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Abdel-Fatah R, Saleh W. Efficacy of amniotic membrane with coronally advanced flap in the treatment of gingival recession: an updated systematic review and meta-analysis. BMC Oral Health 2024; 24:133. [PMID: 38273332 PMCID: PMC10811943 DOI: 10.1186/s12903-023-03825-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/24/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES This systematic review aims to evaluate the efficacy of combining the amniotic membrane (AM) with the coronally advanced flap (CAF) in the treatment of Miller class I and II gingival recession (GR). METHODS The protocol of this updated PRISMA-compliant systematic review was registered in PROSPERO (CRD42023431501). The following treatment outcomes were recorded; recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and clinical attachment level (CAL). We searched the following databases: MEDLINE, Cochrane Library, Google Scholar, EMBASE, Web of Science, and Science Direct. RESULTS Two independent reviewers screened the selected articles. Twenty-two eligible articles were extracted, with 689 sites of GR in 481 patients. No statistically significant difference was found in RD, RW, WKG, and CAL between (AM&CAF) in comparison to control groups. However, the subgroup analysis showed statistically significant differences in RD between the (AM & CAF) group v/s (CAF) alone (P = 0.004). Moreover, the subgroup analysis of the WKG showed statistically significant differences between (AM & CAF) v/s (CAF&CM) (p = 0.04). Additionally, a statistically significant difference was found in the subgroup analysis of CAL between both (AM & CAF) group v/s (CAF) alone (p = 0.0009). CONCLUSION With the limitations of this meta-analysis due to short follow-up periods (6 months), the AM can be considered a viable treatment option for GR defects with satisfactory treatment outcomes comparable to other previously investigated treatment modalities. CLINICAL SIGNIFICANCE While AM showed various beneficial properties as an ideal membrane for the coverage of GR, future studies are required to completely understand the potential application of AM in the treatment of GR.
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Affiliation(s)
- Reham Abdel-Fatah
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
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Chaitra M, Shankar SM, Shivakumar T, Gururaj SB, Chidambar CK, Bhushan KS. Amniotic membrane versus platelet-rich fibrin in treatment of gingival recession- a randomized control trial. Saudi Dent J 2024; 36:192-197. [PMID: 38375378 PMCID: PMC10874856 DOI: 10.1016/j.sdentj.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 02/21/2024] Open
Abstract
Objective To determine the efficacy of latelet-rich fibrin (PRF) and Amniotic membrane (AM) along with the coronally advanced flap (CAF) technique in treating Miller's class I gingival recession (GR) defects. Material and methods A total of 32 sites with Miller's class I GR defects were distributed into Group A (CAF + PRF, n = 16) and Group B (CAF + AM, n = 16). Clinical parameters like gingival index (GI), plaque index (PI), gingival bleeding index (GBI), gingival sulcus depth (GSD), relative attachment level (RAL), and gingival marginal level (GML) were measured at baseline and at 3, 6 and 9 months after surgical intervention. Results PRF and AM with CAF were effective treatment modalities for treating Miller's class I GR defects, with an average root coverage value of 2.00 ± 0.75 mm in Group A and 1.5 ± 0.3 mm in Group B. Complete coverage (100 %) was obtained in 57 % sites of group A and 49 % sites of group B. At the 9-month follow-up, there was a significant increase in relative attachment levels in both groups when compared to baseline. Conclusion In the present study it was observed that there was a clinically and statistically significant improvement in root coverage with both groups. PRF-treated sites showed > 50 % complete coverage and hence were superior. AM showed comparable results to PRF and could be used as an alternative.
