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Cetiner DO, Isler SC, Ilikci-Sagkan R, Sengul J, Kaymaz O, Corekci AU. The adjunctive use of antimicrobial photodynamic therapy, light-emitting-diode photobiomodulation and ozone therapy in regenerative treatment of stage III/IV grade C periodontitis: a randomized controlled clinical trial. Clin Oral Investig 2024; 28:426. [PMID: 38992200 PMCID: PMC11239751 DOI: 10.1007/s00784-024-05794-0] [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: 01/26/2024] [Accepted: 06/19/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To assess the short-term efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT), light-emitting-diode (LED) photobiomodulation, and topical ozone therapy applications following surgical regenerative treatments on clinical parameters, patient-centered outcomes, and mRNA expression levels of VEGF, IL-6, RunX2, Nell-1, and osterix in gingival crevicular fluid samples in patients with stage III/IV, grade C periodontitis. MATERIALS AND METHODS Forty-eight systemically healthy patients were assigned into four groups to receive adjunctive modalities with regenerative periodontal surgical treatment. A 970 ± 15 nm diode laser plus indocyanine-green for aPDT group, a 626 nm LED for photobiomodulation group, and topical gaseous ozone were applied at 0, 1, 3, and 7 postoperative days and compared to control group. The clinical periodontal parameters, early wound healing index (EHI), and postoperative patients' morbidity were evaluated. The mRNA levels of biomarkers were assessed by real-time polymerase chain reaction. RESULTS No significant difference in the clinical parameters except gingival recession (GR) was identified among the groups. For group-by-time interactions, plaque index (PI) and probing pocket depths (PD) showed significant differences (p = 0.034; p = 0.022). In sites with initial PD > 7 mm, significant differences were observed between control and photobiomodulation groups in PD (p = 0.011), between control and aPDT, and control and photobiomodulation groups in CAL at 6-month follow-up (p = 0.007; p = 0.022). The relative osterix mRNA levels showed a statistically significant difference among the treatment groups (p = 0.014). CONCLUSIONS The additional applications of aPDT and LED after regenerative treatment of stage III/IV grade C periodontitis exhibited a more pronounced beneficial effect on clinical outcomes in deep periodontal pockets.
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Affiliation(s)
- Deniz Ozbay Cetiner
- Department of Periodontology, Faculty of Dentistry, Gazi University, Biskek cad. 1. Sokak No:4, Emek Ankara, 06490, Turkey.
| | - Sila Cagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Biskek cad. 1. Sokak No:4, Emek Ankara, 06490, Turkey
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Rahsan Ilikci-Sagkan
- Department of Medical Biology, School of Medicine, Uşak University, Uşak, 64300, Turkey
| | | | - Ozlem Kaymaz
- Department of Statistic, Faculty of Science, Ankara University, Ankara, Turkey
| | - Ahu Uraz Corekci
- Department of Periodontology, Faculty of Dentistry, Izmir Demokrasi University, Izmir, Turkey
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Kim TJ, Littlejohn CG, Richey KH, Falsafi N, Li C, Wang TJ, Lander B, Chang YC. A Modern Approach to Treat Molar/Incisor Pattern Periodontitis-Review. J Clin Med 2023; 12:6107. [PMID: 37763046 PMCID: PMC10531571 DOI: 10.3390/jcm12186107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Molar-incisor pattern periodontitis (MIPP) is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction affecting the molars and incisors. Formerly referred to as aggressive periodontitis, the terminology for this condition was revised after the 2017 workshop on the classification of periodontal and peri-implant diseases and conditions. Despite the modification in nomenclature, the treatment strategies for MIPP remain a critical area of investigation. The core principles of MIPP treatment involve controlling local and systemic risk factors, managing inflammation, and arresting disease progression. Traditional non-surgical periodontal therapy, including scaling and root planing, is commonly employed as an initial step together with the prescription of antibiotics. Surgical intervention may be necessary to address the severe attachment loss. Surgical techniques like resective and regenerative procedures can aid in achieving periodontal health and improving esthetic outcomes. This review article aims to provide an overview of the current understanding and advancements in the treatment modalities of MIPP. Through an extensive analysis of the existing literature, we discuss various modern therapeutic approaches that have been explored for managing this challenging periodontal condition.
