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Duraisamy AK, Logani A, Kumar V, Chawla A, Sharma S, Pandey RM. Influence of the severity of periodontal disease on the outcome of non-surgical endodontic therapy: A prospective cohort study. Clin Oral Investig 2024; 28:217. [PMID: 38489130 DOI: 10.1007/s00784-024-05611-8] [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: 01/16/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To investigate the influence of severity of periodontal disease on periapical healing after non-surgical endodontic therapy (NSET). MATERIAL AND METHODS In this prospective study, subjects (n = 45) requiring NSET in a mandibular molar tooth with the diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting radiographic periapical index (PAI) score ≥ 3 and concomitant endodontic periodontal lesion (CEPL) without communication were enrolled. After dividing as per the classification of Periodontal and Peri-Implant Diseases and Conditions, subjects were equally allocated into three groups. Group I- only endodontic lesion {control: healthy periodontium (n = 15)}, Group II- CEPL having stage I and II periodontitis (n = 15) and Group III- CEPL having stage III periodontitis (n = 15). Standardized two-visit NSET was performed with 2% chlorhexidine gel as an intracanal medicament. Periodontal therapy was instituted wherever required. Subjects were recalled at 6-and 12-months for clinical and radiographic assessment. Chi-square test was performed to evaluate the difference between the groups. RESULTS At 12-month follow-up, all teeth in the three study groups were asymptomatic. On radiographic evaluation of the periapical region, healing was observed in 80%, 47% and 50% of teeth in Groups I, Group II and Group III, respectively. However, the difference was not statistically significant between the groups (p = 0.150). CONCLUSION The severity of periodontal disease had no influence on periapical healing after NSET in teeth with concomitant endodontic periodontal lesions without communication. CLINICAL RELEVANCE Periodontal disease has significant impact on apical periodontitis however severity of the periodontitis does not negatively impact the apical periodontitis.
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Affiliation(s)
- Arun Kumar Duraisamy
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029.
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Science and Research, New Delhi, India, 110029
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Bizenjima T, Irokawa D, Yamada S, Saito A, Tomita S. A Case Report of Periodontal Regenerative Therapy Using Recombinant Human Fibroblast Growth Factor 2 and Deproteinized Bovine Bone Mineral with Non-incised Papillae Surgical Approach (NIPSA) for Angular Bone Defect in Patient with Stage III Grade C Periodontitis. THE BULLETIN OF TOKYO DENTAL COLLEGE 2023; 64:145-155. [PMID: 37967939 DOI: 10.2209/tdcpublication.2023-0011] [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] [Indexed: 11/17/2023]
Abstract
This report describes a case of Stage III Grade C periodontitis requiring periodontal regenerative therapy. The patient was a 19-year-old woman who presented with the chief complaint of gingival recession in the incisor region. An initial examination revealed that 45.3% of sites had a probing depth of ≥4 mm and 45.8% bleeding on probing. Radiographic examination showed angular bone resorption in #25, 26, 31, 36, and 46 and horizontal resorption in other regions. Initial periodontal therapy was implemented based on a clinical diagnosis of Stage III Grade C periodontitis (generalized aggressive periodontitis). Occlusal adjustment was also performed at sites showing premature contact (#26 and 36) after suppression of inflammation. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF) -2 was performed on #25, 26, and 46. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #31 and 36. A non-incised papillae surgical approach (NIPSA) was used on #31. Periodontal conditions were then re-evaluated and the patient placed on supportive periodontal therapy. Regenerative therapy using rhFGF-2 and DBBM with NIPSA yielded an improvement in clinical parameters and bone resorption. This improvement has been adequately maintained over a 12-month period. Continued care is needed to maintain stable periodontal conditions.
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Fukuba S, Okada M, Iwata T. Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study. Regen Ther 2023; 24:343-350. [PMID: 37674693 PMCID: PMC10477744 DOI: 10.1016/j.reth.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/13/2023] [Accepted: 08/13/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Carbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). Methods A single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. Results The postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. Conclusions The clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.
