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Kučič AC, Gašperšič R. Minimally invasive non-surgical therapy (MINST) in stage III periodontitis patients: 6-month results of a split-mouth, randomised controlled clinical trial. Clin Oral Investig 2023; 27:2075-2087. [PMID: 37014505 PMCID: PMC10071470 DOI: 10.1007/s00784-023-04994-4] [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: 01/15/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES To determine if minimally invasive non-surgical therapy (MINST) outperforms classical non-surgical periodontal therapy for stage III periodontitis with primarily suprabony (horizontal) type defects. MATERIALS AND METHODS In a split-mouth randomised controlled trial, 20 patients' dental quadrants were randomly assigned to MINST or classical non-surgical treatment. The primary outcome variable was the number of sites with probing pocket depth ≥ 5 mm and BOP. Treatment method, tooth type, smoking status, and gender were evaluated using a multivariate multilevel logistic regression model. RESULTS After 6 months, the percentage of sites with PD ≥ 5 mm and BOP that healed (MINST = 75.5%; control group = 74.1%; p = 0.98), and the median number of persisting sites (MINST: 6.5, control group: 7.0; p = 0.925) were similar in both groups. In the test and control groups, respectively, median probing pocket depths (2.0 mm vs. 2.1 mm) and clinical attachment level (1.7 mm vs. 2.0 mm) changed significantly (p < 0.05) but similarly. Significantly less gingival recession occurred in the MINST group's deep molar pockets compared to the control group (p = 0.037). Men (OR = 0.52, p = 0.014) and non-molars (OR = 3.84, p 0.001) had altered odds for healing of sites with PD ≥ 5 mm and BOP. CONCLUSIONS MINST reduces gingival recession associated with molar teeth, although it performs similarly to traditional non-surgical therapy in treating stage III periodontitis with predominately horizontal-type defects. CLINICAL RELEVANCE MINST performs similarly to non-surgical periodontal therapy in stage III periodontitis with predominantly suprabony defects. TRIAL REGISTRATION Clinicaltrials.gov (NCT04036513) on June 29, 2019.
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Affiliation(s)
- Alja Cmok Kučič
- Public Health Centre Celje, Gregorčičeva 5, 3000, Celje, Slovenia
| | - Rok Gašperšič
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski Trg 6, 1000, Ljubljana, Slovenia.
- Department of Oral Medicine and Periodontology, Dental Clinic, University Clinical Centre, Hrvatski Trg 6, 1000, LjubljanaLjubljana, Slovenia.
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Moreno Rodríguez JA, Ortiz Ruiz AJ. Periodontal granulation tissue preservation in surgical periodontal disease treatment: a pilot prospective cohort study. J Periodontal Implant Sci 2022; 52:298-311. [PMID: 36047583 PMCID: PMC9436644 DOI: 10.5051/jpis.2105780289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 11/08/2022] Open
Abstract
Purpose Methods Results Conclusions
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The Effect of Diabetes Mellitus on IGF Axis and Stem Cell Mediated Regeneration of the Periodontium. Bioengineering (Basel) 2021; 8:bioengineering8120202. [PMID: 34940355 PMCID: PMC8698546 DOI: 10.3390/bioengineering8120202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Periodontitis and diabetes mellitus (DM) are two of the most common and challenging health problems worldwide and they affect each other mutually and adversely. Current periodontal therapies have unpredictable outcome in diabetic patients. Periodontal tissue engineering is a challenging but promising approach that aims at restoring periodontal tissues using one or all of the following: stem cells, signalling molecules and scaffolds. Mesenchymal stem cells (MSCs) and insulin-like growth factor (IGF) represent ideal examples of stem cells and signalling molecules. This review outlines the most recent updates in characterizing MSCs isolated from diabetics to fully understand why diabetics are more prone to periodontitis that theoretically reflect the impaired regenerative capabilities of their native stem cells. This characterisation is of utmost importance to enhance autologous stem cells based tissue regeneration in diabetic patients using both MSCs and members of IGF axis.