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Affiliation(s)
- Taewan J. Kim
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Caroline G. Littlejohn
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Kristen H. Richey
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Neda Falsafi
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA;
| | - Tun-Jan Wang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Bradley Lander
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA 19104, USA; (T.J.K.); (C.G.L.); (K.H.R.); (N.F.); (T.-J.W.); (B.L.)
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L Abe G, Tsuboi R, Kitagawa H, Sasaki JI, Li A, Kohno T, Imazato S. Poly(lactic acid/caprolactone) bilayer membrane blocks bacterial penetration. J Periodontal Res 2022; 57:510-518. [PMID: 35212414 DOI: 10.1111/jre.12980] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/18/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The clinical outcomes of guided tissue regeneration (GTR) or guided bone regeneration (GBR) procedures can be impaired if a bacterial infection develops at the surgical site. Membrane exposure is one of the causes of the onset of bacterial infection. Previously, we have fabricated a poly(lactic acid/caprolactone) (PLCL) bilayer membrane composed of a porous layer and a compact layer. The compact layer acts as a barrier against connective tissue and epithelial cells, and we hypothesized that it could also be an effective barrier against bacterial cells. The objective of this study was to evaluate the ability of the PLCL bilayer membrane to block bacterial cell penetration, which would be useful for preventing postoperative infections. METHODS Porphyromonas gingivalis, Streptococcus mutans, and multispecies bacteria collected from human saliva were used in this study. Bacteria were seeded directly on the compact layer of a PLCL bilayer membrane, and bacterial adhesion to the membrane, as well as penetration into the membrane's structure, were assessed. Bacterial adhesion was evaluated by the number of colonies formed at 6, 24, and 72 h, and penetration was observed using a scanning electron microscope at 24 and 72 h. Commercially available membranes, composed of poly(lactic-co-glycolic acid) or type I collagen, were used as controls. RESULTS P. gingivalis, S. mutans, and the multispecies bacteria obtained from human saliva adhered onto all the membranes after only 6 h of incubation. However, fewer adherent cells were observed for the PLCL bilayer membrane compared with the controls for all experimental periods. The PLCL membrane was capable of blocking bacterial penetration, and no bacterial cells were observed in the structure. In contrast, bacteria penetrated both the control membranes and were observed at depths of up to 80 µm after 72 h of incubation. CONCLUSION Membrane characteristics may influence how bacterial colonization occurs. The PLCL membrane had reduced bacterial adhesion and blocked bacterial penetration, and these characteristics could contribute to a favorable outcome for regenerative treatments. In the event of membrane exposure at GTR/GBR surgical sites, membranes with an efficient barrier function, such as the PLCL bilayer membrane, could simplify the management of GTR/GBR complications.
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Affiliation(s)
- Gabriela L Abe
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Ririko Tsuboi
- Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Haruaki Kitagawa
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Jun-Ichi Sasaki
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Aonan Li
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Tomoki Kohno
- Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.,Department of Advanced Functional Materials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Rojas MA, Marini L, Russo P, Blardi V, Schmidlin PR, Pilloni A. Clinical Pilot Series of Non-Self-Contained Periodontal Infrabony Defects Treated with a Slowly Resorbable Bovine Pericardium Membrane in Combination with Low-Temperature-Treated Decellularized Bovine Bone Particles. Dent J (Basel) 2021; 9:dj9100110. [PMID: 34677172 PMCID: PMC8534930 DOI: 10.3390/dj9100110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 12/21/2022] Open
Abstract
The aim of this case series was to present the clinical outcomes of non-contained intrabony periodontal defects (IPDs) treated by means of papillary preservation flaps in association with a slowly resorbable bovine pericardium membrane (BPM) and a low-temperature-treated bovine bone graft (BBG). Eight healthy, non-smoking patients (two males and six females, mean age 48 ± 8 years) with stage 3 periodontitis and at least one site with residual probing depth (PD) ≥ 6 mm associated with a non-contained IPD ≥ 3 mm were treated. Two weeks after surgery, no adverse events were observed, and an early wound healing score (EHS) of 8.1 ± 1.0 was recorded. After 1 year, the mean probing depth (PD) reduction and mean clinical attachment level gain (CAL-gain) accounted for 4.8 ± 0.7 and 3.5 ± 0.7 mm, respectively, whereas the mean gingival recession (REC) was of 1.2 ± 0.3 mm. Radiographic bone fill was observed in all cases. In conclusion, the treatment of non-contained IPDs with a slowly resorbable BPM and a low-temperature-treated BBG could be considered safe and may result in significant clinical improvements 1 year after surgery.