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Affiliation(s)
- Shunsuke Fukuba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Munehiro Okada
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
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McClain PK. The use of recombinant human platelet-derived growth factor-BB in combination with β-tricalcium phosphate and rhPDGF-BB in combination with freeze-dried bone allograft plus barrier in two separate complex infrabony defects with long-term follow-up. Clin Adv Periodontics 2022; 12:256-261. [PMID: 36281628 DOI: 10.1002/cap.10212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/04/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Reports from a large-scale, prospective, masked, randomized controlled clinical trial demonstrated gain in attachment level, linear bone gain, and percentage bone fill in infrabony defects treated with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and β-tricalcium phosphate (β-TCP) at 6 months. A follow up to that trial at 24 months showed the results were stable in terms of gain in clinical parameters, and assessment of selective cases demonstrated stability at 5 years. The cases presented in this report provide clinical applications to support the use of this biologic in complex infrabony defects. An infrabony defect is described as a periodontal pocket with its base apical to the crest of the alveolar bone. Infrabony defects may have one, two, or three bony walls creating challenges in management. METHODS Two complex infrabony defect cases are presented in this report: one using rhPDGF-BB with β-TCP and the other using rhPDGF-BB with freeze-dried bone allograft (FDBA) and a resorbable barrier membrane. The techniques are described with results showing long-term follow up and reentry at 8 and 14 years (respectively). RESULTS Both cases demonstrate significant gains in clinical attachment levels as well as bone-like fill as observed radiographically and at reentry. CONCLUSIONS These case reports of combining rhPDGF-BB with β-TCP or with FDBA and a barrier membrane support the literature showing improvement in attachment levels and demonstrating bone fill in complex infrabony defects. The results can be maintained long term.
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Murakami T, Imamura K, Watanabe-Egawa N, Tomita S, Saito A. Surgical Periodontal Therapy Using Recombinant Human Fibroblast Growth Factor-2 in Combination with Carbonate Apatite Granules for Stage III Grade B Periodontitis: A Case Report with 1-year Follow-up. THE BULLETIN OF TOKYO DENTAL COLLEGE 2022; 63:145-153. [PMID: 35965084 DOI: 10.2209/tdcpublication.2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This report describes a case of generalized chronic periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 60-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth mobility and pain in tooth #26. Periodontal examination at the first visit revealed that 32.0% of sites had a probing depth of ≥4 mm and 43.8% bleeding on probing. Radiographic examination revealed vertical bone resorption in #17. Horizontal resorption was noted in other areas. Initial periodontal therapy consisting of plaque control, scaling and root planing, and caries treatment was performed based on a clinical diagnosis of Stage III Grade B periodontitis. Tooth #26 was extracted due to bone resorption extending as far as the root apex. After reevaluation, periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) in combination with carbonate apatite (CO3Ap) granules was performed for #17. Following reevaluation, a zirconia crown (#16) and zirconia bridge (#24-27) were placed. Following further reevaluation, the patient was placed on supportive periodontal therapy (SPT). The periodontal regenerative therapy using rhFGF-2 with CO3Ap granules yielded an improvement in the vertical bone resorption observed in #17. This improvement has been adequately maintained over a 1-year period postoperatively. Continued SPT is needed to maintain stable periodontal conditions.
