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Kojima K, Kamata Y, Shimizu T, Sato S, Suzuki S, Takanashi Y, Hojo S, Yoshino T, Fuchida S, Tamura T, Minabe M, Kodama T, Kessoku T, Oyamada S. Recombinant human fibroblast growth factor and autogenous bone for periodontal regeneration: Alone or in combination? A randomized clinical trial. J Periodontal Res 2024. [PMID: 38853125 DOI: 10.1111/jre.13310] [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: 01/04/2024] [Revised: 05/22/2024] [Accepted: 05/26/2024] [Indexed: 06/11/2024]
Abstract
AIM To compare the outcomes of therapy using recombinant human fibroblast growth factor (rhFGF)-2 combined with autologous bone grafting (ABG) therapy with those of rhFGF-2 alone and ABG alone in the treatment of periodontal intraosseous defects. METHODS Periodontal intraosseous defects were randomized to receive rhFGF-2 therapy + ABG, rhFGF-2 therapy alone, or ABG alone. Periodontal examination and periapical radiography were performed preoperatively and at 3, 6, and 12 months postoperatively. RESULTS At the 12 months follow-up, all three groups showed significant improvement in the clinical attachment level (CAL): 5.6 ± 1.6, 5.8 ± 1.7, and 5.2 ± 1.6 mm in the rhFGF-2 + ABG, rhFGF-2 alone, and ABG alone groups, respectively, with no significant inter-group differences (p < .05). rhFGF-2 therapy (alone or in combination) resulted in greater bone defect filling (BDF) (2.3 ± 1.2 mm and 2.6 ± 1.9 mm, respectively) than ABG therapy alone (1.2 ± 1.2 mm). Gingival recession was lesser in the ABG alone (1.2 ± 1.1 mm) and rhFGF-2 + ABG groups (1.4 ± 0.8 mm) than in the rhFGF-2 alone group (2.2 ± 1.2 mm). CONCLUSION The results of this study showed that at 12 months postoperatively, all treatments resulted in statistically significant clinical improvements compared to the baseline. From these results, it can be concluded that rhFGF-2 promotes hard tissue regeneration in intraosseous defects.
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Affiliation(s)
- Kosuke Kojima
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Yohei Kamata
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Tomoko Shimizu
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Satsuki Sato
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Sota Suzuki
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Yuya Takanashi
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Sawako Hojo
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Takeshi Yoshino
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Shinya Fuchida
- Department of Education Planning, Kanagawa Dental University, Yokosuka, Japan
| | - Toshiyuki Tamura
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | | | - Toshiro Kodama
- Department of Implantology and Periodontology, Graduate School of Dentistry, Kanagawa Dental University, Yokohama, Kanagawa, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology, International University Health and Welfare Graduate School of Medicine, Chiba, Japan
| | - Shunsuke Oyamada
- Department of Biostatistics, JORTC Data Center 2-54-6-302, Tokyo, Japan
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Zaaya S, Elbattawy W, Yusri S, Fawzy El-Sayed KM. Micro-needling versus acellular dermal matrix in RT1 gingival recession coverage: A randomized clinical trial. J Periodontal Res 2024. [PMID: 38660934 DOI: 10.1111/jre.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
AIMS This randomized trial assessed for the first time the efficacy of coronally advanced flap (CAF) followed by micro-needling (MN) in contrast to CAF with acellular dermal matrix (ADM) on gingival thickness (GT, primary outcome), keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), recession depth (RD), recession width (RW), recession reduction (Rec-Red), complete root coverage (CRC) and percentage of root coverage (all secondary outcomes) in management of RT1 gingival recession in patients with thin gingival phenotype. METHODS A total of 24 patients (n = 24) with a thin gingival phenotype and single RT1 gingival recession in the aesthetic zone were randomly allocated to test- (CAF + MN; n = 12) or control group (CAF + ADM; n = 12). All clinical parameters were evaluated at baseline, 3 and 6 months. RESULTS Both groups independently demonstrated significant gain in GT, RW, RD, CAL, PD, Rec-Red, CRC and percentage of root coverage, with reduced PI and BOP (p < .05) at 3 and 6 months, without intergroup differences (p > .05). At 6 months, KTW gain was significantly higher in CAF + MN (5.08 ± 0.9 mm) than in CAF + ADM-group (4.25 ± 1.06 mm; p < .05). Stepwise linear regression model with GT as dependent variable showed that base-line GT was the only statistically significant predictor for GT with a direct correlation between base-line GT and GT after 6 months. CONCLUSION CAF followed by MN could represent a promising graft-less approach for increasing gingival thickness, comparable to CAF with ADM, with superior keratinized tissue width improvement, in the treatment of RT1 recession defects in patients with thin gingival phenotype.