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Qi L, Ge W, Cao N, Wang S, Qian Y, Wang X, Zhang L. Effects of autologous concentrated growth factor on gingival thickness in periodontal accelerated osteogenic orthodontics: a 6-month randomized controlled trial. BMC Oral Health 2021; 21:604. [PMID: 34814921 PMCID: PMC8609726 DOI: 10.1186/s12903-021-01967-5] [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: 05/30/2021] [Accepted: 11/10/2021] [Indexed: 12/22/2022] Open
Abstract
Background Earlier studies have not given clear results of concentrated growth factor (CGF) on gingival thickness (GT) in periodontal accelerated osteogenic orthodontics (PAOO). This randomized controlled trial aimed to evaluate the effects of CGF on GT in patients with thin gingival phenotype undergoing PAOO. Methods Forty four patients presenting 264 anterior mandibular teeth were recruited and randomly allocated to one of the groups: test—positioning of autologous CGF after PAOO or control—positioning of a collagen membrane after PAOO. GT, gingival height (GH), buccal alveolar bone thickness (BT), and buccal alveolar bone height (BH) were evaluated depending on cross-sectional CBCT images at t0 (before surgery) and t1(6 months after surgery). Results GT were increased in both groups at t1 compared to t0. Yet, higher values were observed in the test group (from 0.94 ± 0.23 to 1.31 ± 0.33 mm) compared to the control group (from 0.94 ± 0.19 to 1.02 ± 0.16 mm) (p < 0.05). Moreover, in the intergroup comparison, GT at t1 in the test group was significantly higher compared to the control group (p < 0.01). Furthermore, the GT of central incisors, lateral incisors and canine teeth all showed significantly changes compared with baseline and the test group showed higher increase (p < 0.01). No statistically significant difference were found in GH, BT, BH and all clinical parameters between two groups at t1 (p > 0.05). Conclusions Within the limitation of this study, gingival thickness could be increased by using CGF in PAOO for the patients with thin gingival phenotype. Trial registration The study was registered in Chinese Clinical Trial Registry (http://www.chictr.org.cn/index.aspx) under the number ChiCTRINR17013346, Registered 11 November 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01967-5.
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Affiliation(s)
- Lei Qi
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Weiwen Ge
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Ningning Cao
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Shoupeng Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Yifeng Qian
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Xudong Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Lei Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China. .,College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, Shanghai, 200011, China. .,National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
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Pagni G, Tavelli L, Rasperini G. The Evolution of Surgical Techniques and Biomaterials for Periodontal Regeneration. Dent Clin North Am 2021; 66:75-85. [PMID: 34794555 DOI: 10.1016/j.cden.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The understanding of biological concepts in wound healing together with the evolution in biomaterials applied in periodontal regeneration allowed for improved, minimally invasive surgical techniques with a wider range of application and adapted to achieve multiple goals at the same time. Regenerating attachment was never the sole end point, but maintaining the patient's own natural dentition in health and esthetics is becoming a feasible goal even in cases considered challenging just a few years ago. In this article we report on the evolution of techniques and biomaterials and their application in esthetic and challenging cases.
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Affiliation(s)
- Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Via della Commenda 12, Milan 20122, Italy
| | - Lorenzo Tavelli
- Department of Periodontics, University of Michigan School of Dentistry, 1011 N University Avenue, Ann Arbor, MI 48109, USA; Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Via della Commenda 12, Milan 20122, Italy.