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Affiliation(s)
- M.P. Chaitra
- Department of Periodontology, Sharavathi Dental College and Hospital, Shimoga, India
| | | | - T.P. Shivakumar
- Department of Periodontology, Subbaih Institute of Dental Sciences, Shimoga, India
| | - Soumya B. Gururaj
- Department of Periodontology, Sharavathi Dental College and Hospital, Shimoga, India
| | - Chethana K. Chidambar
- Department of Periodontology, Sharavathi Dental College and Hospital, Shimoga, India
| | - Kala S. Bhushan
- Department of Periodontology, Sharavathi Dental College and Hospital, Shimoga, India
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Nemati M, Nowrouzi M, Nemati F, Alizadeh A. The improving effects of the amnion and chorion membranes on tissue regeneration in periodontal disorders: A systematic review. Tissue Cell 2023; 83:102147. [PMID: 37437330 DOI: 10.1016/j.tice.2023.102147] [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: 01/30/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
Background, recently, amnion-chorion membranes (ACMs), has provided new strategy to induce tissue regeneration in periodontal disorders. These biomaterials are rich sources of various biomarkers such as growth factors, proteins, and stem cells (SCs) which can accelerate regeneration. Numerous studies have been investigated beneficial effects of these materials on periodontal disorders⁹ tissue regeneration. Objective, the aim of this review was to evaluate therapeutic efficacy of these biomaterials, (combination of different effective biomarkers and SCs), more cost-effectiveness and with lower immune adverse effects on tissue regenerating in periodontal diseases. Methods, inclusion criterion was the English language and full text publications. Reviews, or strategies other than ACMs application for periodontal disorders treatment, and mechanism other than tissue regeneration were excluded. Data source, this search was done in PubMed, web of science (WOS) and Scopus using keywords. The search were repeated in May 2023 to identify any report that emerged during the time to develop the manuscript. After assessing bias, total of 151 articles were initially identified. After deleting duplication (30) using hand- screening, 121 papers met all inclusion criteria and were selected. Moreover, 31 papers were reviewed and excluded. Among remained articles (90), 57 articles excluded due to unrelated, 33 articles were assessed for the efficacy of ACMs on treating periodontal disorders. The most of studies used this material in the coronally flap technique. Miller recession defects was the most investigated periodontal disorder and clinical parameters were the most evaluated parameters in assessing the efficacy of ACMs. Discussion, different findings might be explained by different study designs, application techniques, or periodontal disorders in these studies. In the present review, we summarize the impacts of ACMs on tissues regeneration in treating periodontal disorders, but despite the promising and ameliorating results of this review, further studies are needed to assess these beneficial effects tissue to clarify the their helpfulness in clinical management of periodontal disorders. This review did not receive any funding.
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Affiliation(s)
- Marzieh Nemati
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Massoumeh Nowrouzi
- Department of periodontics, School of dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Nemati
- School of Dentistry, Shiraz University of Medical Science, Shiraz, Iran
| | - Aliakbar Alizadeh
- Department of Tissue Engineering, School of Advanced Technology in Medicine Shiraz University of Medical Sciences, Shiraz, Iran; Nanobiology and Nanomedicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Law EJ, Taib H, Berahim Z. Amniotic Membrane: An Approach to Periodontal Regeneration. Cureus 2022; 14:e27832. [PMID: 36106255 PMCID: PMC9458385 DOI: 10.7759/cureus.27832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
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Nath J, Changmai A, Bhattacharjee K, Phukan A, Chakraborty D, Das U. Management of gingival recession by coronally advanced flap with and without amniotic membrane: A clinical study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S486-S489. [PMID: 36110708 PMCID: PMC9469340 DOI: 10.4103/jpbs.jpbs_29_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/20/2022] [Accepted: 03/15/2022] [Indexed: 11/04/2022] Open
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Gomaa M, El Guindy H, Shoukheba M, Metwalli A. Healing of experimental gingival recession defects treated with amnion allograft: histologic and histometric analysis in dogs. J Oral Biosci 2022; 64:93-99. [DOI: 10.1016/j.job.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/24/2022]
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Dhawan S, Takiar M, Manocha A, Dhawan R, Malhotra R, Gupta J. Functionally graded membrane: A novel approach in the treatment of gingival recession defects. J Indian Soc Periodontol 2021; 25:411-417. [PMID: 34667384 PMCID: PMC8452168 DOI: 10.4103/jisp.jisp_583_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/02/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Guided tissue regeneration has recently been advocated in re-constructing soft-tissue dimensions in recession defects. Advancement in nanotechnology has led to increased zest for approaches such as electrospinning of biologically active; nanofibrous functionally graded regenerative membranes for periodontal tissue engineering. A functionally graded membrane (FGM) had been tailored by incorporating chitosan and nano-hydroxyapatite over Amnion membrane and used in gingival recession defects. Study Design: It was single-blind, randomized controlled study. Split-mouth study was conducted in nine patients and 22 sites with recession defects were selected. Sites were divided into Group A (Amnion membrane with coronal advanced flap) and Group B (FGM with coronal advanced flap). Materials and Methods: Sites were assessed clinically by recording plaque index (PI), gingival index (GI), vertical recession defect depth (VRDD), relative clinical attachment level (CAL), and width of keratinized tissue at baseline, 3–6 months; and radiographically by recording linear bone growth by dentascan at baseline and 6 months. Result: Both groups showed statistically significant reduction in PI, GI and VRDD, and CAL and nonsignificant reduction in width of keratinized tissue at 3 and 6 months postoperatively. Group A showed statistically significant linear bone growth at 6 months. Group B also showed gain in linear bone growth at 6 months; however, result was statistically nonsignificant. Conclusion: FGM had shown favorable results by enhancing bone growth while preventing the gingival tissue downgrowth.