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Affiliation(s)
- Salma Zaaya
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Weam Elbattawy
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sarah Yusri
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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Mojtahedi Nia M, Shirmohammadi A, Mohammadi H, Roshangar L, Babaloo A. Effect of autologous conditioned serum (ACS) on histological characteristics and expression of soft tissue IL-1β gene after horizontal ridge augmentation surgery. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:52-55. [PMID: 37645547 PMCID: PMC10460780 DOI: 10.34172/japid.2023.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/30/2023] [Indexed: 08/31/2023]
Abstract
Background Horizontal ridge augmentation surgeries are common procedures in periodontics. Histological changes in soft tissues affect the success of surgery in many ways. Autologous conditioned serum (ACS) increases interleukin-1 receptor antagonist (IL-1Ra) and causes inflammation modulation. Therefore, the present study aimed to investigate the effect of ACS on histological changes and gene expression of soft tissues after horizontal ridge augmentation surgeries. Methods This double-blind split-mouth clinical trial was performed on patients needing implants with horizontal ridge augmentation (n=21). The control and intervention groups were considered split-mouth in two areas of the patients' oral soft tissues. A collagen membrane impregnated with ACS was used on the test side, and only a collagen membrane was used on the control side. After four months, histological changes in soft tissues, such as the amount of connective tissue collagen, fibroblast and inflammatory cell counts, and expression of the IL-1β gene, were evaluated. Results The fibroblast counts in the ACS group were significantly higher than in the control group. In addition, ACS caused a significant increase in the amount of collagen in the soft tissues compared to the control group (P<0.01). However, the number of inflammatory cells was similar in the two groups (P>0.05). IL-1β gene expression was not significantly different between the case and control groups. Conclusion Under the limitations of the present study and based on the results of histological examinations, ACS increased the number of fibroblasts and the amount of collagen in soft tissues without affecting inflammatory cells (P=0.562).
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Affiliation(s)
- Mehdi Mojtahedi Nia
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohammadi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamidreza Mohammadi
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Department of Histology and Embryology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirreza Babaloo
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Fraser D, Caton J, Benoit DSW. Periodontal Wound Healing and Regeneration: Insights for Engineering New Therapeutic Approaches. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.815810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Periodontitis is a widespread inflammatory disease that leads to loss of the tooth supporting periodontal tissues. The few therapies available to regenerate periodontal tissues have high costs and inherent limitations, inspiring the development of new approaches. Studies have shown that periodontal tissues have an inherent capacity for regeneration, driven by multipotent cells residing in the periodontal ligament (PDL). The purpose of this review is to describe the current understanding of the mechanisms driving periodontal wound healing and regeneration that can inform the development of new treatment approaches. The biologic basis underlying established therapies such as guided tissue regeneration (GTR) and growth factor delivery are reviewed, along with examples of biomaterials that have been engineered to improve the effectiveness of these approaches. Emerging therapies such as those targeting Wnt signaling, periodontal cell delivery or recruitment, and tissue engineered scaffolds are described in the context of periodontal wound healing, using key in vivo studies to illustrate the impact these approaches can have on the formation of new cementum, alveolar bone, and PDL. Finally, design principles for engineering new therapies are suggested which build on current knowledge of periodontal wound healing and regeneration.