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6
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Apical approach in periodontal reconstructive surgery with enamel matrix derivate and enamel matrix derivate plus bone substitutes: a randomized, controlled clinical trial. Clin Oral Investig 2021; 26:2793-2805. [PMID: 34791548 PMCID: PMC8898230 DOI: 10.1007/s00784-021-04256-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/23/2021] [Indexed: 11/17/2022]
Abstract
Objectives This parallel, randomized controlled clinical trial evaluated the influence of bone substitutes (BS) on the efficacy of the non-incised papillae surgical approach (NIPSA) with enamel matrix derivate (EMD) in resolving deep, isolated, combined non-contained intrabony and supra-alveolar periodontal defects, preserving the soft tissue. Material and methods Twenty-four patients were randomized to treatment with NIPSA and EMD or NIPSA plus EMD and BS. Bleeding on probing (BoP), interproximal clinical attachment level (CAL), interproximal probing depth (PD), recession (REC), location of the tip of the papilla (TP), and width of the keratinized tissue (KT) were evaluated before surgery and at 1 year post-surgery (primary outcomes). Wound closure was assessed at 1 week post‐surgery, and supra‐alveolar attachment gain (SUPRA-AG) was recorded at 1 year post‐surgery. Results At 1 week, 87.5% of cases registered complete wound closure and there were no cases of necrosis, without differences between groups (p > .05). At 1 year, all cases showed negative BoP. A significant PD reduction (NIPSA + EMD 8.25 ± 2.70 mm vs. NIPSA + EMD + BS 6.83 ± 0.81 mm) and CAL gain (NIPSA + EMD 8.33 ± 2.74 mm vs. NIPSA + EMD + BS 7.08 ± 2.68 mm) were observed (p < .001) in both groups, without significant between-group differences (p > .05). The residual PD was < 5 mm in all defects (NIPSA + EMD 2.50 ± 0.67 mm vs. NIPSA + EMD + BS 2.67 ± 0.78 mm). Soft tissues were preserved without significant between-group differences (REC: NIPSA + EMD 0.25 ± 0.45 mm vs. NIPSA + EMD + BS 0.17 ± 0.58 mm, p > .05; KT: 0.00 ± 0.43 mm vs. 0.08 ± 0.67 mm, p > .05). There were improvements in the papilla in both groups (TP: NIPSA + EMD 0.33 ± 0.49 mm vs. NIPSA + EMD + BS 0.45 ± 0.52 mm, p > .05), which was only significant in the NIPSA EMD + BS group (0.45 ± 0.52 mm; p < .05). In both groups, CAL gain was recorded in the supra-alveolar component, showing full resolution of the intrabony component of the defect in all cases (SUPRA-AG: NIPSA + EMD 1.83 ± 1.11 mm vs. NIPSA + EMD + BS 2.00 ± 1.76 mm, p > .05). Conclusions NIPSA and EMD with or without BS seem to be a valid surgical approach in the treatment of isolated, deep non-contained periodontal defects. In our study, both treatments resulted in significant PD reduction and CAL gain, that extended in the supra-alveolar component, without differences with the use of BS. Both treatments resulted in soft tissue preservation. However, the addition of BS may improve interdental papillary tissue. Clinical relevance
NIPSA, with or without bone substitutes, resulted in significant periodontal improvement, with soft tissue preservation in isolated, deep non-contained periodontal defects. The application of bone substitutes may provide interproximal soft tissue gain. Clinical trial registration Clinicaltrials.gov: NCT04712630. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04256-1.
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7
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Moreno-Rodríguez JA, Ortiz-Ruiz AJ. Papilla preservation periodontal surgery in periodontal reconstruction for deep combined intra-suprabony defects. Retrospective analysis of a registry-based cohort. J Clin Exp Dent 2021; 13:e769-e775. [PMID: 34512915 PMCID: PMC8412809 DOI: 10.4317/jced.58265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background Suprabony defects are the most prevalent defects and there is very little evidence on their treatment. This study aims to assess the effectiveness of papilla preservation periodontal surgery in the periodontal reconstruction of combined deep intra-suprabony defects.
Material and Methods 20 patients with combined intrabony and supra-alveolar deep periodontal defects treated by papilla preservation periodontal surgery were analyzed. Defects were treated with enamel matrix derivate plus xenograft. Clinical recordings made before surgery and at 12 months.
Results Papilla preservation periodontal surgery showed significant PPD reduction (4.4 ± 1.46 mm; p<0.001), clinical attachment gain (3.35 ± 1.6 mm; p<0.001), increased REC (1.05 ± 0.94; p<0.001), papilla apical displacement (0.85 ± 1.31 mm; p<0.005) and KT reduction (0.5 ± 0.76 mm; p<0.05). At one week, there was incomplete wound closure and necrosis in 40% and 30% of the treated sites, respectively. At one year, the intrabony component filling was 73.65 ± 27.6 % and the supra-alveolar attachment gain indicated an incomplete intrabony defect resolution (-0.15 ± 1.56 mm).
Conclusions Periodontal pocket was significantly reduced and the level of clinical attachment increased. However, there was significant recession of the gingival margin and the papilla and a trend to incomplete resolution of the intrabony component. Key words:Periodontitis, surgical flaps, reconstructive surgery, regeneration.
