1
|
Badr AM, Shalaby HK, Awad MA, Hashem MA. Assessment of bone morphogenetic protein-7 loaded chitosan/β-Glycerophosphate hydrogel on periodontium tissues regeneration of class III furcation defects. Saudi Dent J 2023; 35:760-767. [PMID: 37817788 PMCID: PMC10562118 DOI: 10.1016/j.sdentj.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background Periodontitis is a long-term, multifactorial inflammatory condition that is triggered by bacterial germs and interacts with the host's immune system. The unique attachment of fibrous tissue between the cementum and bone presents a challenge for periodontal regeneration. Aim To achieve the lowest optimum dose of BMP-7 that helps in periodontal regeneration, involving newly formed cementum, PDL and bone. Materials and methods Five healthy mongrel dogs were used for the study. A critical class III furcation defect was created using rotating burs. The bone defects (ten defects for each group) were allocated to one of the subsequent groups: (Group 1) control with the surgical defect only. (Group 2) Surgical defect implanted with hydrogel only (CS/β-GP). (Group 3) Surgical defect implanted with CS/BMP-7 (50 ng/ml). (Group 4) Surgical defect implanted with CS/BMP-7 (100 ng/ml). Results Histomorphometric and H&E analysis revealed a statistically significant difference in bone, PDL, and cementum regeneration defects filled with CS/BMP-7 (100 ng/ml) compared with other groups. Conclusion The standard effective dose for BMP-7 use in periodontal regeneration is 100 ng/ml.
Collapse
|
2
|
Zhou Z, Qi X, Notice T. Treatment of mandibular grade III furcation involvement using platelet-rich fibrin and allogenic graft with 12-month follow-up - A case report. J Oral Biol Craniofac Res 2020; 10:542-546. [PMID: 32923359 DOI: 10.1016/j.jobcr.2020.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Furcation involvement (FI) in multi-rooted teeth is challenging for proper oral hygiene, clinical treatment, and leads to poor prognosis. Traditional treatment modalities often result in sacrificing periodontal bone. Multiple regenerative approaches have been attempted to treat furcation defects, but complete regeneration of the periodontal apparatus in grade III furcation has not been reported. Platelet rich fibrin (PRF) shows great potential in enhancing tissue regeneration, angiogenesis, and prevention of infection. This case report introduces a treatment combining allogenic bone grafts with PRF to treat mandibular grade III furcation lesions with a one-year follow-up. Case presentation Two patients presented with grade III FIs of the mandibular first molars, with intrabony defects requiring guided tooth regeneration (GTR). PRF was collected from each patient to serve as biologics, by mixing with allogenic bone graft, and packed into the furcation and intrabony defects. The PRF membranes were also used for space maintenance. The twelve-month postoperative follow-up demonstrated quicker tissue healing, significant pocket reduction, clinical attachment gain, as well as radiographic bone fill in both cases. Conclusion Successful periodontal regeneration of grade III furcation defects can be achieved by using PRF in combination with bone allograft.
