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Patel B, Joshi S, Nagrani T, Girdhar GA, Patel H, Sinha S, Haque M, Kumar S, Haq MA. Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects. Cureus 2023; 15:e44394. [PMID: 37654905 PMCID: PMC10468150 DOI: 10.7759/cureus.44394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.
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Affiliation(s)
- Bhavin Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Surabhi Joshi
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Tanya Nagrani
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Gaurav A Girdhar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Heli Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Susmita Sinha
- Physiology, Khulna City Medical College Hospital, Khulna, BGD
| | - Mainul Haque
- Karnavati Scientific Research Center, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Santosh Kumar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Md Ahsanul Haq
- Biostatistics, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), Dhaka, BGD
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Nakamura K, Koide M, Kobayashi Y, Yamashita T, Matsushita M, Yasuda H, Ishihara Y, Yoshinari N, Udagawa N. Sclerostin deficiency effectively promotes bone morphogenetic protein-2-induced ectopic bone formation. J Periodontal Res 2023. [PMID: 37154419 DOI: 10.1111/jre.13134] [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: 12/13/2022] [Revised: 03/15/2023] [Accepted: 04/27/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Severe periodontitis causes alveolar bone resorption, resulting in tooth loss. Developments of tissue regeneration therapy that can restore alveolar bone mass are desired for periodontal disease. The application of bone morphogenetic protein-2 (BMP-2) has been attempted for bone fractures and severe alveolar bone loss. BMP-2 reportedly induces sclerostin expression, an inhibitor of Wnt signals, that attenuates bone acquisition. However, the effect of sclerostin-deficiency on BMP-2-induced bone regeneration has not been fully elucidated. We investigated BMP-2-induced ectopic bones in Sost-knockout (KO) mice. METHODS rhBMP-2 were implanted into the thighs of C57BL/6 (WT) and Sost-KO male mice at 8 weeks of age. The BMP-2-induced ectopic bones in these mice were examined on days 14 and 28 after implantation. RESULTS Immunohistochemical and quantitative RT-PCR analyses showed that BMP-2-induced ectopic bones expressed sclerostin in osteocytes on days 14 and 28 after implantation in Sost-Green reporter mice. Micro-computed tomography analysis revealed that BMP-2-induced ectopic bones in Sost-KO mice showed a significant increased relative bone volume and bone mineral density (WT = 468 mg/cm3 , Sost-KO = 602 mg/cm3 ) compared with those in WT mice on day 14 after implantation. BMP-2-induced ectopic bones in Sost-KO mice showed an increased horizontal cross-sectional bone area on day 28 after implantation. Immunohistochemical staining showed that BMP-2-induced ectopic bones in Sost-KO mice had an increased number of osteoblasts with osterix-positive nuclei compared with those in WT mice on days 14 and 28 after implantation. CONCLUSION Sclerostin deficiency increased bone mineral density in BMP-2-induced ectopic bones.
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Affiliation(s)
- Keigo Nakamura
- Department of Operative Dentistry, Endodontology and Periodontology, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Masanori Koide
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Yasuhiro Kobayashi
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Teruhito Yamashita
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Mai Matsushita
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Hisataka Yasuda
- Bioindustry Division, Oriental Yeast Co., Ltd., Tokyo, Japan
| | | | - Nobuo Yoshinari
- Department of Operative Dentistry, Endodontology and Periodontology, Matsumoto Dental University, Shiojiri, Nagano, Japan
| | - Nobuyuki Udagawa
- Division of Hard Tissue Research, Institute for Oral Science, Matsumoto Dental University, Shiojiri, Nagano, Japan
- Department of Biochemistry, Matsumoto Dental University, Shiojiri, Nagano, Japan
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Ikhar AS, Kolte RA, Kolte AP, Purohit AR, Dahake RN. Efficacy of platelet rich fibrin with and without metformin in the treatment of periodontal osseous defects: a systematic review and meta-analysis. Acta Odontol Scand 2023; 81:186-195. [PMID: 35786379 DOI: 10.1080/00016357.2022.2095024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The systematic review and meta-analysis aimed to evaluate the efficacy of Metformin (MF) with Platelet Rich Fibrin (PRF) over PRF alone in the treatment of periodontal osseous defects. MATERIALS AND METHODS An extensive electronic search for articles published up to September 2021 was conducted on 'Embase', 'PubMed' and other library databases accompanied with manual searching. Randomized controlled trials (RCTs), comparing MF plus PRF Vs PRF alone in periodontal osseous defects were identified in which periodontal pocket depth (PPD), Clinical attachment level (CAL) and Intrabony defect depth (IBD Depth) were the outcome measures. RESULTS Four studies compared MF plus PRF vs .PRF alone in periodontal osseous defects. Meta-analysis was carried out for PPD reduction, CAL gain and IBD Depth changes. A standardized mean difference (SMD) of 1.86 for PPD reduction, 1.95 for CAL gain and 1.31 for IBD Depth reduction in all the studies was observed and the findings were statistically significant favouring test group. CONCLUSION The systematic review indicates supplemental benefits of combination therapy of MF + PRF over monotherapy in resolving periodontal osseous defects. In our quest to achieve maximum regeneration in periodontal osseous defects, combination therapies such as MF + PRF have reported to be better treatment choices over other modalities.
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Affiliation(s)
- Aishwarya S Ikhar
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Rajashri A Kolte
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Abhay P Kolte
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Aishwarya R Purohit
- Department of Periodontology and Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Rahul N Dahake
- Department of Oral and Maxillofacial Surgery, VSPM Dental College and Research Centre, Nagpur, India
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Mhatre A, Shetty D, Shetty A, Dharmadhikari S, Wadkar P. Comparative evaluation of the physical properties of membranes for periodontal regeneration: An In vitro Study. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_113_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Effects of Obesity on Bone Healing in Rats. Int J Mol Sci 2021; 22:ijms222413339. [PMID: 34948136 PMCID: PMC8704371 DOI: 10.3390/ijms222413339] [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: 10/31/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Although the association between periodontitis and obesity is well explored, it is unclear whether obesity is associated with a worse therapeutic outcome after periodontal treatment. The aim of this study was to investigate the effects of obesity on bone healing with and without the application of regeneration-promoting molecules. A standardized bone fenestration-type defect was created over the root of the mandibular first molar in 15 Wistar rats. Ten animals received a high-fat, high-sucrose diet (HFSD), while the remaining five animals were fed a standard diet. During surgery, the fenestration defects from half of the HFSD-fed, i.e., obese animals, were treated with regeneration-promoting molecules (enamel matrix derivative; EMD). After four weeks, bone healing was evaluated by histomorphometry, TRAP staining and immunohistochemistry for RUNX2 and osteopontin. The analyses revealed that the spontaneous healing of the periodontal defects was compromised by obesity. Application of EMD partially compensated for the negative effect of obesity. Nevertheless, EMD-stimulated bone healing in obese animals was not better than the spontaneous healing in the obesity-free control group, indicating that obesity may also inhibit the stimulatory effects of regeneration-promoting molecules. Our results show that obesity can negatively influence bone healing and suggest that bone healing may be compromised in humans.