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Affiliation(s)
- Shivani Dhawan
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Megha Takiar
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Anish Manocha
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar Deemed to be University, Ambala, Haryana, India
| | - Rajan Dhawan
- Department of Conservative Dentistry and Endodontics, Maharishi Markandeshwar College of Dental Sciences and Research, Maharishi Markandeshwar University, Ambala, Haryana, India
| | - Ranjan Malhotra
- Department of Periodontology and Oral Implantology, Himachal Dental College, Sunder Nagar, Himachal Pradesh University, Shimla, India
| | - Jyoti Gupta
- Department of Periodontology and Oral Implantology, Harvansh Singh Judge Institute of Dental Sciences, Chandigarh, India
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Bilaminar Technique with Coronally Advanced Flap and Cryopreserved Human Amniotic Membrane in the Treatment of Gingival Recessions. Case Rep Dent 2020; 2020:7827092. [PMID: 32908716 PMCID: PMC7471788 DOI: 10.1155/2020/7827092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/23/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022] Open
Abstract
Gingival recessions are usually treated with surgical therapies which involve the use of connective tissue autograft in order to thicken the gingival tissue. This has an important biological repercussion on patients since they will have surgical wounds in two different oral cavity sites. In this case report, we offer an alternative technique for the treatment of a Miller class I gingival recession. A 40-year-old female patient has been treated with a combination of bilaminar and coronally advance flap techniques to cover a Miller class I gingival recession with addition of cryopreserved human amniotic membrane. The human amniotic membrane has been employed to thicken the keratinized tissue. The human amniotic membrane in combination with bilaminar and coronally advance flap techniques has produced aesthetically and functionally satisfying results, covering completely the gingival recession and restoring the natural colour and thickness of the gingiva. Bilaminar technique with coronally advanced flap and cryopreserved human amniotic membrane is a valid alternative in treating Miller class I and II gingival recessions and reduce the biological morbidity of a double intervention.
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Martelloni M, Montagner G, Trojan D, Abate R. Amniotic Membrane In Palatal Epithelial-Connective Tissue Reconstruction. Int Med Case Rep J 2019; 12:349-354. [PMID: 31819667 PMCID: PMC6875521 DOI: 10.2147/imcrj.s213275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/22/2019] [Indexed: 11/27/2022] Open
Abstract
Mucogingival surgery has the objective to obtain coverage of the recession, with a favorable long-term prognosis, but also to minimize postoperative problems and surgery-related risks. Human amniotic membrane is increasingly employed for periodontal tissue repair in order to promote epithelialization and to reduce pain and scar tissue formation. A 38-year-old female patient reports dental hypersensitivity resulting from gingival recession affecting tooth 4.1. A mucogingival surgical procedure was proposed and a partial-thickness flap of epithelial-connective tissue was harvested from the palate and grafted on to the receiving site. The amniotic membrane was positioned at the donor site to reduce postoperative morbidity and to encourage rapid palatal healing. One week after the application of HAM (human amniotic membrane), the wound was healed and 1 month after the donor site was completely re-epithelialized. The present case report suggests that in the surgical treatment of gingival recession with palatal epithelial-connective tissue graft, HAM promotes rapid epithelialization of the palatal donor site wound with a reduction in morbidity.