Collapse
Affiliation(s)
- Zheng Zhou
- University of Detroit Mercy School of Dentistry, Detroit, MI, USA.,Private Practice, Livonia, MI, USA
| | - Xia Qi
- University of Detroit Mercy School of Dentistry, Detroit, MI, USA.,School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang, Hebei, China
| | - Tinisha Notice
- University of Detroit Mercy School of Dentistry, Detroit, MI, USA
| |
Collapse
|
3
|
Tanneberger AM, Al-Maawi S, Herrera-Vizcaíno C, Orlowska A, Kubesch A, Sader R, Kirkpatrick CJ, Ghanaati S. Multinucleated giant cells within the in vivo implantation bed of a collagen-based biomaterial determine its degradation pattern. Clin Oral Investig 2020; 25:859-873. [PMID: 32514904 PMCID: PMC7878236 DOI: 10.1007/s00784-020-03373-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/25/2020] [Indexed: 12/21/2022]
Abstract
Objectives The aim of the present study was to characterize the cellular reaction to a xenogeneic resorbable collagen membrane of porcine origin using a subcutaneous implantation model in Wistar rats over 30 days. Materials and methods Ex vivo, liquid platelet-rich fibrin (PRF), a leukocyte and platelet-rich cell suspension, was used to evaluate the blood cell membrane interaction. The material was implanted subcutaneously in rats. Sham-operated rats without biomaterial displayed physiological wound healing (control group). Histological, immunohistological, and histomorphometric analyses were focused on the inflammatory pattern, vascularization rate, and degradation pattern. Results The membrane induced a large number of mononuclear cells over the observation period, including lymphocytes, macrophages, and fibroblasts. After 15 days, multinucleated giant cells (MNGCs) were observed on the biomaterial surface. Their number increased significantly, and they proceeded to the center of the biomaterial on day 30. These cells highly expressed CD-68, calcitonin receptor, and MMP-9, but not TRAP or integrin-ß3. Thus, the membrane lost its integrity and underwent disintegration as a consequence of the induction of MNGCs. The significant increase in MNGC number correlated with a high rate of vascularization, which was significantly higher than the control group. Physiological wound healing in the control group did not induce any MNGCs at any time point. Ex vivo blood cells from liquid-PRF did not penetrate the membrane. Conclusion The present study suggests a potential role for MNGCs in biomaterial degradation and questions whether it is beneficial to accept them in clinically approved biomaterials or focus on biomaterials that induce only mononuclear cells. Thus, further studies are necessary to identify the function of biomaterial-induced MNGCs. Clinical relevance Understanding the cellular reaction to biomaterials is essential to assess their suitability for specific clinical indications and outline the potential benefit of specific group of biomaterials in the respective clinical indications.
Collapse
Affiliation(s)
- Anna Maria Tanneberger
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Sarah Al-Maawi
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Carlos Herrera-Vizcaíno
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Anna Orlowska
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Alica Kubesch
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - C J Kirkpatrick
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Shahram Ghanaati
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, FORM (Frankfurt Orofacial Regenerative Medicine) Lab, University Hospital Frankfurt Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| |
Collapse
|
4
|
Shkreta M, Atanasovska-Stojanovska A, Dollaku B, Belazelkoska Z. Exploring the Gingival Recession Surgical Treatment Modalities: A Literature Review. Open Access Maced J Med Sci 2018; 6:698-708. [PMID: 29731944 PMCID: PMC5927507 DOI: 10.3889/oamjms.2018.185] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/25/2018] [Accepted: 03/26/2018] [Indexed: 12/01/2022] Open
Abstract
Gingival recessions present complex soft tissue pathology, with a multiple aetiology and a high prevalence which increases with age. They are defined as an exposure of the root surface of the teeth as a result of the apical migration of the gingival margin beyond the cementum-enamel junction, causing functional and aesthetic disturbances to the affected individuals. Aiming to ensure complete root coverage and satisfying aesthetic outcomes, a wide range of surgical techniques have been proposed through the decades for the treatment of the gingival recessions. The following literature review attempts to provide a comprehensive, structured and up-to-date summary of the relevant literature regarding these surgical techniques, aiming to emphasise for each technique its indications, its long-term success and predictability, its advantages and disadvantages about each other.
Collapse
Affiliation(s)
- Mirsad Shkreta
- Department of Oral Pathology and Periodontology, Dental Clinical Center, Faculty of Stomatology, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Aneta Atanasovska-Stojanovska
- Department of Oral Pathology and Periodontology, Dental Clinical Center, Faculty of Stomatology, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Blerta Dollaku
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University “Hasan Prishtina”, Prishtina, Kosovo
| | - Zlatanka Belazelkoska
- Department of Oral Pathology and Periodontology, Dental Clinical Center, Faculty of Stomatology, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| |
Collapse
|
5
|
Kawasaki T, Ohba S, Nakatani Y, Asahina I. Clinical study of guided bone regeneration with resorbable polylactide-co-glycolide acid membrane. Odontology 2018; 106:334-339. [PMID: 29429055 DOI: 10.1007/s10266-018-0349-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/15/2017] [Indexed: 11/25/2022]
Abstract
The guided bone regeneration (GBR) technique is often applied to provide sufficient bone for ideal implant placement. The objective of this study was to evaluate whether GC membrane®, which has already been used for guided tissue regeneration (GTR), can also be available for GBR. Twenty-three implants in 18 patients were evaluated in the study. All patients underwent implant placement with GBR using GC membrane®. Cone-beam computed tomography was performed at 13-30 weeks after surgery and the amount of augmented bone was assessed. The implant stability quotient (ISQ) was measured at the second operation to evaluate implant stability. Although wound dehiscence was observed at 4 of 23 regions (17.4%), all wounds closed quickly without any events by additional antibiotic administration. GBR-induced bone augmentation of 0.70-2.56 mm horizontally and 0-6.82 mm vertically. Only 0.18 mm of bone recession was observed at 16-24 months after implant placement. GBR with GC membrane® induced sufficient bone augmentation, leading to successful implant treatment. The present results suggest that GC membrane® is available not only for GTR, but also for GBR.