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Rexhepi I, Paolantonio M, Romano L, Serroni M, Santamaria P, Secondi L, Paolantonio G, Sinjari B, De Ninis P, Femminella B. Efficacy of inorganic bovine bone combined with leukocyte and platelet-rich fibrin or collagen membranes for treating unfavorable periodontal infrabony defects: Randomized non-inferiority trial. J Periodontol 2021; 92:1576-1587. [PMID: 33547808 DOI: 10.1002/jper.20-0305] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Growing evidence shows the efficacy of platelet concentrates in periodontal therapy. This study aimed to demonstrate that an inorganic bovine bone graft (IBB) in combination with a leukocyte and platelet rich fibrin (L-PRF) is non-inferior to a combination with a collagen membrane (CM) when managing unfavorable infrabony defects (IBDs). METHODS All patients exhibited at least one unfavorable IBD; they were randomly assigned to two groups, 31 treated with L-PRF+IBB and 31 with CM+IBB. A clinical and radiographic examination was performed at baseline and 12 months later. Clinical attachment level (CAL), gingival recession (GR), probing depth (PD), and radiographic defect bone level (DBL) post-therapy changes were compared between the two treatments. A non-inferiority margin = 1 mm was set to determine the efficacy of the test treatment (-1 mm for GR); a second non-inferiority margin = 0.5 mm (-0.5 mm for GR) was chosen for clinical relevance. RESULTS Twelve months after surgery a significant improvement of clinical and radiographic parameters was observed at both experimental sites. The 90% confidence intervals of the CM+IBB-L-PRF+IBB mean difference for CAL gain (-0.810 mm [-1.300 to -0.319]) and DBL gain (-0.648 mm [-1.244 to -0.052]) were below the 0.5 mm non-inferiority margin; GR increase (1.284 mm [0.764 to 1.804]) remained above the -0.5 mm, while PD reduction (0.499 mm [0.145 to 0.853]) crossed its 0.5-mm margin. CONCLUSIONS The L-PRF+IBB treatment of unfavorable IBDs offers non-inferior efficacy for CAL gain, showing less GR and more DBL gain too, while for PD reduction it is inferior to the CM+IBB treatment.
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Affiliation(s)
- Imena Rexhepi
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Michele Paolantonio
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Luigi Romano
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Matteo Serroni
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Pasquale Santamaria
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Lorenzo Secondi
- Department of Surgical Science, Plastic and Reconstructive Surgery, Tor Vergata University, Rome, Italy
| | - Giulia Paolantonio
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Bruna Sinjari
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
| | - Paolo De Ninis
- "Luisa D'Annunzio" Institute for High Culture, Pescara, Italy
| | - Beatrice Femminella
- Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy
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Archila-Montañez E, Medina-Ocampo PE. [Interpretation of periapical healing in radiological images. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e087. [PMID: 38463730 PMCID: PMC10919837 DOI: 10.21142/2523-2754-0904-2021-087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/12/2021] [Indexed: 03/12/2024] Open
Abstract
Interpretation of the state of healing of chronic apical periodontitis or apical curettage with apicoectomy in radiological images is based on the analysis of changes in the appearance of the periapical area and in the bone structure adjacent to the site of inflammation or surgical intervention, which are projected onto normal bone structures. However, distortion of structures or the superposition of anatomical images should be considered when interpreting radiographs. We compared conventional studies of evaluation of the periapical area following treatment, together with 2D images, with the periapical index and the criteria of evaluation in both successful and unsuccessful cases of endodontic surgical treatment. Some studies have reported that the radiographic appearance of the tooth crown and root may facilitate interpretation of the periapical area. In addition, cone-beam computed tomography can show the relationship between injured and repairing tissue using buccal and lingual tables to measure the periphery in transverse reconstruction. Indeed, complex biological events and mechanisms can occur during the healing process of periapical and root tissues. Knowledge of the diversity of tissues is essential to identify the dynamics of the signs of regeneration or the presence of healing due to repair. Hence, the aim of this article was to identify the criteria used to interpret periapical healing in two-dimensional or three-dimensional images and their relationship with diagnosis and treatment according to the literature currently available.
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Affiliation(s)
- Eloísa Archila-Montañez
- Especialista en Endodoncia de la Fundación Universitaria San Martín. Bogotá, Colombia. Especialista en Endodoncia Fundación Universitaria San Martín Bogotá Colombia
| | - Paola Elena Medina-Ocampo
- Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Universidad Científica del Sur Lima Peru
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Hoz L, López S, Zeichner-David M, Arzate H. Regeneration of rat periodontium by cementum protein 1-derived peptide. J Periodontal Res 2021; 56:1223-1232. [PMID: 34510433 DOI: 10.1111/jre.12921] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Cementum protein 1 (CEMP1) has the capacity to promote differentiation of periodontal ligament (PDL) cells toward a cementoblastic phenotype in vitro and bone regeneration in vivo. In this study, we tested the capabilities of a synthetic cementum protein 1-derived peptide, MGTSSTDSQQAGHRRCSTSN (CEMP1-p1), to promote regeneration of periodontal structures in a periodontal fenestration defect in rats. MATERIAL AND METHODS Fenestration defects were created using an extra-oral approach in the buccal aspect of the mandibular first molar roots. Eighteen male Wistar rats were divided into three groups. Two controls (defects non-treated or defects treated with a gelatin matrix scaffold [GMS] only) and the experimental group treated with 5 µg/dose of CEMP1-p1 embedded in GMS. After 28 days, the animals were sacrificed, and the mandibles processed for histopathological examination. Expression of cementum proteins, cementum attachment protein (CAP), CEMP1, integrin binding sialoprotein (IBSP), and osteocalcin (OCN), was assessed using immunofluorescence. The formation of new cementum, bone, and PDL fibers were compared between control and experimental groups. RESULTS The histological analysis revealed that the control group without any treatment new cementum or oriented PDL fibers were not observed. However, the presence of newly bone was detected. In the control group treated with GMS, new cementum formation was not detectable, the PDL fibers were oriented parallel to the longitudinal root axis, and new bone formation was observed. The experimental group showed deposit of acellular extrinsic fiber cementum (AEFC) in a lamellae-like feature with inserted Sharpey's fibers, formation of cellular mixed stratified cementum (CMSC) with the presence of cementocytes, and newly formed bone close to the cementum-enamel junction. Cementoblast cells adjacent to new cementum expressed CAP, CEMP1, IBSP, and OCN. CONCLUSION These studies show that CEMP1-p1 promotes the formation of AEFC, CMSC, new PDL with Sharpey's fibers inserted in cementum and bone, thus providing strong evidence that the synthetic peptide CEMP1-p1 promotes periodontal regeneration in a rat fenestration model.