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Immunohistochemical Evaluation of Periodontal Regeneration Using a Porous Collagen Scaffold. Int J Mol Sci 2021; 22:ijms222010915. [PMID: 34681574 PMCID: PMC8535773 DOI: 10.3390/ijms222010915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/03/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022] Open
Abstract
(1) Aim: To immunohistochemically evaluate the effect of a volume-stable collagen scaffold (VCMX) on periodontal regeneration. (2) Methods: In eight beagle dogs, acute two-wall intrabony defects were treated with open flap debridement either with VCMX (test) or without (control). After 12 weeks, eight defects out of four animals were processed for paraffin histology and immunohistochemistry. (3) Results: All defects (four test + four control) revealed periodontal regeneration with cementum and bone formation. VCMX remnants were integrated in bone, periodontal ligament (PDL), and cementum. No differences in immunohistochemical labeling patterns were observed between test and control sites. New bone and cementum were labeled for bone sialoprotein, while the regenerated PDL was labeled for periostin and collagen type 1. Cytokeratin-positive epithelial cell rests of Malassez were detected in 50% of the defects. The regenerated PDL demonstrated a larger blood vessel area at the test (14.48% ± 3.52%) than at control sites (8.04% ± 1.85%, p = 0.0007). The number of blood vessels was higher in the regenerated PDL (test + control) compared to the pristine one (p = 0.012). The cell proliferative index was not statistically significantly different in pristine and regenerated PDL. (4) Conclusions: The data suggest a positive effect of VCMX on angiogenesis and an equally high cell turnover in the regenerated and pristine PDL. This VCMX supported periodontal regeneration in intrabony defects.
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Yoshida W, Matsugami D, Murakami T, Bizenjima T, Imamura K, Seshima F, Saito A. Combined effects of systemic parathyroid hormone (1-34) and locally delivered neutral self-assembling peptide hydrogel in the treatment of periodontal defects: An experimental in vivo investigation. J Clin Periodontol 2019; 46:1030-1040. [PMID: 31292977 DOI: 10.1111/jcpe.13170] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/05/2019] [Accepted: 07/06/2019] [Indexed: 12/13/2022]
Abstract
AIM To evaluate in vivo combination therapy of systemic parathyroid hormone (PTH) and locally delivered neutral self-assembling peptide (SAP) hydrogel for periodontal treatment. MATERIALS AND METHODS Viability/proliferation of rat periodontal ligament cells in a neutral SAP nanofibre hydrogel (SPG-178) was evaluated using WST-1 assay. Periodontal defects were created mesially to the maxillary first molars in 40 Wistar rats. Defects were filled with 1.5% SPG-178 or left unfilled. Animals received PTH (1-34) or saline injections every 2 days. Microcomputed tomography, histological, and immunohistochemical examinations were used to evaluate healing at 2 or 4 weeks postoperative. RESULTS At 72 hr, cells in 1.5% SPG-178 showed increased viability/proliferation compared to cells in 0.8% SPG-178 or untreated controls. In vivo, systemic PTH resulted in significantly greater bone volume in the Unfilled group at 2 weeks (p = .01) and 4 weeks (p < .0001) than in the saline control. At 4 weeks, a significantly greater bone volume was observed in the PTH/SPG-178 (p = .0003) and PTH/Unfilled (p = .004) groups than in Saline/SPG-178 group. Histologically, greater bone formation was observed in PTH/SPG-178 at 4 weeks than in other groups. In the PTH/SPG-178 group, increased proportions of PCNA-, VEGF-, and Osterix-positive cells were observed in the treated sites. CONCLUSIONS These findings suggest that intermittent systemic PTH and locally delivered neutral SAP hydrogel enhance periodontal healing.
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Affiliation(s)
- Wataru Yoshida
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Tasuku Murakami
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | | | - Kentaro Imamura
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Fumi Seshima
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
| | - Atsushi Saito
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan.,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
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Cai X, Yang F, Walboomers XF, Wang Y, Jansen JA, van den Beucken JJJP, Plachokova AS. Periodontal regeneration via chemoattractive constructs. J Clin Periodontol 2018; 45:851-860. [PMID: 29779212 PMCID: PMC6055718 DOI: 10.1111/jcpe.12928] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/04/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
Aim Chemoattractants, such as stromal cell‐derived factor‐1α (SDF‐1α), can offer an advantage for periodontal regeneration by recruiting the patient’s own stem cells to stimulate self‐repair. We here developed a chemoattractive construct for periodontal regeneration using SDF‐1α and evaluated its efficacy in vivo. Materials and Methods SDF‐1α was loaded on gelatin sponge and tested in vitro for SDF‐1α release. Subsequently, SDF‐1α constructs were implanted into rat periodontal defects for 1 and 6 weeks, with unloaded materials and empty defects as controls. The regenerative efficacy was evaluated by micro‐CT, histological and histomorphometrical analyses. Results In vitro results showed limited SDF‐1α release up to 35 days. In contrast, SDF‐1α constructs significantly improved periodontal defect regeneration in terms of alveolar bone height, new bone area and functional ligament length. Additionally, SDF‐1α constructs decreased the inflammatory response at Week 6. Conclusion Chemoattractive constructs significantly improved periodontal regeneration in terms of alveolar bone height, new bone area and functional ligament length.