Collapse
Affiliation(s)
- Takako Kawasaki
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
| | - Yuya Nakatani
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| |
Collapse
|
6
|
Górski B, Jalowski S, Górska R, Zaremba M. Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial. Clin Oral Investig 2018; 22:2819-28. [PMID: 29411112 DOI: 10.1007/s00784-018-2368-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 01/25/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study was to compare the clinical and radiographic efficacy of guided tissue regeneration with a modified perforated collagen membrane (MPM) or standard collagen membrane (CM) in the treatment of intrabony defects in patients with aggressive periodontitis (AgP). MATERIALS AND METHODS Fifteen AgP patients were included in the study. Two single intrabony defects of at least 3 mm depth with ≥ 6 mm probing pocket depth (PPD) from each patient were randomly assigned to either xenogenic graft plus MPM (test group) or xenogenic graft plus CM (control group). PPD, clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and at 12 months. The radiographic assessments included the measurements of defect depth (DD), change in alveolar crest position (ACP), linear defect fill (LDF), and percentage defect fill (%DF). RESULTS After treatment, PPD, CAL, DD, and ACP values improved significantly in both groups, without statistical differences between them. However, with respect to LDF and %DF, the 12-month radiographic analysis at MPM-treated sites showed a significant improvement compared to the 6-month outcomes, that was not observed at control sites (additional LDF of 0.4 ± 0.5 mm, p = 0.010 and %DF of 6.4 ± 7.6%, p = 0.025). CONCLUSIONS Both strategies proved effective in the treatment of intrabony defects in patients with AgP. Nonetheless, enhanced LDF and %DF 12 months postoperatively at MPM-treated sites may stem from cellular and molecular migration from the periosteum and overlying gingival connective tissue through barrier's pores. CLINICAL RELEVANCE Modification of CM may have positive ramifications on periodontal regeneration.
Collapse
|
7
|
Tayebi L, Rasoulianboroujeni M, Moharamzadeh K, Almela TKD, Cui Z, Ye H. 3D-printed membrane for guided tissue regeneration. Mater Sci Eng C Mater Biol Appl 2017. [PMID: 29519424 DOI: 10.1016/j.msec.2017.11.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Three-dimensional (3D) printing is currently being intensely studied for a diverse set of applications, including the development of bioengineered tissues, as well as the production of functional biomedical materials and devices for dental and orthopedic applications. The aim of this study was to develop and characterize a 3D-printed hybrid construct that can be potentially suitable for guided tissue regeneration (GTR). For this purpose, the rheology analyses have been performed on different bioinks and a specific solution comprising 8% gelatin, 2% elastin and 0.5% sodium hyaluronate has been selected as the most suitable composition for printing a structured membrane for GTR application. Each membrane is composed of 6 layers with strand angles from the first layer to the last layer of 45, 135, 0, 90, 0 and 90°. Confirmed by 3D Laser Measuring imaging, the membrane has small pores on one side and large pores on the other to be able to accommodate different cells like osteoblasts, fibroblasts and keratinocytes on different sides. The ultimate cross-linked product is a 150μm thick flexible and bendable membrane with easy surgical handling. Static and dynamic mechanical testing revealed static tensile modules of 1.95±0.55MPa and a dynamic tensile storage modulus of 314±50kPa. Through seeding the membranes with fibroblast and keratinocyte cells, the results of in vitro tests, including histological analysis, tissue viability examinations and DAPI staining, indicated that the membrane has desirable in vitro biocompatibility. The membrane has demonstrated the barrier function of a GTR membrane by thorough separation of the oral epithelial layer from the underlying tissues. In conclusion, we have characterized a biocompatible and bio-resorbable 3D-printed structured gelatin/elastin/sodium hyaluronate membrane with optimal biostability, mechanical strength and surgical handling characteristics in terms of suturability for potential application in GTR procedures.