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Affiliation(s)
- Lía Hoz
- Laboratorio de Biología Periodontal, Facultad de Odontología, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de Mexico, CDMX, 04510, México
| | - Sonia López
- Laboratorio de Biología Periodontal, Facultad de Odontología, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de Mexico, CDMX, 04510, México
| | - Margarita Zeichner-David
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Higinio Arzate
- Laboratorio de Biología Periodontal, Facultad de Odontología, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de Mexico, CDMX, 04510, México
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Bapat RA, Parolia A, Chaubal T, Dharamadhikari S, Abdulla AM, Sakkir N, Arora S, Bapat P, Sindi AM, Kesharwani P. Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry. Biomater Sci 2021; 9:3244-3283. [PMID: 33949464 DOI: 10.1039/d1bm00233c] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Dental treatment is provided for a wide variety of oral health problems like dental caries, periodontal diseases, periapical infections, replacement of missing teeth and orthodontic problems. Various biomaterials, like composite resins, amalgam, glass ionomer cement, acrylic resins, metal alloys, impression materials, bone grafts, membranes, local anaesthetics, etc., are used for dental applications. The physical and chemical characteristics of these materials influence the outcome of dental treatment. It also impacts on the biological, allergic and toxic potential of biomaterials. With innovations in science and their positive results, there is also a need for awareness about the biological risks of these biomaterials. The aim of dental treatment is to have effective, yet safe, and long-lasting results for the benefit of patients. For this, it is important to have a thorough understanding of biomaterials and their effects on local and systemic health. Materials used in dentistry undergo a series of analyses before their oral applications. To the best of our knowledge, this is the first and original review that discusses the reasons for and studies on the toxicity of commonly used biomaterials for applications in dentistry. It will help clinicians to formulate a methodical approach for the selection of dental biomaterials, thus providing an awareness for forecasting their risk of toxic reactions.
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Affiliation(s)
- Ranjeet Ajit Bapat
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Abhishek Parolia
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Tanay Chaubal
- Faculty, Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Anshad Mohamed Abdulla
- Faculty, Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nasil Sakkir
- Registrar Endodontist, Central Security Hospital, Abha, Kingdom of Saudi Arabia
| | - Suraj Arora
- Faculty, Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Prachi Bapat
- Dentist, Modern Dental College, Indore 453112, Madhya Pradesh, India
| | - Amal M Sindi
- Faculty, Oral Diagnostic Sciences Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Prashant Kesharwani
- Faculty, Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India.
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Chu C, Wang Y, Wang Y, Yang R, Liu L, Rung S, Xiang L, Wu Y, Du S, Man Y, Qu Y. Evaluation of epigallocatechin-3-gallate (EGCG) modified collagen in guided bone regeneration (GBR) surgery and modulation of macrophage phenotype. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:73-82. [DOI: 10.1016/j.msec.2019.01.083] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/20/2019] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
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Needleman I, Worthington HV, Giedrys‐Leeper E, Tucker R. WITHDRAWN: Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst Rev 2019; 5:CD001724. [PMID: 31141165 PMCID: PMC6541039 DOI: 10.1002/14651858.cd001724.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Conventional treatment of destructive periodontal (gum) disease arrests the disease but does not usually regain the bone support or connective tissue lost in the disease process. Guided tissue regeneration (GTR) is a surgical procedure that specifically aims to regenerate the periodontal tissues when the disease is advanced and could overcome some of the limitations of conventional therapy. OBJECTIVES To assess the efficacy of GTR in the treatment of periodontal infra-bony defects measured against conventional surgery (open flap debridement (OFD)) and factors affecting outcomes. SEARCH METHODS We conducted an electronic search of the Cochrane Oral Health Group Trials Register, MEDLINE and EMBASE up to April 2004. Handsearching included Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and bibliographies of all relevant papers and review articles up to April 2004. In addition, we contacted experts/groups/companies involved in surgical research to find other trials or unpublished material or to clarify ambiguous or missing data and posted requests for data on two periodontal electronic discussion groups. SELECTION CRITERIA Randomised, controlled trials (RCTs) of at least 12 months duration comparing guided tissue regeneration (with or without graft materials) with open flap debridement for the treatment of periodontal infra-bony defects. Furcation involvements and studies specifically treating aggressive periodontitis were excluded. DATA COLLECTION AND ANALYSIS Screening of possible studies and data extraction was conducted independently. The methodological quality of studies was assessed in duplicate using individual components and agreement determined by Kappa scores. Methodological quality was used in sensitivity analyses to test the robustness of the conclusions. The Cochrane Collaboration statistical guidelines were followed and the results expressed as mean differences (MD and 95% CI) for continuous outcomes and risk ratios (RR and 95% CI) for dichotomous outcomes calculated using random-effects models. Any heterogeneity was investigated. The primary outcome measure was change in clinical attachment. MAIN RESULTS The search produced 626 titles, of these 596 were clearly not relevant to the review. The full text of 32 studies of possible relevance was obtained and 15 