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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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Polymeric Scaffolds for Dental, Oral, and Craniofacial Regenerative Medicine. Molecules 2021; 26:molecules26227043. [PMID: 34834134 PMCID: PMC8621873 DOI: 10.3390/molecules26227043] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 01/10/2023] Open
Abstract
Dental, oral, and craniofacial (DOC) regenerative medicine aims to repair or regenerate DOC tissues including teeth, dental pulp, periodontal tissues, salivary gland, temporomandibular joint (TMJ), hard (bone, cartilage), and soft (muscle, nerve, skin) tissues of the craniofacial complex. Polymeric materials have a broad range of applications in biomedical engineering and regenerative medicine functioning as tissue engineering scaffolds, carriers for cell-based therapies, and biomedical devices for delivery of drugs and biologics. The focus of this review is to discuss the properties and clinical indications of polymeric scaffold materials and extracellular matrix technologies for DOC regenerative medicine. More specifically, this review outlines the key properties, advantages and drawbacks of natural polymers including alginate, cellulose, chitosan, silk, collagen, gelatin, fibrin, laminin, decellularized extracellular matrix, and hyaluronic acid, as well as synthetic polymers including polylactic acid (PLA), polyglycolic acid (PGA), polycaprolactone (PCL), poly (ethylene glycol) (PEG), and Zwitterionic polymers. This review highlights key clinical applications of polymeric scaffolding materials to repair and/or regenerate various DOC tissues. Particularly, polymeric materials used in clinical procedures are discussed including alveolar ridge preservation, vertical and horizontal ridge augmentation, maxillary sinus augmentation, TMJ reconstruction, periodontal regeneration, periodontal/peri-implant plastic surgery, regenerative endodontics. In addition, polymeric scaffolds application in whole tooth and salivary gland regeneration are discussed.
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Latimer JM, Maekawa S, Yao Y, Wu DT, Chen M, Giannobile WV. Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects. Front Bioeng Biotechnol 2021; 9:704048. [PMID: 34422781 PMCID: PMC8378232 DOI: 10.3389/fbioe.2021.704048] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Additive manufacturing (AM) is the automated production of three-dimensional (3D) structures through successive layer-by-layer deposition of materials directed by computer-aided-design (CAD) software. While current clinical procedures that aim to reconstruct hard and soft tissue defects resulting from periodontal disease, congenital or acquired pathology, and maxillofacial trauma often utilize mass-produced biomaterials created for a variety of surgical indications, AM represents a paradigm shift in manufacturing at the individual patient level. Computer-aided systems employ algorithms to design customized, image-based scaffolds with high external shape complexity and spatial patterning of internal architecture guided by topology optimization. 3D bioprinting and surface modification techniques further enhance scaffold functionalization and osteogenic potential through the incorporation of viable cells, bioactive molecules, biomimetic materials and vectors for transgene expression within the layered architecture. These computational design features enable fabrication of tissue engineering constructs with highly tailored mechanical, structural, and biochemical properties for bone. This review examines key properties of scaffold design, bioresorbable bone scaffolds produced by AM processes, and clinical applications of these regenerative technologies. AM is transforming the field of personalized dental medicine and has great potential to improve regenerative outcomes in patient care.
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Affiliation(s)
- Jessica M Latimer
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Shogo Maekawa
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yao Yao
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - David T Wu
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Laboratory for Cell and Tissue Engineering, Harvard John A. Paulson School of Engineering and Applied Sciences, Boston, MA, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Michael Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
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Murakami T, Matsugami D, Yoshida W, Imamura K, Bizenjima T, Seshima F, Saito A. Healing of Experimental Periodontal Defects Following Treatment with Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral. Biomolecules 2021; 11:biom11060805. [PMID: 34072351 PMCID: PMC8226676 DOI: 10.3390/biom11060805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to investigate the effects of fibroblast growth factor (FGF)-2 used in combination with deproteinized bovine bone mineral (DBBM) on the healing of experimental periodontal defects. Periodontal defects created in rats were treated by FGF-2, DBBM, FGF-2 + DBBM, or left unfilled. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing. In vitro cell viability/proliferation on DBBM with/without FGF-2 was assessed by WST-1. Cell behavior was analyzed using scanning electron and confocal laser scanning microscopy. Osteogenic differentiation was evaluated by staining with alkaline phosphatase and alizarin red. Bone volume fraction was significantly greater in FGF-2 and FGF-2 + DBBM groups than in other groups at 2 and 4 weeks postoperatively. In histological assessment, newly formed bone in FGF-2 and FGF-2 + DBBM groups appeared to be greater than other groups. Significantly greater levels of proliferating cell nuclear antigen-, vascular endothelial growth factor-, and osterix-positive cells were observed in FGF-2 and FGF-2 + DBBM groups compared to Unfilled group. In vitro, addition of FGF-2 to DBBM promoted cell viability/proliferation, attachment/spreading, and osteogenic differentiation. The combination therapy using FGF-2 and DBBM was similarly effective as FGF-2 alone in the healing of experimental periodontal defects. In certain bone defect configurations, the combined use of FGF-2 and DBBM may enhance healing via promotion of cell proliferation, angiogenesis, and osteogenic differentiation.