Collapse
Affiliation(s)
- Lobat Tayebi
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK; Marquette University School of Dentistry, Milwaukee, WI 53233, USA
| | | | - Keyvan Moharamzadeh
- School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK
| | - Thafar K D Almela
- School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK
| | - Zhanfeng Cui
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK
| | - Hua Ye
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford OX3 7DQ, UK.
| |
Collapse
|
8
|
Uppada UK, Kalakonda B, Koppolu P, Varma N, Palakurthy K, Manchikanti V, Prasad S, Samar S, Swapna LA. Combination of hydroxyapatite, platelet rich fibrin and amnion membrane as a novel therapeutic option in regenerative periapical endodontic surgery: Case series. Int J Surg Case Rep 2017; 37:139-144. [PMID: 28667922 PMCID: PMC5493814 DOI: 10.1016/j.ijscr.2017.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 11/24/2022] Open
Abstract
Our article was an attempt to focus on combined benefits of Bio-Gen mix®, PRF and amnion membrane to provide a viable regenerative option in periapical surgery. To the best of our knowledge, there has been no evidence related to the application of a human placental membrane in periapical surgery. Our presented case reports provide an insight into this novel therapeutic option. The presented case reports confirm that the amnion membrane combined with bone graft and PRF have enhanced the healing outcomes and provided endodontists a sustainable tool while performing surgeries in the esthetic zone.
Introduction Periapical surgery is the last resort in the arsenal of an endodontist to effectively deal with periapical lesions that result from necrosis of the pulp. Bone grafts, growth factors and membranes form an array of regenerative materials that influence the healing outcome of periapical surgery. Presentation of case The main purpose of the two cases reported here was to assess the potential benefits of a combination of bone graft, platelet-rich fibrin (PRF) and amnion membrane in terms of reduced post-operative discomfort, radiographic evidence of accelerated periapical bone healing and present a novel therapeutic option in the management of large periapical lesions. Two cases of radicular cysts were treated through a combined regenerative approachof Bio-Gen mix®, PRF and amnion membrane. The patients were assessed for discomfort immediate post-operatively and after a week. The patients were recalled every month for the next 6 months for radiographic assessment of the periapical healing. Discussion Literature is replete with articles that have substantiated the role of demineralized bone matrix comprising a mixture of cancellous and cortical bone graft particles in enhancing regeneration. To the best of our knowledge, there has been no evidence related to the application of a human placental membrane in periapical surgery. Hence, the rationale of using a combined approach of Bio-Gen mix®, PRF and amnion membrane was to combine the individual advantages of these materials to enhance clinical and radiographic healing outcomes. Our present case reports provide an insight into this novel therapeutic option. Conclusion The results of this case seriessubstantiatesthe credibility of using a combination ofamnion membrane with a bone graft and PRF to enhance radiographic healing outcome with decreased post-operative discomfort and present a viable regenerative treatment modality in periapical surgery.
Collapse
Affiliation(s)
- Uday Kiran Uppada
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India.