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Affiliation(s)
| | | | - Diletta Trojan
- Treviso Tissue Bank Foundation Onlus, Treviso, 31100, Italy
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Chang YY, Kim SH, Goh MS, Yun JH. Comparative preclinical assessment of the use of dehydrated human amnion/chorion membrane to repair perforated sinus membranes. J Periodontal Implant Sci 2019; 49:330-343. [PMID: 31681490 PMCID: PMC6819694 DOI: 10.5051/jpis.2019.49.5.330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose The aim of this study was to evaluate the use of dehydrated human amnion/chorion membrane (dHACM) to repair perforated sinus membranes in rabbits. Methods Bilateral surgical windows (7.5-mm diameter) were prepared on the nasal bones of 14 rabbits. Standardized circular perforations (5-mm diameter) were made in the sinus membrane by manipulating implant twist drills. The perforated sinus membranes were repaired using dHACM or a resorbable collagen membrane (CM). The negative control (NC) group did not undergo perforated sinus membrane repair, while the positive control (PC) group underwent sinus augmentation without perforations. The same amount of deproteinized porcine bone mineral was grafted in all 4 groups. After 6 weeks, micro-computed tomography (micro-CT) and histomorphometric evaluations were conducted. Results The micro-CT analysis revealed that the total augmented volume was not significantly different among the groups. In the dHACM group, newly formed bone filled the augmented area with remaining biomaterials; however, non-ciliated flat epithelium and inflammatory cells were observed on the healed sinus membrane. Histometric analysis showed that the percentage of newly formed bone area in the dHACM group did not differ significantly from that in the CM group. The dHACM group showed a significantly higher percentage of newly formed bone area than the NC group, but there was no significant difference between the dHACM and PC groups. Conclusions dHACM could be a feasible solution for repairing sinus membrane perforations that occur during sinus floor augmentation.
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Affiliation(s)
- Yun-Young Chang
- Department of Dentistry, Inha International Medical Center, Incheon, Korea
| | - Su-Hwan Kim
- Department of Periodontics, Asan Medical Center & Department of Dentistry, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi-Seon Goh
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Indrawati DW, Munadziroh E, Sulisetyawati TIB, El Fadhlallah PM. Sponge amnion potential in post tooth extraction wound healing by interleukin-6 and bone morphogenetic protein-2 expression analysis: An animal study. Dent Res J (Isfahan) 2019; 16:283-288. [PMID: 31543933 PMCID: PMC6749851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Wound tooth extraction is a mechanical injury that traumatizes adjacent tissue. Sponge amnion contains growth factors that can promote postextraction wound healing. Amnion membranes can be transformed into sponge form rendering it easier to use. The aim of this study is to analyze interleukin-6 (IL-6) and bone morphogenetic protein-2 (BMP-2) expression in postextraction wound healing on the 1st and 7th day after sponge amnion application. MATERIALS AND METHODS Twenty-eight Wistar rats were used in this experimental descriptive analytical study. Fourteen animals' first right anterior mandible tooth was extracted; then, the socket applied by sponge amnion and sutured (treatment group), while 14 others only sutured (as control group). The alveolar bone tissue of animal was observed 1st and 7th days after extraction and then was analyzed using immunohistostaining to identify the expression of IL-6 and BMP-2. Statistical analysis was performed using one-way ANOVA with the level of significance (P < 0.05). RESULTS IL-6 expression in the treatment group was significantly lower than the control group on the 1st and 7th days (P = 0.000). BMP-2 expression in the treatment group was significantly higher than the control group on the 1st and 7th days (P = 0.000). CONCLUSION Sponge amnion can promote the healing process by increasing the expression of BMP-2 and decreasing IL-6 expression.
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Affiliation(s)
- Dwi Wahyu Indrawati
- Department of Dental Health Science, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Elly Munadziroh
- Department of Biomaterial, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia,Address for correspondence: Dr. Elly Munadziroh, Faculty of Dental Medicine, Universitas Airlangga, Jl.Prof. Dr. Moestopo 47, Surabaya 60132, Indonesia. E-mail:
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Xu CM, Zhang JM, Wu YF, Zhao L. [Research progress on substitutes for autogenous soft tissue grafts in mucogingival surgery]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:208-213. [PMID: 31168989 DOI: 10.7518/hxkq.2019.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Mucogingival surgery is a general term for periodontal surgeries that correct aberrant periodontal soft tissues. Conventional mucogingival surgeries with pedicle flap or autologous soft tissue graft for treatment of gingival recession and insufficient keratinized tissues are always related to disadvantages such as need for a second surgery site, limited supplies, and complaints for postoperative discomfort. In this regard, research and application of soft tissue substitutes have gained increasing attention. Various kinds of soft tissue substitutes, including acellular dermal matrix and xenogeneic collagen matrix, have been developed and applied to clinical treatment. This review aims to summarize advances in research of the characteristics and clinical effectiveness of several soft tissue substitutes and provide references for clinical application.