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Affiliation(s)
- Tasuku Murakami
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
| | - Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
| | - Takahiro Bizenjima
- Chiba Dental Center, Tokyo Dental College, Mihama-ku, Chiba 2618502, Japan;
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan; (T.M.); (D.M.); (W.Y.); (K.I.); (F.S.)
- Oral Health Science Center, Tokyo Dental College, Chiyoda-ku, Tokyo 1010061, Japan
- Correspondence:
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Bizenjima T, Irokawa D, Tanaka K, Saito A, Tomita S. Periodontal Regenerative Therapy with Recombinant Human Fibroblast Growth Factor-2 and Deproteinized Bovine Bone Mineral in Patient with Chronic Periodontitis: An 18-month Follow-up Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2021; 62:107-117. [PMID: 33994421 DOI: 10.2209/tdcpublication.2020-0034] [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: 11/06/2022]
Abstract
This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 62-year-old man who presented with the chief complaint of gingival swelling in the molar region. An initial examination revealed that 31.6% of sites had a probing depth of ≥4 mm and 18.5% bleeding on probing. Radiographic examination revealed vertical bone resorption in #14, 25, 26, 27, 32, 37, 45, and 47, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy consisting of plaque control and scaling and root planing was performed. Occlusal adjustment of premature contact sites was performed after inflammation was suppressed. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 was performed on #14, 25, 26, 32, and 37. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #45 and 47. Other sites with residual periodontal pockets were treated by open flap debridement, and #27 was extracted due to a bone defect exceeding the root apex. Progress was then reevaluated and the patient placed on supportive periodontal therapy. Periodontal regenerative therapy using rhFGF-2 in combination with DBBM resulted in an improvement in clinical parameters and vertical bone resorption. This improvement has been adequately maintained over an 18-month period. The periodontal treatment provided resulted in a marked improvement in the patient's oral health-related quality of life.
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Sabu BS, Chandrashekar KT, Mishra R, Tripathi VD, Khatri H, Deo A. Evaluation of Morinda citrifolia (noni) fruit extract as a bone regenerative material in the treatment of periodontal intrabony osseous defects: Clinical and cone-beam computed tomography assessment. J Indian Soc Periodontol 2021; 25:144-149. [PMID: 33888947 PMCID: PMC8041072 DOI: 10.4103/jisp.jisp_58_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 09/15/2020] [Accepted: 10/11/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nature and its products can be utilized for regeneration in periodontal destruction and damage to supporting tissues. We come across the use of various graft materials to reestablish the lost bone and for the long-term survival of teeth. The objective of this study was to evaluate the bone fill efficacy of Morinda citrifolia fruit extract in the periodontal bone defect. MATERIALS AND METHODS This randomized study included twenty patients indicated for periodontal regenerative therapy and were equally divided and assigned into the experimental and control group. Open flap debridement alone was performed in the control group, while placement of extract along with open flap debridement was done in the experimental group. Clinical parameters assessed were gingival index, probing pocket depth, and relative attachment level, and the amount of bone fill was assessed using cone-beam computed tomography (CBCT) at baseline and at 6-month interval. RESULTS From the values of clinical parameters, there was a mean reduction in probing pocket and gain in attachment level and a 27.7% increase in bone fill in experimental group as compared to the control group from CBCT analysis. CONCLUSIONS The use of M. citrifolia fruit extract in the intraosseous defect was found to be efficacious in terms of relative attachment level and the amount of bone fill, and it had shown some anti-inflammatory affect.