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Affiliation(s)
| | - Antonio J Ortiz-Ruiz
- DDS, MSc, PhD. Department of Stomatology, Faculty of Medicine, University of Murcia, Spain
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Latimer JM, Maekawa S, Yao Y, Wu DT, Chen M, Giannobile WV. Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects. Front Bioeng Biotechnol 2021; 9:704048. [PMID: 34422781 PMCID: PMC8378232 DOI: 10.3389/fbioe.2021.704048] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Additive manufacturing (AM) is the automated production of three-dimensional (3D) structures through successive layer-by-layer deposition of materials directed by computer-aided-design (CAD) software. While current clinical procedures that aim to reconstruct hard and soft tissue defects resulting from periodontal disease, congenital or acquired pathology, and maxillofacial trauma often utilize mass-produced biomaterials created for a variety of surgical indications, AM represents a paradigm shift in manufacturing at the individual patient level. Computer-aided systems employ algorithms to design customized, image-based scaffolds with high external shape complexity and spatial patterning of internal architecture guided by topology optimization. 3D bioprinting and surface modification techniques further enhance scaffold functionalization and osteogenic potential through the incorporation of viable cells, bioactive molecules, biomimetic materials and vectors for transgene expression within the layered architecture. These computational design features enable fabrication of tissue engineering constructs with highly tailored mechanical, structural, and biochemical properties for bone. This review examines key properties of scaffold design, bioresorbable bone scaffolds produced by AM processes, and clinical applications of these regenerative technologies. AM is transforming the field of personalized dental medicine and has great potential to improve regenerative outcomes in patient care.
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Affiliation(s)
- Jessica M Latimer
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Shogo Maekawa
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yao Yao
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - David T Wu
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Laboratory for Cell and Tissue Engineering, Harvard John A. Paulson School of Engineering and Applied Sciences, Boston, MA, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Michael Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
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9
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Simonelli A, Minenna L, Trombelli L, Farina R. Single flap approach with or without enamel matrix derivative in the treatment of severe supraosseous defects: a retrospective study. Clin Oral Investig 2021; 25:6385-6392. [PMID: 33855656 PMCID: PMC8531052 DOI: 10.1007/s00784-021-03941-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/07/2021] [Indexed: 11/19/2022]
Abstract
Aim To comparatively evaluate the clinical effectiveness of the single flap approach (SFA) with and without enamel matrix derivative (EMD) in the treatment of supraosseous defects (SDs) associated with deep pockets. Materials and methods Twenty patients, each contributing one SD associated with a deep (≥ 6 mm) pocket and treated with buccal SFA either alone (SFA group; n = 10) or in combination with EMD (SFA+EMD group; n =10), were retrospectively selected. Clinical parameters (probing depth, PD; clinical attachment level, CAL; gingival recession, REC) had been assessed at pre-surgery and 12 months post-surgery. Results Complete wound closure was observed in 70% and 80% of defects treated with SFA and SFA+EMD, respectively. Treatments resulted in a significant PD reduction of 3.1±1.0 mm (p=0.005). In SFA+EMD group, 100% of closed pockets was obtained, while 90% of closed pockets was observed in SFA group. Both treatments resulted in a significant CAL gain of 2.1±0.9 mm and 1.9±1.7 mm in SFA and SFA+EMD group, respectively (p= 0.465). In both groups, REC significantly increased 1.0±1.1 mm in SFA group and 1.1±1.1 mm in SFA+EMD group (p= 0.722). Conclusions Within their limits, the findings of present study suggest that SFA may represent a valuable option for the surgical treatment of SDs associated with deep pockets. EMD did not result in a significant clinical benefit to the procedure. Clinical relevance SFA may represent a valuable option in obtaining pocket closure when treating SDs associated with deep residual pockets.