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Affiliation(s)
- Chun-Mei Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jin-Mei Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ya-Fei Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Munadziroh E, Indrawati D, Sulisetyawati TB, El Fadhlallah P. Sponge amnion potential in post tooth extraction wound healing by interleukin-6 and bone morphogenetic protein-2 expression analysis: An animal study. Dent Res J (Isfahan) 2019. [DOI: 10.4103/1735-3327.266089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Fénelon M, Catros S, Fricain JC. What is the benefit of using amniotic membrane in oral surgery? A comprehensive review of clinical studies. Clin Oral Investig 2018; 22:1881-1891. [PMID: 29682688 DOI: 10.1007/s00784-018-2457-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Since its first use for the reconstruction of tissue defects in the oral cavity in 1985, human amniotic membrane (hAM) has been widely studied in the field of oral surgery. Despite the growing number of publications in this field, there is no systematic review or meta-analysis concerning its clinical applications, outcome assessments, and relevance in oral surgery. The aim of this review is to provide a thorough understanding of the potential use of hAM for soft and hard tissue reconstruction in the oral cavity. MATERIALS AND METHODS A systematic electronic and a manual literature search of the MEDLINE-PubMed database and Scopus database was completed. Patient, Intervention, Comparison and Outcomes (PICO) technique was used to select the relevant articles to meet the objective. Studies using hAM for oral reconstruction, and conducted on human subjects, were included in this survey. RESULTS A total of 17 articles were analyzed. Five areas of interest were identified as potential clinical application: periodontal surgery, cleft palate and tumor reconstruction, prosthodontics and peri-implant surgery. Overall, periodontal surgery was the only discipline to assess the efficacy of hAM with randomized clinical trials. The wide variability of preservation methods of hAM and the lack of objective measurements were observed in this study. CONCLUSION hAM is already used in the field of oral surgery. Despite this, there is weak clinical evidence demonstrating convincingly the benefit of hAM in this area compared to standard surgery. CLINICAL RELEVANCE Several studies now suggest the interest of hAM for periodontal tissue repair. Due to its biological and mechanical properties, hAM seems to be a promising treatment for wound healing in various areas of oral reconstruction. However, further randomized clinical trials are needed to confirm these preliminary results.
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Affiliation(s)
- M Fénelon
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France. .,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France.
| | - S Catros
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France.,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France
| | - J C Fricain
- CHU Bordeaux, Dentistry and Oral Health Department, Place Amélie Raba Léon, 33076, Bordeaux, France.,INSERM U1026, University of Bordeaux, Tissue Bioengineering (BioTis), 146 rue Léo-Saignat, F-33000, Bordeaux, France
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Rehan M, Khatri M, Bansal M, Puri K, Kumar A. Comparative Evaluation of Coronally Advanced Flap Using Amniotic Membrane and Platelet-rich Fibrin Membrane in Gingival Recession: An 18-Month Clinical Study. Contemp Clin Dent 2018; 9:188-194. [PMID: 29875559 PMCID: PMC5968681 DOI: 10.4103/ccd.ccd_799_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: An amnion membrane is a placenta-derived tissue that consists of numerous growth factors, proteins, and stem cell reserves which help in accelerated wound healing and regeneration. Platelet-rich fibrin (PRF) also releases growth factors after activation from the platelets and gets trapped within fibrin matrix which has been shown to stimulate the mitogenic response in the periosteum for bone repair and regeneration during normal wound healing. This preliminary, controlled, randomized clinical trial with an 18-month follow-up was aimed to evaluate the effectiveness of coronally advanced flap (CAF) with either PRF membrane or bioresorbable amniotic membrane (AM) in treatment of localized gingival recession defects. Materials and Methods: Sixteen healthy adult patients presenting with Miller Class I recession defects were treated surgically with CAF along with AM (Group I) or PRF (Group II) for coverage of the recession defects. For all patients, plaque index, gingival index, bleeding on probing, clinical attachment level, depth of recession, width of recession, width of attached gingiva, and gingival thickness were evaluated at 6 months and 18 months postoperatively. Statistical analysis was done using paired t-test, repeated measure analysis of variance test, Bonferroni test for intragroup comparison and unpaired t-test for intergroup comparison. Results: The results showed statistically nonsignificant (P < 0.01) difference in all clinical parameters at the 6- and 18-month follow-ups in both groups. Gingival recession in both PRF and amnion group when evaluated individually, significantly reduced from baseline to 6 months (P = 0.000) and from baseline to 18 months (P = 0.000). However, the mean value from 6 months to 18 months was statistically nonsignificant. Conclusion: The present study demonstrated that both CAF + PRF and CAF + AM are equally effective in providing clinically significant outcomes with respect to root coverage with AM showing the better percentage of root coverage as compared to PRF.
