type. CONCLUSION Within the limits of the present study, it may be concluded that root cementum preservation may affect the new cementum formation following GTR in class III furcation defects, and the treatment modality did not influence the type of newly formed cementum.
Collapse
Affiliation(s)
- P F Gonçalves
- Division of Periodontics, School of Dentistry at Piracicaba, UNICAMP, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
9
|
Sculean A, Schwarz F, Chiantella GC, Donos N, Arweiler NB, Brecx M, Becker J. Five-year results of a prospective, randomized, controlled study evaluating treatment of intra-bony defects with a natural bone mineral and GTR. J Clin Periodontol 2007; 34:72-7. [PMID: 17243997 DOI: 10.1111/j.1600-051x.2006.01007.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Treatment with a natural bone mineral (NBM) and a guided tissue regeneration (GTR) has been shown to promote periodontal regeneration. However, until now there are only very limited data on the long-term clinical results following this regenerative technique. AIM To present the 5-year results of a prospective, randomized, controlled clinical study evaluating the treatment of deep intra-bony defects either with open flap debridement (OFD) and a combination of an NBM and GTR (test) or OFD alone (control). METHODS Nineteen patients diagnosed with advanced chronic periodontitis, and each of whom displayed one intra-bony defect, received randomly the test or the control treatment. Results were evaluated at baseline, at 1 and at 5 years following therapy. RESULTS No statistically significant differences in any of the investigated parameters were observed at baseline between the two groups. At 1 year after therapy, the test group showed a reduction in mean probing depth (PD) from 9.1+/-1.1 to 3.7+/-0.8 mm (p<0.001) and a change in mean clinical attachment level (CAL) from 10.4+/-1.3 to 6.4+/-1.2 mm (p<0.001). At 5 years, mean PD and CAL measured 4.3+/-0.8 and 6.7+/-1.6 mm, respectively. At 5 years, both PD and CAL were statistically significantly improved compared with baseline (p<0.001) without statistically significant differences between the 1- and 5-year results. In the control group, mean PD was reduced from 8.9+/-1.3 to 4.9+/-1.2 mm (p<0.001) and mean CAL changed from 10.6+/-1.4 to 8.8+/-1.5 mm (p<0.01). At 5 years, mean PD and CAL measured 5.6+/-1.1 and 9.1+/-1.3 mm, respectively, and were still statistically significantly improved compared with baseline (p<0.01). No statistically significant differences were found between the 1- and 5-year results. The test treatment, at both 1 and 5 years, yielded statistically significantly higher CAL gains than the control one (p<0.01). Compared with baseline, at 5 years a CAL gain of > or =3 mm was found in nine defects (90%) of the test group but in none of the defects treated with OFD alone. CONCLUSIONS It was concluded that (i) treatment of intra-bony defects with OFD+NBM+GTR may result in significantly higher CAL gains than treatment with OFD, and (ii) the clinical results obtained after both treatments can be maintained over a period of 5 years.
Collapse
Affiliation(s)
- Anton Sculean
- Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
10
|
Laurell L, Bose M, Graziani F, Tonetti M, Berglundh T. The structure of periodontal tissues formed following guided tissue regeneration therapy of intra-bony defects in the monkey. J Clin Periodontol 2006; 33:596-603. [PMID: 16899103 DOI: 10.1111/j.1600-051x.2006.00951.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the periodontal tissues formed following guided tissue regeneration (GTR) therapy of intra-bony defects (IBD). METHODS Eight adult Macaca fascicularis monkeys were used. Proximal IBD were created at the mandibular second pre-molars and second molars. After 3 months, GTR surgery was performed. The animals were euthanized at 6 months and 2 years after surgery. Block biopsies were harvested, and prepared for histological analysis. RESULTS At 6 months the defect had healed with new cementum (NC), periodontal ligament (PDL) and bone. The NC seemed to be firmly anchored to the dentin. Supra-crestally, the NC consisted of a 10 microm thick layer of acellular extrinsic fibre cementum (AEFC). Sub-crestally, the NC was considerably thicker and consisted of an inner layer of AEFC and an outer thicker layer of cellular mixed fibre cementum (CMFC). The extrinsic fibre density amounted to about 10 fibres per 100 microm. The PDL was wider than the pristine PDL and widened in coronal direction. After 2 years of healing, the thickness of the NC in the sub-crestal compartment had increased by about 20 microm and the fibre density had increased by about 50%. CONCLUSION After 2 years of healing the structure of the regenerated tissues resembled that of pristine periodontal tissues.
Collapse
Affiliation(s)
- Lars Laurell
- Department of Periodontology, Eastman Dental Institute, University College London, London, UK.