studies were excluded. Therefore 17 RCTs were included in this review, 16 studies testing GTR alone and two testing GTR + bone substitutes (one study had both test treatment arms).No tooth loss was reported in any study although these data are incomplete where patient follow up was not complete. For attachment level change, the mean difference between GTR and OFD was 1.22 mm (95% CI Random Effects: 0.80 to 1.64, Chi2 for heterogeneity 69.1 (df = 15), P < 0.001, I2 = 78%) and for GTR + bone substitutes was 1.25 mm (95% CI 0.89 to 1.61, Chi2 for heterogeneity 0.01 (df = 1), P = 0.91). GTR showed a significant benefit when comparing the numbers of sites failing to gain 2 mm attachment with risk ratio 0.54 (95% CI Random Effects: 0.31 to 0.96, Chi2 for heterogeneity 8.9 (df = 5), P = 0.11). The number needed to treat (NNT) for GTR to achieve one extra site gaining 2 mm or more attachment over open flap debridement was therefore 8 (95% CI 5 to 33), based on an incidence of 28% of sites in the control group failing to gain 2 mm or more of attachment. For baseline incidences in the range of the control groups of 3% and 55% the NNTs are 71 and 4.Probing depth reduction was greater for GTR than OFD: 1.21 mm (95% CI 0.53 to 1.88, Chi2 for heterogeneity 62.9 (df = 10), P < 0.001, I2 = 84%) or GTR + bone substitutes, weighted mean difference 1.24 mm (95% CI 0.89 to 1.59, Chi2 for heterogeneity 0.03 (df = 1), P = 0.85).For gingival recession, a statistically significant difference between GTR and open flap debridement controls was evident (mean difference 0.26 mm (95% CI Random Effects: 0.08, 0.43, Chi2 for heterogeneity 2.7 (df = 8), P = 0.95), with a greater change in recession from baseline for the control group.Regarding hard tissue probing at surgical re-entry, a statistically significant greater gain was found for GTR compared with open flap debridement. This amounted to a weighted mean difference of 1.39 mm (95% CI 1.08 to 1.71, Chi2 for heterogeneity 0.85 (df = 2), P = 0.65). For GTR + bone substitutes the difference was greater, with mean difference 3.37 mm (95% CI 3.14 to 3.61).Adverse effects were generally minor although with an increased treatment time for GTR. Exposure of the barrier membrane was frequently reported with a lack of evidence of an effect on healing. AUTHORS' CONCLUSIONS GTR has a greater effect on probing measures of periodontal treatment than open flap debridement, including improved attachment gain, reduced pocket depth, less increase in gingival recession and more gain in hard tissue probing at re-entry surgery. However there is marked variability between studies and the clinical relevance of these changes is unknown. As a result, it is difficult to draw general conclusions about the clinical benefit of GTR. Whilst there is evidence that GTR can demonstrate a significant improvement over conventional open flap surgery, the factors affecting outcomes are unclear from the literature and these might include study conduct issues such as bias. Therefore, patients and health professionals need to consider the predictability of the technique compared with other methods of treatment before making final decisions on use. Since trial reports were often incomplete, we recommend that future trials should follow the CONSORT statement both in their conduct and reporting.There is therefore little value in future research repeating simple, small efficacy studies. The priority should be to identify factors associated with improved outcomes as well as investigating outcomes relevant to patients. Types of research might include large observational studies to generate hypotheses for testing in clinical trials, qualitative studies on patient-centred outcomes and trials exploring innovative analytic methods such as multilevel modelling. Open flap surgery should remain the control comparison in these studies.
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Affiliation(s)
- Ian Needleman
- UCL Eastman Dental InstituteUnit of Periodontology and International Centre for Evidence‐Based Oral Health256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Elaine Giedrys‐Leeper
- UCL Eastman Dental InstituteUnit of Periodontology, Division of Restorative Dental Sciences256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Richard Tucker
- UCL Eastman Dental InstituteUnit of Periodontology, Division of Restorative Dental Sciences256 Gray's Inn RoadLondonUKWC1X 8LD
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12
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Susanto A, Susanah S, Priosoeryanto BP, Satari MH, Komara I. The effect of the chitosan-collagen membrane on wound healing process in rat mandibular defect. J Indian Soc Periodontol 2019; 23:113-118. [PMID: 30983781 PMCID: PMC6434731 DOI: 10.4103/jisp.jisp_232_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Collagen and chitosan are potential biomaterials for medical applications; chitosan-collagen membranes are used as a barrier membrane in guided tissue regeneration and guided bone regeneration. Aims: The purpose of this study was to analyze the effect of the chitosan-collagen membrane on wound healing in rat mandibular defect by counting the number of fibroblasts and new blood vessels. Materials and Methods: As much as 24 male Wistar rats were divided into two groups, the treatment and control group. Bone defects were made In the rat mandible with diamond bur with a diameter of 2 mm, then the defect was covered with a chitosan-collagen membrane, and the control group was covered without application of chitosan-collagen membrane. After the 3rd, 7th, 14th, and the 21st day, the defect site was analyzed histologically. The number of fibroblasts and blood vessels was counted under a light microscope, at five fields with ×1000 and ×400 microscope magnification. Statistical Analysis Used: This study was done by using analysis of variance and unpaired t-test. Results: The average number of fibroblasts and blood vessels in the treatment group was higher than the control group. There was a significant difference in the number of fibroblasts on the 3rd and 7th day (P = 0.001; P = 0.001) and the number of blood vessels on the 3rd day (P = 0.04). Conclusion: The chitosan-collagen membrane was able to increase the number of fibroblasts and new blood vessels in the wound healing process.