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Affiliation(s)
- Xinjie Cai
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands.,The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Yang
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands
| | | | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - John A Jansen
- Department of Biomaterials, Radboudumc, Nijmegen, the Netherlands
| | | | - Adelina S Plachokova
- Department of Implantology and Periodontology, Radboudumc, Nijmegen, the Netherlands
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Yu SJ, Lee YS, Choung HW, Park YH, Kim BO, Park JC. Effect of preameloblast-conditioned medium and CPNE7 on root surfaces in dogs: a histologic and histomorphometric evaluation. J Mol Histol 2018; 49:265-276. [PMID: 29525888 DOI: 10.1007/s10735-018-9766-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/08/2018] [Indexed: 12/16/2022]
Abstract
Preameloblast-conditioned medium (PACM) has been reported as a potent dentin regenerative material, but its effects as a mixture on periodontal regeneration and the role of CPNE7 in PACM are not known. The purpose of this study is to evaluate the histologic and histomorphometric effects of preameloblast-conditioned medium (PACM) and CPNE7 on periodontal tissue healing in dogs. Seventy-two mandibular premolar roots from ten dogs were extracted and randomly divided into six groups (n = 12 each): (1) positive control group; (2) negative control group; (3) cementum-removed and PACM-treated group; (4) cementum-preserved and PACM-treated group; (5) CPNE7-inactivated PACM-treated group; and (6) recombinant CPNE7-treated group. The extracted roots were replanted into extraction sockets for 4 and 8 weeks and analyzed histologically. Most of the root surfaces in the negative control group showed ankylosis; and those in the experimental groups showed newly formed PDL-like and cementum-like tissues. Histomorphometric analysis of horizontal sections showed that the mean length of the PDL on the roots of the positive controls was similar to those in cementum-removed or -preserved and PACM-treated group at 8 weeks (p = 1.08). Sagittal sections showed that the mean length of the new cementum on the roots in cementum-removed and PACM-treated group was significantly greater than that in CPNE7-inactivated PACM-treated group (p = 0.037). The mean length of the newly formed PDL on the roots in CPNE7- inactivated PACM-treated and rCPNE7-treated groups was significantly greater than that in the negative controls at 8 weeks (p = 0.037, p = 0.036). The use of PACM and CPNE7 in tooth replantation resulted in increased PDL and cementum formation, suggesting the beneficial role of PACM and CPNE7 in periodontal tissue healing.
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Affiliation(s)
- Sang-Joun Yu
- Department of Periodontology, School of Dentistry, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Yoon Seon Lee
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, BK 21, Seoul National University, 1 Gwanakro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Han-Wool Choung
- Department of Oral and Maxillofacial Surgery, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Yeongeon-dong, Seoul, 03080, Republic of Korea
| | - Yeoung-Hyun Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, BK 21, Seoul National University, 1 Gwanakro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Byung-Ock Kim
- Department of Periodontology, School of Dentistry, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea
| | - Joo-Cheol Park
- Laboratory for the Study of Regenerative Dental Medicine, Department of Oral Histology-Developmental Biology, School of Dentistry and Dental Research Institute, BK 21, Seoul National University, 1 Gwanakro, Gwanak-gu, Seoul, 08826, Republic of Korea.