| | | | | | | | | |
Collapse
|
11
|
Affiliation(s)
- Margarita Zeichner-David
- Centre for Craniofacial Molecular Biology, School of Dentistry, Division of Surgical, Therapeutics and Bioengineering Sciences, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
12
|
Graziani F, Laurell L, Tonetti M, Gottlow J, Berglundh T. Periodontal wound healing following GTR therapy of dehiscence-type defects in the monkey: short-, medium- and long-term healing. J Clin Periodontol 2005; 32:905-14. [PMID: 15998277 DOI: 10.1111/j.1600-051x.2005.00789.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe periodontal wound healing in dehiscence-type defects following guided tissue re-generation (GTR) therapy. METHODS Ten adult Macaca fascicularis monkeys were used. Buccal dehiscence-type defects were created at the maxillary second pre-molars and second molars. After 3 months, GTR surgery was performed. The animals were euthanized at 6 weeks, 6 months and 2 years after surgery. Block biopsies were harvested, and prepared for histological analysis. RESULTS A new attachment apparatus was structured already after 6 weeks of healing. A 10-20 microm thin layer of acellular extrinsic fibre cementum (AEFC) had formed along the instrumented root surface. At 6 months, the thickness of the supracrestal cementum was comparable with that at 6 weeks, while the thickness of the subcrestal cementum had increased to 40-60 microm. In this zone, the cementum consisted of an inner layer of AEFC attached to the circum-pulpal dentin and an outer layer of cellular mixed fibre cementum (CMFC). The numerical extrinsic fibre density was twice that at 6 weeks. At 2 years, the periodontal tissues resembled the pristine periodontium. CONCLUSION Periodontal healing following GTR therapy of recession-type defects will result in a restitutio ad integrum, i.e. healing by re-generation. A continuous maturation process occurs over at least 2 years.
Collapse
Affiliation(s)
- Filippo Graziani
- Department of Periodontology, Eastman Dental Institute, University College London, London, UK
| | | | | | | | | |
Collapse
|
13
|
Sculean A, Stavropoulos A, Berakdar M, Windisch P, Karring T, Brecx M. Formation of human cementum following different modalities of regenerative therapy. Clin Oral Investig 2005; 9:58-64. [PMID: 15635476 DOI: 10.1007/s00784-004-0288-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2004] [Accepted: 09/16/2004] [Indexed: 10/26/2022]
Abstract
The aim of the present study was to compare newly formed cementum following different types of regenerative therapy in humans. Eighteen patients, each displaying one advanced intrabony defect around teeth scheduled for extraction, were included in this study. The defects were treated with either guided tissue regeneration (GTR), enamel matrix protein derivative (EMD), EMD plus bioactive glass, bovine-derived xenograft (BDX), BDX plus GTR, or BDX plus EMD. After healing, the teeth were removed together with their surrounding soft and hard tissues. Cellular content, presence of artifactual splits between the new cementum and the old one or the dentin surface, and thickness of the new cementum were evaluated. Irrespective of treatment, the new cementum was of a reparative, cellular, extrinsic and intrinsic fiber type. There were no differences in cementum thickness among treatments. These findings indicate that in humans, (a) the new cementum formed after different types of regenerative therapy was, irrespective of the treatment, of a reparative, cellular, extrinsic and intrinsic fiber type, and (b) the regenerative modality does not seem to influence the type of newly formed cementum.
Collapse
Affiliation(s)
- A Sculean
- Department of Periodontology and Biomaterials, Radboud University Nijmegen, Philips van Leydenlaan 25, Internal Postal Code 117, 6500 HB, Nijmegen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
14
|
Stavropoulos A, Karring T. Long-term stability of periodontal conditions achieved following guided tissue regeneration with bioresorbable membranes: case series results after 6-7 years. J Clin Periodontol 2004; 31:939-44. [PMID: 15491307 DOI: 10.1111/j.1600-051x.2004.00586.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the results of guided tissue regeneration (GTR) treatment of intrabony defects with bioresorbable membranes after 6-7 years, and to disclose factors that may influence the long-term outcome of the treatment. METHODS Twenty-five defects in 19 patients were treated by means of polylactic acid/citric acid ester copolymer bioresorbable membranes. At baseline and after 1 and 6-7 years, the following parameters were recorded: (1) probing pocket depth (PPD), (2) gingival recession (REC), (3) probing attachment level (PAL)=PPD+REC, (4) presence/absence of plaque (PI), (5) presence/absence of bleeding on probing (BOP). Smoking habits and frequency of dental-control visits were also recorded. Significance of differences between categorical variables was evaluated with McNemar's test, and between numerical variables with the t-test for paired observations. Generalized linear models were constructed to evaluate the influence of various factors on PAL gain and PPD changes from 1 to 6-7 years. Association of smoking, frequency of dental controls, oral hygiene, and BOP with sites losing > or =2 mm in PAL was evaluated with Fisher's exact test. RESULTS At baseline, a mean PPD of 8.7+/-1.1 mm and a mean PAL of 9.8+/-1.5 mm was recorded. Statistically significant clinical improvements were observed at 1 and 6-7 years after GTR treatment. An average residual PPD of 3.8+/-1.1 mm and a mean PAL gain of 3.8+/-1.4 mm were observed after 1 year. After 6-7 years the corresponding values were 4.7+/-1.3 and 3.6+/-1.4 mm, respectively. There were no statistically significant differences between the 1- and the 6-7-year values. At the 6-7-year control, only 16% of the sites had lost > or =2 mm (maximum 3 mm), of the PAL gain obtained 1 year after GTR treatment. None of the sites had lost all of the attachment gained 1 year after treatment. Smoking, frequency of dental controls, oral hygiene, and BOP did not seem to influence the change of PPD and PAL gain, or the stability of PAL gain (i.e. losing PAL or not) from 1 to 6-7 years from treatment. CONCLUSION Clinical improvements achieved by GTR treatment of intrabony defects by means of bioresorbable membranes can be maintained on a long-term basis.
Collapse
Affiliation(s)
- Andreas Stavropoulos
- Department of Periodontology and Oral Gerontology, Royal Dental College, Aarhus University, Denmark.
| | | |
Collapse
|