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Affiliation(s)
- Mariana A Rojas
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Lorenzo Marini
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Paola Russo
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Vittorio Blardi
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Division of Periodontology & Peri-Implant Diseases, University of Zurich, 8032 Zürich, Switzerland
| | - Andrea Pilloni
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Fileto Mazzonetto AL, Casarin RCV, Santamaria MP, Andere NMRB, Araújo CF, Videira Clima da Silva R, Purisaca JEV, Sallum EA, Sallum AW. Clinical, radiographic, and patient-centered outcomes after use of enamel matrix proteins for the treatment of intrabony defects in patients with aggressive periodontitis: A 12-month multicenter clinical trial. J Periodontol 2020; 92:995-1006. [PMID: 33107596 DOI: 10.1002/jper.20-0493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the clinical, radiographic and patient-centered results of enamel matrix derivative (EMD) therapy in intrabony defects in aggressive periodontitis (AgP) patients and compare them with those in chronic periodontitis (CP) patients. METHODS Sixty intrabony defects in AgP and CP patients associated with ≥ 6 mm residual probing pocket depth (PPD) were included and randomly assigned to one of three groups: AgP+CS (conservative surgery) (n = 20); AgP+CS/EMD (n = 20); CP+CS/EMD (n = 20). Clinical parameters were measured at baseline and after 6 and 12 months. Defect resolution (DR) and bone filling (BF) were used for radiographic analysis. The quality of life was recorded at baseline and 6 months using OHIP-14 and VAS scale in the early post-therapy period. RESULTS PPD and relative clinical attachment level (rCAL) improved for all groups during follow-up (P ≤ 0.05), and AgP+CS/EMD presented a higher rCAL gain (2.4 ± 1.0 mm) when compared to AgP control patients (1.6 ± 1.6 mm, P ≤ 0.05) after 12 months. No difference was observed between AgP+CS/EMD and CP+CS/EMD groups (P > 0.05). No radiographic differences were observed among groups at any time point (P > 0.05). All the groups reported a positive impact on OHIP-14 total score, without differences among them. CONCLUSIONS EMD therapy of intrabony defects promotes additional benefits in AgP patients, presenting a similar regeneration rate compared to CP patients, and has proven to be a viable therapy for the treatment of individuals with AgP.
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Affiliation(s)
| | | | | | | | - Cássia Fernandes Araújo
- Department of Diagnosis and Surgery, State University of São Paulo, São José dos Campos, Brazil
| | | | | | - Enilson Antonio Sallum
- Department of Prosthesis and Periodontology, State University of Campinas, Piracicaba, Brazil
| | - Antonio Wilson Sallum
- Department of Prosthesis and Periodontology, State University of Campinas, Piracicaba, Brazil
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Díaz-Faes L, Fernández-Somoano A, Magán-Fernández A, Mesa F. Efficacy of regenerative therapy in aggressive periodontitis: a systematic review and meta-analysis of randomised controlled clinical trials. Clin Oral Investig 2020; 24:1369-1378. [PMID: 32060656 DOI: 10.1007/s00784-020-03237-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/04/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). MATERIAL AND METHODS A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CLINICAL RELEVANCE Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.