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Affiliation(s)
- Blessy Shin Sabu
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
| | - Kabbur Thippanna Chandrashekar
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
| | - Rohit Mishra
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
| | - Vandana Dubey Tripathi
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
| | - Honey Khatri
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
| | - Ankita Deo
- Department of Periodontics and Implantology, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna Airport Road, Affiliated to Madhya Pradesh Medical Science University (MPMSU), Jabalpur, Madhya Pradesh, 482002, India
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Özcan E, Saygun I, Kantarcı A, Özarslantürk S, Serdar MA, Özgürtaş T. The effects of a novel non-invasive application of platelet-rich fibrin on periodontal clinical parameters and gingival crevicular fluid transforming growth factor-β and collagen-1 levels: A randomized, controlled, clinical study. J Periodontol 2021; 92:1252-1261. [PMID: 33382101 DOI: 10.1002/jper.20-0713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several potential benefits have been attributed to the platelet-rich fibrin (PRF), including enhanced tissue healing properties. In this study, we hypothesized that the application of PRF as an adjunct to conventional scaling and root planing (ScRp) would enhance the outcomes of non-surgical periodontal therapy. METHODS The present study was a split-mouth randomized controlled clinical trial design in 24 deep periodontal pockets in 12 patients with periodontitis. The pockets were randomly assigned as test or control. The test group received PRF as an adjunct to ScRp, whereas the control group received ScRp only. We measured periodontal clinical parameters at baseline, 3, and 6 months after the treatments. To study the initial healing in response to treatment, transforming growth factor-β (TGF-β) and collagen-1 (Col-1) in gingival crevicular fluid (GCF) were measured using enzyme-linked immunosorbent assay at baseline, third, seventh, and 14th days. RESULTS The test group showed a significantly greater pocket reduction, higher clinical attachment gain, and less gingival recession than the control group at 3 and 6 months. The test Col-1 levels (1.27 ± 1.05, 1.35 ± 0.76, 0.97 ± 0.53 ng/site) and TGF-β levels (11.93 ± 2.68, 12.54 ± 3.66, 17.19 ± 11.66 pg/site) were higher than the control Col-1 levels (0.76 ± 0.20, 0.84 ± 0.24, 0.57 ± 0.19 ng/site) and TGF-β levels (6.34 ± 1.67, 6.35 ± 3.44, 7.51 ± 2.85 pg/site) at all measurement days respectively. CONCLUSIONS Non-surgical application of the PRF as an adjunct to conventional ScRp may effectively improve the periodontal clinical parameters via increasing expression of the GCF TGF-β and Col-1 levels.
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Affiliation(s)
- Erkan Özcan
- Gulhane Dentistry Faculty, Department of Periodontology, University of Health Sciences, Ankara, Turkey
| | - Işıl Saygun
- Gulhane Dentistry Faculty, Department of Periodontology, University of Health Sciences, Ankara, Turkey
| | | | - Savaş Özarslantürk
- Gulhane Dentistry Faculty, Department of Oral and Maxillofacial Radiology, University of Health Sciences, Ankara, Turkey
| | | | - Taner Özgürtaş
- Gulhane Medical Faculty, Department of Biochemistry, Health Sciences University, Ankara, Turkey
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13
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Aoki H, Bizenjima T, Seshima F, Sato M, Irokawa D, Yoshikawa K, Yoshida W, Imamura K, Matsugami D, Kitamura Y, Kita D, Sugito H, Tomita S, Saito A. Periodontal surgery using rhFGF-2 with deproteinized bovine bone mineral or rhFGF-2 alone: 2-year follow-up of a randomized controlled trial. J Clin Periodontol 2020; 48:91-99. [PMID: 33030228 PMCID: PMC7984167 DOI: 10.1111/jcpe.13385] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
AIM To compare outcomes of rhFGF-2 + DBBM therapy with rhFGF-2 alone in the treatment of intrabony defects. This study provides 2-year follow-up results from the previous randomized controlled trial. MATERIALS AND METHODS Defects were randomly allocated to receive rhFGF-2 + DBBM (test) or rhFGF-2 (control). Treated sites were re-evaluated at 2 years postoperatively, using original clinical and patient-centred measures. RESULTS Thirty-eight sites were available for re-evaluation. At 2 years, both groups showed a significant improvement in clinical attachment level (CAL) from baseline. A gain in CAL of 3.4 ± 1.3 mm in the test group and 3.1 ± 1.5 mm in the control group was found. No significant inter-group difference was noted. Both groups showed a progressive increase in radiographic bone fill (RBF). The test treatment yielded greater RBF (56%) compared with the control group (41%). The control treatment performed better in contained defects in terms of CAL and RBF. There was no significant difference in patient-reported outcomes between groups. CONCLUSIONS At 2-year follow-up, the test and cotrol treatments were similarly effective in improving CAL, whereas the test treatment achieved a significantly greater RBF. In both treatments, favourable clinical, radiographic, and patient-reported outcomes can be sustained for at least 2 years. TRIAL REGISTRATION The University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) 000025257.