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Affiliation(s)
- Agus Susanto
- Department of Periodontics, Faculty of Dentistry, Universitas Padjadjaran, Indonesia
| | - Susi Susanah
- Department of Pediatrics, Faculty of Medicine, Universitas Padjadjaran, Indonesia
| | | | | | - Ira Komara
- Department of Periodontics, Faculty of Dentistry, Universitas Padjadjaran, Indonesia
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13
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Sharma HM, Vijay D, Deepika PC. Whale's tail technique. JOURNAL OF THE INTERNATIONAL CLINICAL DENTAL RESEARCH ORGANIZATION 2019. [DOI: 10.4103/jicdro.jicdro_19_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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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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15
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Cheng AW, Berridge JP, McGary RT, Erley KJ, Johnson TM. The Extraction Socket Management Continuum: A Hierarchical Approach to Dental Implant Site Development. Clin Adv Periodontics 2018; 9:91-104. [DOI: 10.1002/cap.10049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/16/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Albert W. Cheng
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Joshua P. Berridge
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Ryan T. McGary
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Kenneth J. Erley
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
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16
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Han J, Ma B, Liu H, Wang T, Wang F, Xie C, Li M, Liu H, Ge S. Hydroxyapatite nanowires modified polylactic acid membrane plays barrier/osteoinduction dual roles and promotes bone regeneration in a rat mandible defect model. J Biomed Mater Res A 2018; 106:3099-3110. [DOI: 10.1002/jbm.a.36502] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/13/2018] [Accepted: 07/02/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Jing Han
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; School of Stomatology, Shandong University; Jinan 250012 China
- Department of Periodontology; School of Stomatology, Shandong University; Jinan 250012 China
| | - Baojin Ma
- State Key Laboratory of Crystal Materials; Shandong University; Jinan 250100 China
| | - Hongrui Liu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; School of Stomatology, Shandong University; Jinan 250012 China
- Department of Bone Metabolism; School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration; Jinan 250100 China
| | - Ting Wang
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; School of Stomatology, Shandong University; Jinan 250012 China
- Department of Periodontology; School of Stomatology, Shandong University; Jinan 250012 China
| | - Fang Wang
- Department of Periodontology; Yantai Stomatological Hospital; Yantai 264001 China
| | - Chengjia Xie
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; School of Stomatology, Shandong University; Jinan 250012 China
- Department of Periodontology; School of Stomatology, Shandong University; Jinan 250012 China
| | - Minqi Li
- Department of Bone Metabolism; School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration; Jinan 250100 China
| | - Hong Liu
- State Key Laboratory of Crystal Materials; Shandong University; Jinan 250100 China
| | - Shaohua Ge
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; School of Stomatology, Shandong University; Jinan 250012 China
- Department of Periodontology; School of Stomatology, Shandong University; Jinan 250012 China
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17
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Videoscope-Assisted Minimally Invasive Surgery (VMIS) for Bone Regeneration around Teeth and Implants: A Literature Review and Technique Update. Dent J (Basel) 2018; 6:dj6030030. [PMID: 29986378 PMCID: PMC6162722 DOI: 10.3390/dj6030030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background—The literature related to minimally invasive periodontal surgery is reviewed. This includes the original minimally invasive surgery (MIS) procedure for bone regeneration, the modification of MIS for the minimally invasive surgery technique (MIST) and modified MIST (M-MIST) procedures, and the introduction of the videoscope for oral surgical procedures and the ability to perform videoscope-assisted minimally invasive surgery (VMIS). The evolution from MIS through MIST to the current VMIS is reviewed. The results from studies of each of these methods are reported. Conclusion—The use of small incisions that produce minimal trauma and preserve most of the blood supply to the periodontal and peri-implant tissues results in improved regenerative outcomes, minimal to absent negative esthetic outcomes, and little or no patient discomfort. Minimally invasive procedures are a reliable method to regenerate periodontal tissues.
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18
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Kurian IG, Dileep P, Ipshita S, Pradeep AR. Comparative evaluation of subgingivally-delivered 1% metformin and Aloe vera gel in the treatment of intrabony defects in chronic periodontitis patients: A randomized, controlled clinical trial. ACTA ACUST UNITED AC 2018; 9:e12324. [PMID: 29981205 DOI: 10.1111/jicd.12324] [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: 07/05/2017] [Accepted: 12/10/2017] [Indexed: 11/27/2022]
Abstract
AIM The aim of the current study was to explore the effectiveness of locally-delivered 1% metformin (MtF) and Aloe vera (AV) gel as an adjunct to scaling and root planning (SRP) in the treatment of intrabony defects in chronic periodontitis patients. METHODS A total of 90 volunteers were randomly assigned to three treatment groups: (a) SRP + placebo gel; (b) SRP + 1% MtF gel; and (c) SRP + AV gel. Clinical parameters, including gingival index (GI), bleeding on probing (BoP), pocket probing depth (PPD), and clinical attachment level (CAL), were recorded at baseline, and 6 and 12 months. The radiological assessment of bone defect fill was done at 6 and 12 months. RESULTS GI, BoP, PPD, and CAL improved in all the groups; however, the mean PPD reduction, CAL gain, and percentage of bone fill was found to be greater in the MtF and AV groups than the placebo group at all visits. CONCLUSION Local delivery of 1% MtF and AV gel stimulates a significant PPD reduction, CAL gain, and improved bone fill and regeneration when compared with placebo gel. Results were significantly better with the use of 1% MtF gel than AV gel.
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Affiliation(s)
- Ida G Kurian
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Pankaj Dileep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Sahu Ipshita
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Avani R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
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19
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Capetillo JF, Coleman BG, Johnson TM. Combination Bone Replacement Graft with Dense Polytetrafluoroethylene Barrier Membrane for Treatment of an Infrabony Periodontal Defect. Clin Adv Periodontics 2018. [DOI: 10.1002/cap.10026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Joseph F. Capetillo
- Department of Periodontics; Korea Dental Health Activity; United States Army; Seoul Republic of Korea
| | - Brandon G. Coleman
- United States Army Advanced Education Program in Periodontics; Fort Gordon GA
- Department of Periodontics; Army Postgraduate Dental School; Uniformed Services University of the Health Sciences; Fort Gordon GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics; Fort Gordon GA
- Department of Periodontics; Army Postgraduate Dental School; Uniformed Services University of the Health Sciences; Fort Gordon GA
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20
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Alves AMM, de Miranda Fortaleza LM, Filho ALMM, Ferreira DCL, da Costa CLS, Viana VGF, Santos JZLV, de Oliveira RA, de Meira Gusmão GO, Soares LES. Evaluation of bone repair after application of a norbixin membrane scaffold with and without laser photobiomodulation (λ 780 nm). Lasers Med Sci 2018; 33:1493-1504. [DOI: 10.1007/s10103-018-2506-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/05/2018] [Indexed: 02/07/2023]
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21
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Crossman J, Elyasi M, El-Bialy T, Flores Mir C. Cementum regeneration using stem cells in the dog model: A systematic review. Arch Oral Biol 2018; 91:78-90. [PMID: 29684912 DOI: 10.1016/j.archoralbio.2018.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 03/27/2018] [Accepted: 04/01/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Restoring lost tissues of the periodontium, such as cementum, is essential in reducing the risk of tooth loss due to periodontitis and/or severe root resorption. Stem cell therapy is a regenerative strategy in cementum regeneration. This systematic review aimed to analyze the effect of various stem cells and their transplantation method on cementum regeneration in the dog model. METHODS Electronic databases were searched, in addition to performing hand searches and a gray literature search. Titles and abstracts were searched according to the inclusion criteria and full texts were selected to be included in this systematic review. Data was extracted from each article and risk of bias was assessed for individual studies. RESULTS Most studies reported that the treatment using a variety of stem cells resulted in significantly greater cementum regeneration. CONCLUSIONS Because of variations in additional factors included in each study and varied risk of bias among those studies, the effect of each type of stem cell on cementum regeneration in dogs is difficult to clarify. Additional information needs to be obtained from each study in order to further analyze the individual effect of stem cells on cementum regeneration in dogs.