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Affiliation(s)
- Lucía Díaz-Faes
- Department of Periodontics, Faculty of Dentistry, University of Granada, Granada, Spain.
| | - Ana Fernández-Somoano
- Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | | | - Francisco Mesa
- Department of Periodontics, Faculty of Dentistry, University of Granada, Granada, Spain
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Li G, Han N, Yang H, Zhang X, Cao Y, Cao Y, Shi R, Wang S, Fan Z. SFRP2 promotes stem cells from apical papilla‐mediated periodontal tissue regeneration in miniature pig. J Oral Rehabil 2019; 47 Suppl 1:12-18. [PMID: 31469431 DOI: 10.1111/joor.12882] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/23/2019] [Accepted: 08/25/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Guoqing Li
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
- Molecular Laboratory for Gene Therapy and Tooth Regeneration Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Capital Medical University Beijing China
| | - Nannan Han
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
- Department of Periodontology School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Haoqing Yang
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Xiuli Zhang
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
- Department of Periodontology School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Yangyang Cao
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Yu Cao
- Department of General Dentistry School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Ruitang Shi
- Department of Endodontics School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
| | - Songlin Wang
- Molecular Laboratory for Gene Therapy and Tooth Regeneration Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Capital Medical University Beijing China
- Department of Biochemistry and Molecular Biology Capital Medical University School of Basic Medical Sciences Beijing China
| | - Zhipeng Fan
- Laboratory of Molecular Signaling and Stem Cells Therapy Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction School of Stomatology Beijing Stomatological Hospital Capital Medical University Beijing China
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Rakmanee T, Calciolari E, Olsen I, Darbar U, Griffiths GS, Petrie A, Donos N. Expression of growth mediators in the gingival crevicular fluid of patients with aggressive periodontitis undergoing periodontal surgery. Clin Oral Investig 2018; 23:3307-3318. [DOI: 10.1007/s00784-018-2752-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
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Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: subtraction radiography outcomes, prognostic variables, and patient morbidity. Clin Oral Investig 2018; 23:3005-3020. [PMID: 30374832 PMCID: PMC7398389 DOI: 10.1007/s00784-018-2712-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
Abstract
Objectives The main objectives of this study were (1) to evaluate bone/graft density alterations by digital subtraction radiography; (2) to determine factors associated with favorable clinical and radiographic outcomes, and (3) to report on patient morbidity after guided tissue regeneration (GTR) in aggressive periodontitis (AgP) patients. Materials and methods Adapting a split-mouth design, 30 comparative intrabony defects in 15 patients were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). The time period of observation was 12 months. Results There were significant improvements in clinical and radiographic parameters within each group, without intergroup differences. However, higher PPD reduction for three-wall defects was noted in MPM sites (5.22 versus 3.62 mm; p = 0.033). Moreover, a significant gain in bone/graft density of 4.9% from 6 to 12 months post-operatively was observed in test sites. Multivariate analysis demonstrated that morphology of intrabony defects was a predictor of CAL gain (p = 0.06), while independent prognostic variables effecting changes in bone/graft density were radiographic defect depth (p = 0.025) and radiographic angle (p = 0.033). The majority of patients reported some discomfort, pain, and edema with mild intensity without any significant differences between treatment modalities. Conclusions This study demonstrated enhanced bone/graft density gain after GTR with MPM, which may indicate greater area of new bone formation. Independent variables effecting treatment outcomes were intrabony defect morphology, radiographic defect depth, and radiographic angle. Clinical relevance This study supports the regenerative treatment of intrabony defects in AgP patients and identifies some variables with prognostic value.
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Li G, Han N, Zhang X, Yang H, Cao Y, Wang S, Fan Z. Local Injection of Allogeneic Stem Cells from Apical Papilla Enhanced Periodontal Tissue Regeneration in Minipig Model of Periodontitis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3960798. [PMID: 30112386 PMCID: PMC6077668 DOI: 10.1155/2018/3960798] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/03/2018] [Accepted: 06/21/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Discovering suitable seeding cells and simple application technique will be beneficial for MSC-mediated treatment of periodontitis. Stem cells from apical papilla (SCAPs) might be the candidate seeding cell for the periodontal tissues regeneration based on their origin and characters. In this research, we investigated the effect of SCAPs on periodontal tissue regeneration in swine by local injection. METHODS We established experimental periodontitis model in miniature pigs and then treated them with SCAPs by local injection. Clinical assessments, computed tomography (CT) scanning, histologic examination, and quantitative measurements were used to evaluate the effect of periodontal tissues regeneration. RESULTS At 12 weeks after injection, clinical assessments showed that probing depth, gingival recession, and attachment loss values were 5.44±0.77 mm versus 7.33±1.0 mm (p<0.01), 2.33±0.33 mm versus 2.11±0.69 mm (p>0.05), and 7.78±0.84 mm versus 9.44±1.07 mm (p<0.01) in SCAPs group and 0.9% NaCl group, respectively. CT scan results showed a significant increase of 12.86 mm3 alveolar bone regeneration in SCAPs group compared with 0.9% NaCl group. In addition, histopathology results demonstrated remarkable regeneration in SCAPs group, whereas regeneration of periodontal tissue was hardly found in 0.9% NaCl group. CONCLUSION Local injection of SCAPs could effectively restore tissue defects brought about by periodontitis in the swine model. Thus, SCAPs, as an easily accessible dental-deriving stem cell, may serve as an alternative application for periodontitis treatment.