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Affiliation(s)
- Hideto Aoki
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | | | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Masahiro Sato
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kouki Yoshikawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Matsugami
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Yurie Kitamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Daichi Kita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Hiroki Sugito
- Department of Dental Hygiene, Tokyo Dental Junior College, Tokyo, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
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14
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Rojas MA, Marini L, Pilloni A, Sahrmann P. Early wound healing outcomes after regenerative periodontal surgery with enamel matrix derivatives or guided tissue regeneration: a systematic review. BMC Oral Health 2019; 19:76. [PMID: 31064353 PMCID: PMC6505273 DOI: 10.1186/s12903-019-0766-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/15/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Proper wound healing after regenerative surgical procedures is an essential issue for clinical success. Guided tissue regeneration (GTR) and application of enamel matrix derivatives (EMD) are common means to regenerate periodontal tissues. Both methods bear considerable advantages due to their special characteristics, but also go along with certain disadvantages. Today, there is no consensus in the literature whether GTR or EMD show better results regarding early wound healing, which is considered a crucial stage in periodontal regeneration. Therefore, the aim of the present systematic review was to compare the early wound healing after regenerative periodontal surgery with either EMD or GTR treatment. METHODS An electronic literature search in PubMed was performed to identify randomized clinical trials (RCTs) or clinical trials (CTs) comparing regenerative surgery employing EMD and/or GTR in patients with chronic periodontitis. Among the finally included studies, a qualitative and quantitative data extraction regarding early wound healing parameters was performed. Primary outcome parameters were early wound healing index (EWH), flap dehiscence, membrane exposure, suppuration and abscess formation during the first 6 weeks. As secondary parameters, swelling and allergic reactions were assessed. RESULTS Seven studies reporting 220 intrabony periodontal defects in 199 patients were analysed. Flap dehiscence was observed in two studies in 12% of the GTR treated sites and in 10.3% of those treated with EMD. Membrane exposure was evaluated in five studies and was registered in the 28.8% of the defects, while no dehiscence was reported on the EMD group. Swelling was reported only in one study in 8/16 GTR sites and 7/16 EMD sites. Due to considerable heterogeneity of parameters no meta-analysis was possible. CONCLUSIONS Due to considerable heterogeneity of the published studies a clear beneficial effect of the EMD on the early wound healing outcomes after surgical treatment of periodontal intrabony defects cannot be confirmed. Standardized RCT studies are needed in order to allow for proper comparison of early wound healing after both types of surgical approaches.