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Dutra BC, Oliveira AMSD, Oliveira PAD, Manzi FR, Cortelli SC, Cota LODM, Costa FO. Effect of 1% sodium alendronate in the non-surgical treatment of periodontal intraosseous defects: a 6-month clinical trial. J Appl Oral Sci 2017; 25:310-317. [PMID: 28678950 PMCID: PMC5482254 DOI: 10.1590/1678-7757-2016-0252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 12/06/2016] [Indexed: 12/04/2022] Open
Abstract
Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). Results Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. Conclusions Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.
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Affiliation(s)
- Bernardo Carvalho Dutra
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | | | | | - Flavio Ricardo Manzi
- Pontífica Universidade Católica of Minas Gerais, Departamento de Periodontia. Belo Horizonte, MG, Brasil
| | - Sheila Cavalca Cortelli
- Universidade de Taubaté, Departamento de Odontologia, Divisão de Pesquisa Periodontal. Taubaté, SP, Brasil
| | - Luís Otávio de Miranda Cota
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
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Kaner D, Soudan M, Zhao H, Gaßmann G, Schönhauser A, Friedmann A. Early Healing Events after Periodontal Surgery: Observations on Soft Tissue Healing, Microcirculation, and Wound Fluid Cytokine Levels. Int J Mol Sci 2017; 18:ijms18020283. [PMID: 28134829 PMCID: PMC5343819 DOI: 10.3390/ijms18020283] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/19/2017] [Indexed: 12/17/2022] Open
Abstract
Early wound healing after periodontal surgery with or without enamel matrix derivative/biphasic calcium phosphate (EMD/BCP) was characterized in terms of soft tissue closure, changes of microcirculation, and expression of pro- and anti-inflammatory cytokines in gingival crevicular fluid/wound fluid (GCF/WF). Periodontal surgery was carried out in 30 patients (18 patients: application of EMD/BCP for regeneration of bony defects; 12 patients: surgical crown lengthening (SCL)). Healthy sites were observed as untreated controls. GCF/WF samples were collected during two post-surgical weeks. Flap microcirculation was measured using laser Doppler flowmetry (LDF). Soft tissue healing was evaluated after two weeks. GCF/WF levels of interleukin 1β (IL-1β), tumour necrosis factor (TNF-α), IL-6, and IL-10 were determined using a multiplex immunoassay. Surgery caused similar reductions of flap microcirculation followed by recovery within two weeks in both EMD/BCP and SCL groups. GCF/WF and pro-inflammatory cytokine levels were immediately increased after surgery, and returned only partially to baseline levels within the two-week observation period. Levels of IL-10 were temporarily reduced in all surgical sites. Flap dehiscence caused prolonged elevated levels of GCF/WF, IL-1β, and TNF-α. These findings show that periodontal surgery triggers an immediate inflammatory reaction corresponding to the early inflammatory phase of wound healing, and these inflammation measures are temporary in case of maintained closure of the flap. However, flap dehiscence causes prolonged inflammatory exudation from the periodontal wound. If the biological pre-conditions for periodontal wound healing are considered important for the clinical outcome, care should be taken to maintain primary closure of the flap.
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Affiliation(s)
- Doğan Kaner
- Department of Periodontology, Witten/Herdecke University, 58455 Witten, Germany.
| | - Mouaz Soudan
- Department of Periodontology, Witten/Herdecke University, 58455 Witten, Germany.
| | - Han Zhao
- Multi-Disciplinary Treatment Center, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China.
| | - Georg Gaßmann
- Hochschule, University of applied sciences, 50670 Cologne, Germany.
| | - Anna Schönhauser
- Department of Periodontology, Witten/Herdecke University, 58455 Witten, Germany.
| | - Anton Friedmann
- Department of Periodontology, Witten/Herdecke University, 58455 Witten, Germany.