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Affiliation(s)
| | - Maryam Elyasi
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tarek El-Bialy
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores Mir
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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22
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AN YZ, KIM YK, LIM SM, HEO YK, KWON MK, CHA JK, LEE JS, JUNG UW, CHOI SH. Physiochemical properties and resorption progress of porcine skin-derived collagen membranes: In vitro and in vivo analysis. Dent Mater J 2018; 37:332-340. [DOI: 10.4012/dmj.2017-065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yin-Zhe AN
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
| | - You-Kyoung KIM
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
| | - Su-Min LIM
- Biomaterials part, Research and Development Center, Neobiotech Co., Ltd
| | - Yeong-Ku HEO
- Global Academy of Osseointegration, Local Clinic
| | - Mi-Kyung KWON
- Biomaterials part, Research and Development Center, Neobiotech Co., Ltd
| | - Jae-Kook CHA
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
| | - Jung-Seok LEE
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
| | - Ui-Won JUNG
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
| | - Seong-Ho CHOI
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University
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23
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Graziani F, Karapetsa D, Mardas N, Leow N, Donos N. Surgical treatment of the residual periodontal pocket. Periodontol 2000 2017; 76:150-163. [PMID: 29193404 DOI: 10.1111/prd.12156] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 01/28/2023]
Abstract
The ultimate goal of periodontal therapy is to prevent further disease progression in order to reduce the risk of tooth loss. This objective can be achieved through a number of therapeutic modalities comprising both the nonsurgical and surgical phases of periodontal therapy. Nonsurgical periodontal treatment has been shown to control periodontal infection and to arrest progression of the disease in a significant number of cases. However, despite completion of nonsurgical treatment, a number of periodontal pockets, defined as 'residual', often remain. The presence of residual pockets may jeopardize tooth survival and be a risk factor of further disease progression, and ultimately tooth loss. Therefore, the aim of this review is to analyze the knowledge available on the indications for and the performance of periodontal surgical treatment of residual pockets in terms of 'traditional' (clinical, microbiological), patient-based and systemic health outcomes.
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24
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Chu C, Deng J, Sun X, Qu Y, Man Y. Collagen Membrane and Immune Response in Guided Bone Regeneration: Recent Progress and Perspectives. TISSUE ENGINEERING PART B-REVIEWS 2017; 23:421-435. [PMID: 28372518 DOI: 10.1089/ten.teb.2016.0463] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Chenyu Chu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jia Deng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xianchang Sun
- Yantai Zhenghai Bio-Tech, Laboratory of Shandong Province, Yantai, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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25
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De Bruyckere T, Eghbali A, Younes F, Cleymaet R, Jacquet W, De Bruyn H, Cosyn J. A 5-year prospective study on regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen-enriched bovine-derived xenograft. Clin Oral Investig 2017; 22:1235-1242. [DOI: 10.1007/s00784-017-2208-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
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26
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Mrunal DM, Jaypal JS, Wilson RS, Chatterjee A. Whale's tail technique: A case series. J Indian Soc Periodontol 2017; 20:460-463. [PMID: 28298831 PMCID: PMC5341324 DOI: 10.4103/0972-124x.188333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The Whale's tail technique performed to obtain maximum interdental papilla fill in the anterior region after placement of bone grafts. This study aims to assess the clinical efficacy of this new technique. This report describes a series of three cases with a probing depth of 6–7 mm in the maxillary anterior teeth and their treatment with Whale's tail technique to obtain regeneration and maximum papilla preservation. The cases in this report showed a pocket depth reduction of 3-4mm and a clinical attachment gain of 3-4mm. The application of the “Whale's tail” flap leads to clinically significant improvement of hard and soft tissue conditions and allows regeneration of wide intrabony defects involving the maxillary anterior teeth with notable interdental diastemas, maintaining interproximal tissue to recreate a functional attachment with esthetic results.
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Affiliation(s)
- Deshpande Milind Mrunal
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Jarde Samiksha Jaypal
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Rohan Srinivasan Wilson
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontics, The Oxford Dental College and Hospital, Bommanahalli, Bengaluru, Karnataka, India
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27
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Harrel SK, Nunn ME, Abraham CM, Rivera-Hidalgo F, Shulman JD, Tunnell JC. Videoscope Assisted Minimally Invasive Surgery (VMIS): 36-Month Results. J Periodontol 2017; 88:528-535. [PMID: 28183218 DOI: 10.1902/jop.2017.160705] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Clinical outcomes from videoscope assisted minimally invasive surgery (VMIS) at 36 to 58 months are reported. METHODS Fourteen patients having sites with residual probing depth (PD) of at least 5 mm and 2 mm loss of clinical attachment level (CAL) after initial non-surgical therapy were treated with VMIS. RESULTS At 36 months or greater post-surgery there was a statistically significant improvement (P <0.001) in mean PD and CAL (PD: 3.80 ± 1.18 mm, CAL: 4.16 ± 1.18 mm) in all surgical sites compared with baseline. There was a mean improvement in soft tissue height (0.36 ± 0.64 mm, P = 0.03). In most cases, patients reported no postoperative discomfort. CONCLUSIONS Improvements from VMIS appear to be favorable when compared with previously reported results of periodontal regenerative surgery. All improvements were stable over time. The lack of post-surgical recession after VMIS has not been reported with traditional regenerative surgery.