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Affiliation(s)
- Guoqing Li
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
- Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, China
| | - Nannan Han
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
- Department of Periodontology, Capital Medical University School of Stomatology, Beijing 100050, China
| | - Xiuli Zhang
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
- Department of Periodontology, Capital Medical University School of Stomatology, Beijing 100050, China
| | - Haoqing Yang
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
| | - Yangyang Cao
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
| | - Songlin Wang
- Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, Beijing 100050, China
- Department of Biochemistry and Molecular Biology, Capital Medical University School of Basic Medical Sciences, No.10 Xitoutiao Youanmen, Fengtai District, Beijing 100069, China
| | - Zhipeng Fan
- Laboratory of Molecular Signaling and Stem Cells Therapy, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, No. 4 Tiantanxili, Dongcheng District, Beijing 100050, China
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Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 12-month randomized controlled trial. Clin Oral Investig 2018; 22:2819-2828. [PMID: 29411112 DOI: 10.1007/s00784-018-2368-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [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.
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Momen-Heravi F, Kang P. Treatment of Localized Aggressive Periodontitis With Guided Tissue Regeneration Technique and Enamel Matrix Derivative. Clin Adv Periodontics 2017; 7:182-189. [PMID: 31539218 DOI: 10.1902/cap.2017.170007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/07/2017] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Aggressive periodontitis (AgP) is a form of periodontitis characterized by rapid attachment loss in otherwise healthy individuals. Although different treatment options have been explored for management of the disease, control of disease progression and subsequent regeneration of the attachment apparatus are considered the ideal treatment objectives. Limited evidence is available with respect to the efficacy of different regenerative materials in the treatment of AgP. CASE PRESENTATION The present case report describes periodontal regeneration techniques and 6-month outcomes in bilateral intrabony non-contained defects around mandibular first molars in a 21-year-old patient diagnosed with localized AgP (LAgP). Periodontal lesions were treated with regenerative therapy with enamel matrix derivative (EMD) and allograft on the right side and allograft with bioabsorbable collagen membrane without EMD on the left side. Treatment yielded favorable clinical outcomes in terms of probing depth reduction, clinical attachment level gain, minimal gingival inflammation, and radiographic bone fill. Radiographic bone fill was observed after 6 months, suggesting possible periodontal regeneration. CONCLUSION Both regeneration techniques used in this clinical report (guided tissue regeneration involving allograft and bioabsorbable membrane versus EMD combined with allograft without a barrier membrane) resulted in favorable outcomes in the treatment of deep (≥7 mm) non-contained intrabony defects in LAgP.
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Affiliation(s)
- Fatemeh Momen-Heravi
- Division of Periodontics, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY
| | - Philip Kang
- Division of Periodontics, Section of Oral, Diagnostic, and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY
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Keceli HG, Dolgun A, Aydemir Turkal H. Letter to the editor. J Clin Periodontol 2017; 44:632-634. [DOI: 10.1111/jcpe.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Huseyin Gencay Keceli
- Periodontology Department; Faculty of Dentistry; Hacettepe University; Ankara Turkey
| | - Anil Dolgun
- Biostatistics Department; Faculty of Medicine; Hacettepe University; Ankara Turkey
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Corbella S, Weinstein R, Francetti L, Taschieri S, Del Fabbro M. Periodontal regeneration in aggressive periodontitis patients: A systematic review of the literature. ACTA ACUST UNITED AC 2016; 8. [DOI: 10.1111/jicd.12245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/26/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Roberto Weinstein
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
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