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Minimally Invasive Treatment of Infrabony Periodontal Defects Using Dual-Wavelength Laser Therapy. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2016; 2016:7175919. [PMID: 27366790 PMCID: PMC4912985 DOI: 10.1155/2016/7175919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 01/08/2023]
Abstract
Introduction. Surgical management of infrabony defects is an invasive procedure, frequently requiring the use of adjunctive material such as grafts or biologics, which is time-consuming and associated with expense and morbidity to the patient. Lasers in periodontal regeneration have been reported in the literature, with each wavelength having potential benefits through different laser-tissue interactions. The purpose of this case series was to assess the efficacy of a new dual-wavelength protocol in the management of infrabony defects. Materials and Methods. 32 defects (one in each patient) were treated using ultrasonic debridement, followed by flapless application of Erbium, Chromium:Yttrium, Scandium, Gallium, Garnet (Er,Cr:YSGG) laser (wavelength 2780 nm), and final application of diode laser (wavelength 940 nm). Pocket depths (PD) were measured after 6 months and repeat radiographs taken after one year. Results. The mean baseline PD was 8.8 mm (range 6–15 mm) and 6 months later was 2.4 mm (range 2–4 mm), with mean PD reduction being 6.4 ± 1.7 mm (range 3–12 mm). There was a significant gain in relative linear bone height (apical extent of bone), with mean percentage bone fill of 39.7 ± 41.2% and 53% of sites showing at least 40% infill of bone. Conclusion. The results compare favourably with traditional surgery and require further validation through randomised clinical controlled trials.
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Nagayasu-Tanaka T, Anzai J, Takaki S, Shiraishi N, Terashima A, Asano T, Nozaki T, Kitamura M, Murakami S. Action Mechanism of Fibroblast Growth Factor-2 (FGF-2) in the Promotion of Periodontal Regeneration in Beagle Dogs. PLoS One 2015; 10:e0131870. [PMID: 26120833 PMCID: PMC4488280 DOI: 10.1371/journal.pone.0131870] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 06/01/2015] [Indexed: 02/06/2023] Open
Abstract
Fibroblast growth factor-2 (FGF-2) enhances the formation of new alveolar bone, cementum, and periodontal ligament (PDL) in periodontal defect models. However, the mechanism through which FGF-2 acts in periodontal regeneration in vivo has not been fully clarified yet. To reveal the action mechanism, the formation of regenerated tissue and gene expression at the early phase were analyzed in a beagle dog 3-wall periodontal defect model. FGF-2 (0.3%) or the vehicle (hydroxypropyl cellulose) only were topically applied to the defect in FGF-2 and control groups, respectively. Then, the amount of regenerated tissues and the number of proliferating cells at 3, 7, 14, and 28 days and the number of blood vessels at 7 days were quantitated histologically. Additionally, the expression of osteogenic genes in the regenerated tissue was evaluated by real-time PCR at 7 and 14 days. Compared with the control, cell proliferation around the existing bone and PDL, connective tissue formation on the root surface, and new bone formation in the defect at 7 days were significantly promoted by FGF-2. Additionally, the number of blood vessels at 7 days was increased by FGF-2 treatment. At 28 days, new cementum and PDL were extended by FGF-2. Moreover, FGF-2 increased the expression of bone morphogenetic protein 2 (BMP-2) and osteoblast differentiation markers (osterix, alkaline phosphatase, and osteocalcin) in the regenerated tissue. We revealed the facilitatory mechanisms of FGF-2 in periodontal regeneration in vivo. First, the proliferation of fibroblastic cells derived from bone marrow and PDL was accelerated and enhanced by FGF-2. Second, angiogenesis was enhanced by FGF-2 treatment. Finally, osteoblastic differentiation and bone formation, at least in part due to BMP-2 production, were rapidly induced by FGF-2. Therefore, these multifaceted effects of FGF-2 promote new tissue formation at the early regeneration phase, leading to enhanced formation of new bone, cementum, and PDL.