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Affiliation(s)
- Stephen K Harrel
- Department of Periodontology, Baylor College of Dentistry, Texas A&M University, Dallas, TX
| | - Martha E Nunn
- Department of Periodontology, Creighton University, Omaha, NE
| | - Celeste M Abraham
- Department of Periodontology, Baylor College of Dentistry, Texas A&M University, Dallas, TX
| | | | - Jay D Shulman
- Department of Periodontology, Baylor College of Dentistry, Texas A&M University, Dallas, TX
| | - John C Tunnell
- Department of Periodontology, Baylor College of Dentistry, Texas A&M University, Dallas, TX
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28
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Preservation of root cementum: a comparative evaluation of power-driven versus hand instruments. Int J Dent Hyg 2016; 16:202-209. [DOI: 10.1111/idh.12249] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 01/18/2023]
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29
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Lee BS, Lee CC, Lin HP, Shih WA, Hsieh WL, Lai CH, Takeuchi Y, Chen YW. A functional chitosan membrane with grafted epigallocatechin-3-gallate and lovastatin enhances periodontal tissue regeneration in dogs. Carbohydr Polym 2016; 151:790-802. [DOI: 10.1016/j.carbpol.2016.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 06/01/2016] [Accepted: 06/05/2016] [Indexed: 01/08/2023]
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30
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Collagen based barrier membranes for periodontal guided bone regeneration applications. Odontology 2016; 105:1-12. [DOI: 10.1007/s10266-016-0267-0] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
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31
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Biswas S, Sambashivaiah S, Kulal R, Bilichodmath S, Kurtzman GM. Comparative Evaluation of Bioactive Glass (Putty) and Platelet Rich Fibrin in Treating Furcation Defects. J ORAL IMPLANTOL 2016; 42:411-415. [PMID: 27267349 DOI: 10.1563/aaid-joi-d-16-00023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to compare a second-generation bioactive glass putty biomaterial against platelet rich fibrin in treating grade II furcation defects. Subjects were 15 systemically healthy patients (10 males and 5 females, ages 20-50 with a mean age of 38.33) with 20 mandibular molar class II furcation defects according to Glickman's classification. The 20 mandibular molar furcation defects were randomly allocated as follows: Group I, 10 furcation defects were treated using bioactive glass (NovaBone) bone graft putty material; Group II, 10 furcation defects were treated using platelet rich fibrin (PRF). Customized acrylic stents were fabricated on study casts and trimmed to the height contour of the teeth to serve as a fixed reference point for measurements. The following measurements were collected: gingival index, plaque index, vertical probing depth (from gingival margin to base of the pocket), clinical attachment level (CEJ to the base of the pocket), and horizontal probing depth of furcation involvement (using stent). Results showed that both groups had improvement in gingival index (GI) and plaque index (PI) at the recall intervals. There was an overall reduction in both vertical and horizontal probing depth in both groups; however, the Putty group (Group I) showed consistently more vertical probing depth reduction than the PRF group (Group II) at the end of third month (P-value = 0.0004), sixth month (P-value = 0.00001), and ninth month (P-value = 0.0004). Our conclusion was that use of bioactive glass osteostimulative biomaterial yields superior clinical results, including increased pocket depth reduction of class II furcation defects as compared to an autologous platelet concentrate. The clinical significance of our findings include the ease of use and superior biologic performance of second-generation putty bioglass biomaterials in furcation defects.
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Affiliation(s)
- Shriparna Biswas
- 1 Department of Periodontology, Rajarajeswari Dental College and Hospital, Karnataka, India
| | - Savita Sambashivaiah
- 1 Department of Periodontology, Rajarajeswari Dental College and Hospital, Karnataka, India
| | - Rithesh Kulal
- 1 Department of Periodontology, Rajarajeswari Dental College and Hospital, Karnataka, India
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Sukumar S, Dřízhal I, Paulusová V, Bukač J. Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta-Tricalcium Phosphate: Clinical Observations Two Years Post-Surgery. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016. [DOI: 10.14712/18059694.2016.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The study was designed to evaluate the clinical outcome of a composite material, beta-tricalcium phosphate in combination with calcium sulphate, in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. A total of 47 teeth with intrabony defects in 26 periodontitis patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK). Clinical parameters were evaluated which included changes in probing depth, clinical attachment level/loss and gingival recession at the baseline and 2 years postoperatively. The mean differences in measurements between the baseline and 2 years postoperatively were a reduction of 2.07±1.14 mm (p=0.000) in case of probing depth and a gain of 1.93±1.36 mm (p=0.000) in clinical attachment level; but an increase of 0.14±0.73 mm (p=0.571) in gingival recession. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects 2 years after the surgery.
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Avila-Ortiz G, De Buitrago JG, Reddy MS. Periodontal regeneration - furcation defects: a systematic review from the AAP Regeneration Workshop. J Periodontol 2016; 86:S108-30. [PMID: 25644295 DOI: 10.1902/jop.2015.130677] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this review is to present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy to provide clinical guidelines for the therapeutic management of furcation defects and to identify priorities for future research that may advance the understanding of periodontal regenerative medicine. METHODS A comprehensive search based on predetermined eligibility criteria was conducted to identify human original studies and systematic reviews on the topic of periodontal regeneration of furcation defects. Two reviewers independently screened the title and abstract of the entries yielded from the initial search. Subsequently, both reviewers read the full-text version of potentially eligible studies, made a final article selection, and extracted the data of the selected studies considering specific clinical scenarios. The clinical scenarios contemplated in this review included the following: 1) facial and interproximal Class I defects in maxillary molars; 2) facial and lingual Class I defects in mandibular molars; 3) facial and interproximal Class II furcation defects in maxillary molars; 4) facial and lingual Class II furcation defects in mandibular molars; 5) Class III furcation defects in maxillary molars; 6) Class III furcation defects in mandibular molars; and 7) Class I, II, or III furcation defects in maxillary premolars. Endpoints of interest included different clinical, radiographic, microbiologic, histologic, and patient-reported outcomes. RESULTS The initial search yielded a total of 1,500 entries. The final selection consisted of 150 articles, of which six were systematic reviews, 109 were clinical trials, 27 were case series, and eight were case reports. A summary of the main findings of previously published systematic reviews and the available evidence relative to the indication of regenerative approaches for the treatment of furcation defects compared with conventional surgical therapy are presented. Given the marked methodologic heterogeneity and the wide variety of materials and techniques applied in the selected clinical trials, the conduction of a meta-analysis was not viable. CONCLUSIONS On the basis of the reviewed evidence, the following conclusions can be drawn. 1) Periodontal regeneration has been demonstrated histologically and clinically for the treatment of maxillary facial or interproximal and mandibular facial or lingual Class II furcation defects. 2) Although periodontal regeneration has been demonstrated histologically for the treatment of mandibular Class III defects, the evidence is limited to one case report. 3) Evidence supporting regenerative therapy in maxillary Class III furcation defects in maxillary molars is limited to clinical case reports. 4) In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although most Class I furcation defects may be successfully treated with non-regenerative therapy. 5) Future research efforts should be primarily directed toward the conduction of clinical trials to test novel regenerative approaches that place emphasis primarily on patient-reported outcomes and also on histologic demonstration of periodontal regeneration. Investigators should also focus on understanding the influence that local, systemic, and technical factors may have on the outcomes of regenerative therapy in furcation defects.