| | - Butchibabu Kalakonda
- Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
| | - Pradeep Koppolu
- Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
| | - Narendra Varma
- Department of Preventive Dental Sciences, College of Dental Surgery, Prince Sattam Bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Kiran Palakurthy
- Department of Prosthetic Dental Sciences, AlFarabi Colleges, Riyadh, Saudi Arabia
| | | | - Shilpa Prasad
- Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
| | - Shereen Samar
- Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
| | - Lingam Amara Swapna
- Department of Oral medicine and Diagnostic Sciences, AlFarabi Colleges, Saudi Arabia
| |
Collapse
|
9
|
Rakmanee T, Griffiths GS, Auplish G, Darbar U, Petrie A, Olsen I, Donos N. Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months. Clin Oral Investig 2015; 20:1217-25. [PMID: 26411859 DOI: 10.1007/s00784-015-1608-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 09/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to compare clinical outcomes between guided tissue regeneration (GTR) and access flap (AF) surgery in patients with aggressive periodontitis (AgP). METHODS Eighteen AgP patients with similar bilateral intrabony defects were treated in this split-mouth, single-blinded, randomised, controlled clinical trial. All patients presented with ≥3 mm intrabony defects and ≥5 mm periodontal pocket depths (PPD). In each patient, one defect was treated with a polyglycolide membrane according to the GTR principle, whereas the contralateral side was treated with AF. For both sides, a simplified papilla preservation flap was used. At baseline, 6 and 12 months post-surgery, the clinical attachment levels (CAL) and PPD were evaluated. RESULTS At 6 and 12 months, at the GTR sites, the mean [95 % CI] CAL gain was 1.7 mm [1.1, 2.3] and 1.6 mm [0.9, 2.1], respectively, while the mean [95 % CI] PPD reduction was 2.3 mm [1.9, 2.8] and 2.4 mm [1.9, 2.8], respectively. Similar CAL (1.6 mm [1.0, 2.2] and 2.1 mm [1.4, 2.7]) and PPD (2.0 mm [1.5, 2.4] and 2.5 mm [2.0, 3.0]) outcomes were observed at the control sites at 6 and 12 months, respectively. Notably, at the GTR-treated sites, 13 subjects presented with various degrees of membrane exposure. CONCLUSIONS Both therapies were effective in the treatment of intrabony defects in AgP patients, and no statistically significant differences between them could be demonstrated, possibly as a result of the differing degrees of membrane exposure at the GTR sites. CLINICAL RELEVANCE Both periodontal regeneration and conventional periodontal surgery are effective treatments for AgP patients.
Collapse
Affiliation(s)
- Thanasak Rakmanee
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.,Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Gareth S Griffiths
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.,School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Gita Auplish
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Ulpee Darbar
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - Irwin Olsen
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Nikolaos Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK. .,Department of Periodontology, UCL-Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, UK.
| |
Collapse
|
10
|
Gilbert LR, Lohra P, Mandlik VB, Rath SK, Jha AK. Comparative evaluation of surgical modalities for coverage of gingival recession: An Armed Forces Medical College perspective. Med J Armed Forces India 2015; 71:53-9. [PMID: 25609865 DOI: 10.1016/j.mjafi.2011.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 12/20/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Esthetics represents an inseparable part of today's oral therapy, and several procedures have been proposed to preserve or enhance it. Gingival recessions may cause hypersensitivity, impaired esthetics and root caries. Keeping in mind patient's desire for improved esthetics and other related problems, every effort should be made to achieve complete root coverage. METHODS Different types of modalities have been introduced to treat gingival recession including displaced flaps, free gingival graft, connective tissue graft, different type of barrier membranes and combination of different techniques. The aim of this study was to compare the commonly used techniques for gingival recession coverage and evaluate the results obtained. 73 subjects were selected for the present study who were randomly divided into four groups and were followed at baseline and 180 days where following parameters were recorded: (a) Assessment of gingival recession depth (RD); (b) Assessment of pocket depth (PD); (c) Assessment of clinical attachment level (CAL) and (d) Assessment of width of attached gingiva (WAG). RESULTS Results of this study showed statistically significant reduction of gingival recession, with concomitant attachment gain, following treatment with all tested surgical techniques. However, SCTG with CAF technique showed the highest percentage gain in coverage of recession depth as well as gain in keratinized gingiva. Similar results were obtained with CAF alone. The use of GTR and other techniques showed less predictable coverage and gain in keratinized gingiva. CONCLUSION Connective tissue grafts were statistically significantly superior to guided tissue regeneration for improvement in gingival recession reduction.
Collapse
Affiliation(s)
| | - Parul Lohra
- Dental Officer, 333 Fd Hosp, C/O-56 APO, India
| | - V B Mandlik
- Commanding Officer & Corps Dental Advisor, 15 Corps Dental Unit, C/O 56 APO, India
| | - S K Rath
- Senior Specialist (Periodontics), Army Dental Centre, (R&R), Delhi Cantt, India
| | - A K Jha
- Officer Commanding, MDC, Namkum, C/O 56 APO, India
| |
Collapse
|