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Affiliation(s)
- M. A. Rojas
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - L. Marini
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - A. Pilloni
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| | - P. Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
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15
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Joshi AA, Padhye AM, Gupta HS. Platelet derived growth factor-BB levels in gingival crevicular fluid of localized intrabony defect sites treated with platelet rich fibrin membrane or collagen membrane containing recombinant human platelet derived growth factor-BB: A randomized clinical and biochemical study. J Periodontol 2019; 90:701-708. [PMID: 30637748 DOI: 10.1002/jper.18-0496] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/17/2018] [Accepted: 01/01/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Development of autologous and recombinant growth factor/matrix combination products represent a new emerging trend in regenerative therapeutics and have gained increasing attention as a strategy to optimize tissue regeneration. The aim of the present study was to evaluate the levels of platelet derived growth factor-BB (PDGF-BB) in gingival crevicular fluid (GCF) during early healing period after the regenerative treatment of intrabony defects using beta tricalcium phosphate (β-TCP) as a bone regeneration material with either platelet rich fibrin (PRF) membrane or collagen membrane (CM) treated with recombinant human PDGF-BB (rhPDGF-BB). METHODS Twenty patients (13 males and 7 females) with chronic periodontitis participated in this prospective, randomized clinical and biochemical study. Each patient was randomly assigned to PRF membrane (group A) or CM incorporated with rhPDGF-BB (group B). GCF samples were obtained on days 3, 7, 14, and 30 for evaluation of PDGF-BB levels and alkaline phosphatase (ALP) levels. RESULTS On days 3 and 7 following surgery, mean levels of PDGF-BB at sites treated with PRF membrane or CM incorporated with rhPDGF-BB as a barrier membrane were not significantly different. PDGF-BB levels decreased significantly in samples collected on days 14 and 30 with significant differences between both the groups. ALP levels significantly increased from day 3 to day 30 but there was no difference between two groups. CONCLUSION Within the limitations of the study, both PRF membrane and CM incorporated with rhPDGF-BB showed comparable GCF levels of PDGF-BB initially with PRF showing more sustained levels throughout the study period.
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Affiliation(s)
- Amruta A Joshi
- Department of Periodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, India
| | - Ashvini M Padhye
- Department of Periodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, India
| | - Himani S Gupta
- Department of Periodontics, Government Dental College and Hospital, Mumbai, India
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16
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Apicella A, Heunemann P, Dejace L, Marascio M, Plummer CJG, Fischer P. Scaffold requirements for periodontal regeneration with enamel matrix derivative proteins. Colloids Surf B Biointerfaces 2017; 156:221-226. [PMID: 28531879 DOI: 10.1016/j.colsurfb.2017.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 11/18/2022]
Abstract
Periodontitis affects the attachment of natural teeth, and infection or inflammation associated with periodontitis may affect peri-implant tissues. Enamel matrix derivative (EMD) proteins provide stimulation for self-regeneration of the damaged tissue when applied to wide intrabony defects as part of a mixture with bone graft material. As a first step of the process enhancing cell proliferation and ligament formation, we demonstrated that EMD protein precipitation depends strongly on the physical and chemical characteristics of the bone grafts used in the mixture. To guarantee optimum protein-stimulated self-regulation, the pH of the initial EMD formulation must therefore be adjusted between 3.9 and 4.2 in order to compensate the change in pH induced by the bone graft. Moreover, the interaction between the two components resulted in precipitates of different shape and size differently covering the grafts. This outcome might potentially have clinical implications on cell attachment and periodontal ligament extension, which deserve further in vitro and in vivo tests.
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Affiliation(s)
- Alessandra Apicella
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Peggy Heunemann
- Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland
| | - Laurent Dejace
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Matteo Marascio
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Christopher J G Plummer
- Laboratoire des Technologie des Composites et Polymères (LTC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
| | - Peter Fischer
- Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zurich, Switzerland.