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Affiliation(s)
- Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, 44121, Ferrara, Italy.
| | - Luigi Minenna
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, 44121, Ferrara, Italy
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, 44121, Ferrara, Italy.,Operative Unit of Dentistry, AUSL of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Corso Giovecca 203, 44121, Ferrara, Italy.,Operative Unit of Dentistry, AUSL of Ferrara, Ferrara, Italy
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10
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Özcan E, Saygun I, Kantarcı A, Özarslantürk S, Serdar MA, Özgürtaş T. The effects of a novel non-invasive application of platelet-rich fibrin on periodontal clinical parameters and gingival crevicular fluid transforming growth factor-β and collagen-1 levels: A randomized, controlled, clinical study. J Periodontol 2021; 92:1252-1261. [PMID: 33382101 DOI: 10.1002/jper.20-0713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several potential benefits have been attributed to the platelet-rich fibrin (PRF), including enhanced tissue healing properties. In this study, we hypothesized that the application of PRF as an adjunct to conventional scaling and root planing (ScRp) would enhance the outcomes of non-surgical periodontal therapy. METHODS The present study was a split-mouth randomized controlled clinical trial design in 24 deep periodontal pockets in 12 patients with periodontitis. The pockets were randomly assigned as test or control. The test group received PRF as an adjunct to ScRp, whereas the control group received ScRp only. We measured periodontal clinical parameters at baseline, 3, and 6 months after the treatments. To study the initial healing in response to treatment, transforming growth factor-β (TGF-β) and collagen-1 (Col-1) in gingival crevicular fluid (GCF) were measured using enzyme-linked immunosorbent assay at baseline, third, seventh, and 14th days. RESULTS The test group showed a significantly greater pocket reduction, higher clinical attachment gain, and less gingival recession than the control group at 3 and 6 months. The test Col-1 levels (1.27 ± 1.05, 1.35 ± 0.76, 0.97 ± 0.53 ng/site) and TGF-β levels (11.93 ± 2.68, 12.54 ± 3.66, 17.19 ± 11.66 pg/site) were higher than the control Col-1 levels (0.76 ± 0.20, 0.84 ± 0.24, 0.57 ± 0.19 ng/site) and TGF-β levels (6.34 ± 1.67, 6.35 ± 3.44, 7.51 ± 2.85 pg/site) at all measurement days respectively. CONCLUSIONS Non-surgical application of the PRF as an adjunct to conventional ScRp may effectively improve the periodontal clinical parameters via increasing expression of the GCF TGF-β and Col-1 levels.
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Affiliation(s)
- Erkan Özcan
- Gulhane Dentistry Faculty, Department of Periodontology, University of Health Sciences, Ankara, Turkey
| | - Işıl Saygun
- Gulhane Dentistry Faculty, Department of Periodontology, University of Health Sciences, Ankara, Turkey
| | | | - Savaş Özarslantürk
- Gulhane Dentistry Faculty, Department of Oral and Maxillofacial Radiology, University of Health Sciences, Ankara, Turkey
| | | | - Taner Özgürtaş
- Gulhane Medical Faculty, Department of Biochemistry, Health Sciences University, Ankara, Turkey
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11
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Rasperini G, Tavelli L, Barootchi S, McGuire MK, Zucchelli G, Pagni G, Stefanini M, Wang HL, Giannobile WV. Interproximal attachment gain: The challenge of periodontal regeneration. J Periodontol 2020; 92:931-946. [PMID: 33152103 DOI: 10.1002/jper.20-0587] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/27/2020] [Accepted: 10/24/2020] [Indexed: 11/08/2022]
Abstract
The new classification of periodontal diseases recognizes the key role of the interdental clinical attachment for defining the periodontal status and the extent of disease severity. Regenerating interdental clinical attachment not only improves the prognosis of the tooth, but it also lessens the severity of the disease condition. This manuscript provides a state-of-the-art review on surgical reconstructive approaches for treating papillary deficiency associated with soft and hard tissue interproximal defects. Combination therapy of papilla preservation, connective tissue grafting, and coronally advanced flaps may result in regeneration of the intrabony defect coupled with root coverage. Future research highlighted here may have the potential, especially in combination approaches, to repair challenging interproximal soft and hard tissue deficiencies.
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Affiliation(s)
- Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Milan, Italy.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Michael K McGuire
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Private practice, Houston, TX, USA.,Department of Periodontics, Dental Branch Houston and Health Science Center at San Antonio, University of Texas, San Antonio, TX, USA
| | - Giovanni Zucchelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, Milan, Italy
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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