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Affiliation(s)
- Mohd Rehan
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Mansi Bansal
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Komal Puri
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Ashish Kumar
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
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Jain A, Jaiswal GR, Kumathalli K, Kumar R, Singh A, Sarwan A. Comparative Evaluation of Platelet Rich Fibrin and Dehydrated Amniotic Membrane for the Treatment of Gingival Recession- A Clinical Study. J Clin Diagn Res 2017; 11:ZC24-ZC28. [PMID: 28969268 DOI: 10.7860/jcdr/2017/29599.10362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/13/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The main objective of any therapeutic intervention aimed at root coverage is to restore the tissue margin to the cemento-enamel junction and to regenerate the lost periodontium. AIM To compare the effectiveness of Platelet Rich Fibrin (PRF) and Amniotic Membrane (AM) in the treatment of gingival recession by Coronally Advanced Flap (CAF) Technique. MATERIALS AND METHODS Thirty systemically healthy patients who met inclusion-exclusion criteria were selected. After Phase-I therapy, patients were randomly allocated to one of the groups; PRF (Group-A) and Amnion Group (Group-B). Clinical parameters like Plaque Index (PI), Recession Depth (RD) and Width of Keratinized Gingiva (WKG) were measured on the baseline day, three months and six months postoperatively. Mann-Whitney test and Wilcoxon signed ranks test were applied for intergroup and intragroup comparisons respectively. RESULTS Intergroup comparison between platelet rich fibrin and amniotic membrane showed statistically insignificant difference in the recession depth and width of keratinized gingiva at three and six months postoperatively. CONCLUSION Both the membranes were equally effective in terms of recession coverage and increase in width of keratinized gingiva.
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Affiliation(s)
- Ankita Jain
- Postgraduate Student, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
| | - Gagan Rajesh Jaiswal
- Professor, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
| | - Kanteshwari Kumathalli
- Principal and Head, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
| | - Rajesh Kumar
- Reader, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
| | - Alisha Singh
- Postgraduate Student, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
| | - Aakrti Sarwan
- Postgraduate Student, Department of Periodontics, Sri Aurobindo College of Dentistry, Indore, Madhya pradesh, India
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Sali DD, Pauline George J. Demineralized Freeze Dried Bone Allograft With Amniotic Membrane in the Treatment of Periodontal Intrabony Defects - 12 Month Randomized Controlled Clinical Trial. J Periodontol 2016:1-18. [PMID: 27834121 DOI: 10.1902/jop.2016.160260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The goal of randomized controlled clinical study was to compare the clinical and radiological outcomes of the combination of Open flap debridement, Amniotic membrane and Demineralized Freeze Dried bone Allograft with Open flap debridement and Demineralized Freeze Dried bone Allograft alone in the management of periodontal intrabony defects. METHOD 10 patients with bilaterally similar intrabony defects were selected. Each of the intrabony defects were randomly allocated for control and test groups. Control group (n= 10) received open flap debridement (OFD) and Demineralized Freeze Dried bone Allograft (DFDBA) while the test group (n=10) received OFD, DFDBA and Amniotic membrane. Pocket Probing Depth reduction (PPD), Clinical Attachment Level (CAL) gain and radiographic bone gain were assessed. RESULTS Both the groups demonstrated statistically significant PPD reduction, CAL gain and radiographic bone gain. The Intrabony defect (IBD) reduction of 1.78 ± 0.04 mm in radiovisiography (RVG) and 2.02 ± 0.83 mm in cone beam computed tomography (CBCT) with defect resolution of 58.28 % (RVG) and 58.24 % (CBCT) was noted in test group when compared to control group. CONCLUSION All the parameters measured showed similar improvement such as PPD reduction, CAL gain, IBD reduction and defect resolution with OFD + DFDBA + AM and OFD + DFDBA, no statistical significant difference was observed between the two groups .
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Affiliation(s)
- Deepthi D Sali
- Post Graduate Student, Department of Periodontology Krishnadevaraya College of Dental Sciences and Hospital, Hunsamaranahalli, International Airport Road, Bangalore - 562157, India
| | - Joann Pauline George
- Professor, Department of Periodontology Krishnadevaraya College of Dental Sciences and Hospital, Hunsamaranahalli, International Airport Road, Bangalore - 562157, India
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