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17
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Zang SQ, Kang S, Hu X, Wang M, Wang XW, Zhou T, Wang QT. Comparison of Different Periodontal Healing of Critical Size Noncontained and Contained Intrabony Defects in Beagles. Chin Med J (Engl) 2017; 130:477-486. [PMID: 28218223 PMCID: PMC5324386 DOI: 10.4103/0366-6999.199834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Regenerative techniques help promote the formation of new attachment and bone filling in periodontal defects. However, the dimensions of intraosseous defects are a key determinant of periodontal regeneration outcomes. In this study, we evaluated the efficacy of use of anorganic bovine bone (ABB) graft in combination with collagen membrane (CM), to facilitate healing of noncontained (1-wall) and contained (3-wall) critical size periodontal defects. METHODS The study began on March 2013, and was completed on May 2014. One-wall (7 mm × 4 mm) and 3-wall (5 mm × 4 mm) intrabony periodontal defects were surgically created bilaterally in the mandibular third premolars and first molars in eight beagles. The defects were treated with ABB in combination with CM (ABB + CM group) or open flap debridement (OFD group). The animals were euthanized at 8-week postsurgery for histological analysis. Two independent Student's t-tests (1-wall [ABB + CM] vs. 1-wall [OFD] and 3-wall [ABB + CM] vs. 3-wall [OFD]) were used to assess between-group differences. RESULTS The mean new bone height in both 1- and 3-wall intrabony defects in the ABB + CM group was significantly greater than that in the OFD group (1-wall: 4.99 ± 0.70 mm vs. 3.01 ± 0.37 mm, P < 0.05; 3-wall: 3.11 ± 0.59 mm vs. 2.08 ± 0.24 mm, P < 0.05). The mean new cementum in 1-wall intrabony defects in the ABB + CM group was significantly greater than that in their counterparts in the OFD group (5.08 ± 0.68 mm vs. 1.16 ± 0.38 mm; P < 0.05). Likewise, only the 1-wall intrabony defect model showed a significant difference with respect to junctional epithelium between ABB + CM and OFD groups (0.67 ± 0.23 mm vs. 1.12 ± 0.28 mm, P < 0.05). CONCLUSIONS One-wall intrabony defects treated with ABB and CM did not show less periodontal regeneration than that in 3-wall intrabony defect. The noncontained 1-wall intrabony defect might be a more discriminative defect model for further research into periodontal regeneration.
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Affiliation(s)
- Sheng-Qi Zang
- Department of Periodontology, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China
| | - Shuai Kang
- Department of Periodontology, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xin Hu
- Department of Periodontology, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Meng Wang
- Department of Periodontology, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xin-Wen Wang
- Department of Oral Medicine, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi 710032, China
| | - Tao Zhou
- Nondestructive Lab, State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an, Shaanxi 710032, China
| | - Qin-Tao Wang
- Department of Periodontology, State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
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18
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Irokawa D, Takeuchi T, Noda K, Goto H, Egawa M, Tomita S, Sugito H, Nikaido M, Saito A. Clinical outcome of periodontal regenerative therapy using collagen membrane and deproteinized bovine bone mineral: a 2.5-year follow-up study. BMC Res Notes 2017; 10:102. [PMID: 28212665 PMCID: PMC5316180 DOI: 10.1186/s13104-017-2426-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/10/2017] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND This study aimed to evaluate, longitudinally, the outcome of periodontal regenerative therapy using a deproteinized bovine bone mineral (DBBM) in combination with a collagen barrier (CB) for the treatment of intrabony defects. RESULTS Patients with chronic periodontitis who have completed initial periodontal therapy participated in this study. They had at least one 2- or 3-wall intrabony periodontal defect of ≥3 mm in depth. During surgery, defects were filled with DBBM and covered with CB. Ten patients completed 2.5-year reevaluation. At baseline, mean clinical attachment level (CAL) of the treated site was 8.0 mm and mean probing depth (PD) was 7.5 mm. Mean depth of intrabony component was 4.6 mm. Mean gains in CAL at 6 months and 2.5 years were 2.8 ± 1.0 and 1.4 ± 1.5 mm, respectively, both showing a significant improvement from baseline. CAL gains at 1 and 2.5 years were significantly reduced from that at 6 months. A significant improvement in PD was also noted: mean reductions in PD at 6 months and 2.5 years were 4.0 ± 0.8 and 3.2 ± 0.8 mm, respectively. CONCLUSIONS The combination therapy using DBBM and CB yielded statistically significant effects such as CAL gain and PD reduction, up to 2.5 years in the treatment of intrabony defects. However, the trend for decrease in CAL gain over time calls for the need for careful maintenance care.
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Affiliation(s)
- Daisuke Irokawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Katsuya Noda
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Hiroaki Goto
- Private Practice, Goto Dental Clinic, Tokyo, Japan
| | - Masahiro Egawa
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Sachiyo Tomita
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Hiroki Sugito
- Department of Endodontics and Clinical Cariology, Tokyo Dental College, Tokyo, Japan
| | - Masahiko Nikaido
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
- Private Practice, Nikaido Dental Clinic, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
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