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Affiliation(s)
- Toshie Nagayasu-Tanaka
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Jun Anzai
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
| | - Shu Takaki
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
| | - Noriko Shiraishi
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
| | - Akio Terashima
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
| | - Taiji Asano
- Pharmacology Department, Drug Research Center, Kaken Pharmaceutical Co., LTD., Kyoto, Kyoto, Japan
| | - Takenori Nozaki
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masahiro Kitamura
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Shinya Murakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- * E-mail:
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Susin C, Fiorini T, Lee J, De Stefano JA, Dickinson DP, Wikesjö UME. Wound healing following surgical and regenerative periodontal therapy. Periodontol 2000 2015; 68:83-98. [DOI: 10.1111/prd.12057] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/17/2022]
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14
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Skodje A, Idris SBM, Sun Y, Bartaula S, Mustafa K, Finne-Wistrand A, Wikesjö UME, Leknes KN. Biodegradable polymer scaffolds loaded with low-dose BMP-2 stimulate periodontal ligament cell differentiation. J Biomed Mater Res A 2014; 103:1991-8. [DOI: 10.1002/jbm.a.35334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 08/22/2014] [Accepted: 09/10/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Anders Skodje
- Faculty of Medicine and Dentistry; Department of Clinical Dentistry - Periodontics; University of Bergen; Bergen Norway
| | - Shaza Bushra M. Idris
- Faculty of Medicine and Dentistry; Department of Clinical Dentistry - Center for Clinical Dental Research; University of Bergen; Bergen Norway
| | - Yang Sun
- Department of Fibre and Polymer Technology; KTH Royal Institute of Technology; Stockholm Sweden
| | - Sushma Bartaula
- Faculty of Medicine and Dentistry; Department of Clinical Dentistry - Center for Clinical Dental Research; University of Bergen; Bergen Norway
| | - Kamal Mustafa
- Faculty of Medicine and Dentistry; Department of Clinical Dentistry - Center for Clinical Dental Research; University of Bergen; Bergen Norway
| | - Anna Finne-Wistrand
- Department of Fibre and Polymer Technology; KTH Royal Institute of Technology; Stockholm Sweden
| | - Ulf M. E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration; Georgia Regents University; Augusta GA, USA
| | - Knut N. Leknes
- Faculty of Medicine and Dentistry; Department of Clinical Dentistry - Periodontics; University of Bergen; Bergen Norway
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Sugii H, Maeda H, Tomokiyo A, Yamamoto N, Wada N, Koori K, Hasegawa D, Hamano S, Yuda A, Monnouchi S, Akamine A. Effects of Activin A on the phenotypic properties of human periodontal ligament cells. Bone 2014; 66:62-71. [PMID: 24928494 DOI: 10.1016/j.bone.2014.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 04/30/2014] [Accepted: 05/07/2014] [Indexed: 02/05/2023]
Abstract
Periodontal ligament (PDL) tissue plays an important role in tooth preservation by structurally maintaining the connection between the tooth root and the bone. The mechanisms involved in the healing and regeneration of damaged PDL tissue, caused by bacterial infection, caries and trauma, have been explored. Accumulating evidence suggests that Activin A, a member of the transforming growth factor-β (TGF-β) superfamily and a dimer of inhibinβa, contributes to tissue healing through cell proliferation, migration, and differentiation of various target cells. In bone, Activin A has been shown to exert an inhibitory effect on osteoblast maturation and mineralization. However, there have been no reports examining the expression and function of Activin A in human PDL cells (HPDLCs). Thus, we aimed to investigate the biological effects of Activin A on HPDLCs. Activin A was observed to be localized in HPDLCs and rat PDL tissue. When PDL tissue was surgically damaged, Activin A and IL-1β expression increased and the two proteins were shown to be co-localized around the lesion. HPDLCs treated with IL-1β or TNF-α also up-regulated the expression of the gene encoding inhibinβa. Activin A promoted chemotaxis, migration and proliferation of HPDLCs, and caused an increase in fibroblastic differentiation of these cells while down-regulating their osteoblastic differentiation. These osteoblastic inhibitory effects of Activin A, however, were only noted during the early phase of HPDLC osteoblastic differentiation, with later exposures having no effect on differentiation. Collectively, our results suggest that Activin A could be used as a therapeutic agent for healing and regenerating PDL tissue in response to disease, trauma or surgical reconstruction.
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Affiliation(s)
- Hideki Sugii
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hidefumi Maeda
- Department of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Atsushi Tomokiyo
- Colgate Australian Clinical Dental Research Centre, School of Dentistry, University of Adelaide, SA 5005, Australia
| | - Naohide Yamamoto
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan
| | - Naohisa Wada
- Department of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Katsuaki Koori
- Department of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Daigaku Hasegawa
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan
| | - Sayuri Hamano
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan
| | - Asuka Yuda
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan
| | - Satoshi Monnouchi
- Department of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Akifumi Akamine
- Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan; Department of Endodontology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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16
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Matsuura T, Akizuki T, Hoshi S, Ikawa T, Kinoshita A, Sunaga M, Oda S, Kuboki Y, Izumi Y. Effect of a tunnel-structured β-tricalcium phosphate graft material on periodontal regeneration: a pilot study in a canine one-wall intrabony defect model. J Periodontal Res 2014; 50:347-55. [DOI: 10.1111/jre.12213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2014] [Indexed: 12/28/2022]
Affiliation(s)
- T. Matsuura
- Department of Periodontology; Graduate School of Medical and Dental Science; Tokyo Medical and Dental University; Tokyo Japan
| | - T. Akizuki
- Department of Periodontology; Graduate School of Medical and Dental Science; Tokyo Medical and Dental University; Tokyo Japan
- Division of Periodontology; Department of Oral Science; Graduate School of Dentistry; Kanagawa Dental University; Kanagawa Japan
| | - S. Hoshi
- Department of Periodontology; Graduate School of Medical and Dental Science; Tokyo Medical and Dental University; Tokyo Japan
| | - T. Ikawa
- Department of Periodontology; Graduate School of Medical and Dental Science; Tokyo Medical and Dental University; Tokyo Japan
| | - A. Kinoshita
- Department of Educational Media Development; Institute for Library and Media Information Technology; Tokyo Medical and Dental University; Tokyo Japan
| | - M. Sunaga
- Department of Educational Media Development; Institute for Library and Media Information Technology; Tokyo Medical and Dental University; Tokyo Japan
| | - S. Oda
- Oral Diagnosis and General Dentistry; University Hospital of Dentistry; Tokyo Medical and Dental University; Tokyo Japan
| | - Y. Kuboki
- Graduate School of Dental Medicine; Hokkaido University; Sapporo Japan
| | - Y. Izumi
- Department of Periodontology; Graduate School of Medical and Dental Science; Tokyo Medical and Dental University; Tokyo Japan
- Global Center of Excellence Program; International Research Center for Molecular Science in Tooth and Bone Diseases (GCOE Program); Tokyo Japan
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17
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Lee J, Wikesjö UM. Growth/differentiation factor-5: pre-clinical and clinical evaluations of periodontal regeneration and alveolar augmentation - review. J Clin Periodontol 2014; 41:797-805. [DOI: 10.1111/jcpe.12260] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Department of Periodontics; Georgia Regents University College of Dental Medicine; Augusta GA USA
| | - Ulf M.E. Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Departments of Periodontics & Oral Biology; Georgia Regents University College of Dental Medicine; Augusta GA USA
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18
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Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. J Clin Periodontol 2014; 41 Suppl 15:S6-22. [DOI: 10.1111/jcpe.12206] [Citation(s) in RCA: 211] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Anton Sculean
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Reinhard Gruber
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Laboratory of Oral Cell Biology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Dieter D. Bosshardt
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
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Graziani F, Gennai S, Cei S, Ducci F, Discepoli N, Carmignani A, Tonetti M. Does enamel matrix derivative application provide additional clinical benefits in residual periodontal pockets associated with suprabony defects? A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2014; 41:377-86. [DOI: 10.1111/jcpe.12218] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Filippo Graziani
- Department of Surgical Medicine; Molecular Pathology and Critical Area; University of Pisa; Pisa Italy
- University Hospital of Pisa; Sub-Unit of Periodontology and Periodontal Medicine; Pisa Italy
| | - Stefano Gennai
- Department of Surgical Medicine; Molecular Pathology and Critical Area; University of Pisa; Pisa Italy
- University Hospital of Pisa; Sub-Unit of Periodontology and Periodontal Medicine; Pisa Italy
| | - Silvia Cei
- Department of Surgical Medicine; Molecular Pathology and Critical Area; University of Pisa; Pisa Italy
| | - Francesco Ducci
- Department of Surgical Medicine; Molecular Pathology and Critical Area; University of Pisa; Pisa Italy
| | - Nicola Discepoli
- University Hospital of Pisa; Sub-Unit of Periodontology and Periodontal Medicine; Pisa Italy
| | - Alessandro Carmignani
- Department of Surgical Medicine; Molecular Pathology and Critical Area; University of Pisa; Pisa Italy
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