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Kitamura M, Akamatsu M, Kawanami M, Furuichi Y, Fujii T, Mori M, Kunimatsu K, Shimauchi H, Ogata Y, Yamamoto M, Nakagawa T, Sato S, Ito K, Ogasawara T, Izumi Y, Gomi K, Yamazaki K, Yoshie H, Fukuda M, Noguchi T, Takashiba S, Kurihara H, Nagata T, Hamachi T, Maeda K, Yokota M, Sakagami R, Hara Y, Noguchi K, Furuuchi T, Sasano T, Imai E, Ohmae M, Koizumi H, Watanuki M, Murakami S. Randomized Placebo-Controlled and Controlled Non-Inferiority Phase III Trials Comparing Trafermin, a Recombinant Human Fibroblast Growth Factor 2, and Enamel Matrix Derivative in Periodontal Regeneration in Intrabony Defects. J Bone Miner Res 2016; 31:806-14. [PMID: 26547659 DOI: 10.1002/jbmr.2738] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 10/22/2015] [Accepted: 11/04/2015] [Indexed: 12/20/2022]
Abstract
We investigated the efficacy, safety, and clinical significance of trafermin, a recombinant human fibroblast growth factor (rhFGF)-2, for periodontal regeneration in intrabony defects in Phase III trials. Study A, a multicenter, randomized, double-blind, placebo-controlled study, was conducted at 24 centers. Patients with periodontitis with 4-mm and 3-mm or deeper probing pocket depth and intrabony defects, respectively, were included. A total of 328 patients were randomly assigned (2:1) to receive 0.3% rhFGF-2 or placebo, and 323 patients received the assigned investigational drug during flap surgery. One of the co-primary endpoints, the percentage of bone fill at 36 weeks after drug administration, was significantly greater in the rhFGF-2 group at 37.131% (95% confidence interval [CI], 32.7502 to 41.5123; n = 208) than it was in the placebo group at 21.579% (95% CI, 16.3571 to 26.8011; n = 100; p < 0.001). The other endpoint, the clinical attachment level regained at 36 weeks, was not significantly different between groups. Study B, a multicenter, randomized, blinded (patients and evaluators of radiographs), and active-controlled study was conducted at 15 centers to clarify the clinical significance of rhFGF-2. Patients with 6-mm and 4-mm or deeper probing pocket depth and intrabony defects, respectively, were included. A total of 274 patients were randomly assigned (5:5:2) to receive rhFGF-2, enamel matrix derivative (EMD), or flap surgery alone. A total of 267 patients received the assigned treatment during flap surgery. The primary endpoint, the linear alveolar bone growth at 36 weeks, was 1.927 mm (95% CI, 1.6615 to 2.1920; n = 108) in the rhFGF-2 group and 1.359 mm (95% CI, 1.0683 to 1.6495; n = 109) in the EMD group, showing non-inferiority (a prespecified margin of 0.3 mm) and superiority of rhFGF-2 to EMD. Safety problems were not identified in either study. Therefore, trafermin is an effective and safe treatment for periodontal regeneration in intrabony defect, and its efficacy was superior in rhFGF-2 compared to EMD treatments.
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Affiliation(s)
| | | | | | - Yasushi Furuichi
- School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan
| | - Takeo Fujii
- Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri, Japan
| | - Mari Mori
- School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan
| | - Kazushi Kunimatsu
- Dental Training Center, Kensei-kai Medical Incorporated Association, Numazu, Japan
| | | | - Yorimasa Ogata
- School of Dentistry at Matsudo, Nihon University, Matsudo, Japan
| | | | | | - Shuichi Sato
- School of Dentistry, Nihon University, Tokyo, Japan
| | - Koichi Ito
- School of Dentistry, Nihon University, Tokyo, Japan
| | | | - Yuichi Izumi
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuhiro Gomi
- School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Kazuhisa Yamazaki
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiromasa Yoshie
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Mitsuo Fukuda
- Dental Hospital, Aichi-Gakuin University, Nagoya, Japan
| | | | - Shogo Takashiba
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hidemi Kurihara
- Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshihiko Nagata
- Institute of Health Biosciences, Graduate School, University of Tokushima, Tokushima, Japan
| | | | - Katsumasa Maeda
- Medical Corporation Fukuwa-kai Beppu Dental Clinic, Fukuoka, Japan
| | - Makoto Yokota
- Medical Corporation Fukuwa-kai Beppu Dental Clinic, Fukuoka, Japan
| | | | - Yoshitaka Hara
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuyuki Noguchi
- Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Toshi Furuuchi
- Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Takashi Sasano
- Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Enyu Imai
- Nakayamadera Imai Clinic, Takarazuka, Japan
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Kamboj M, Arora R, Gupta H. Comparative evaluation of the efficacy of synthetic nanocrystalline hydroxyapatite bone graft (Ostim ®) and synthetic microcrystalline hydroxyapatite bone graft (Osteogen ®) in the treatment of human periodontal intrabony defects: A clinical and denta scan study. J Indian Soc Periodontol 2016; 20:423-428. [PMID: 28298825 PMCID: PMC5341318 DOI: 10.4103/0972-124x.184036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: To evaluate the relative efficacy of synthetic nanocrystalline hydroxyapatite (HA) (Ostim®) and microcrystalline HA (Osteogen®) bone grafts in the treatment of human periodontal intrabony defects clinically and radiographically through denta scan. Materials and Methods: Ten chronic periodontitis patients with bilateral intrabony periodontal defects of ≥2 mm radiographic defect depth below 55 years of age were selected randomly and treated with synthetic nanocrystalline HA (Ostim®) or synthetic microcrystalline HA (Osteogen®) bone graft. Clinical parameters including probing depth (PD) and clinical attachment level (CAL) were measured preoperatively and postoperatively at 3 and 6 months for each of the defects using an occlusal acrylic stent. Radiographic parameters were measured with the help of denta scan preoperatively and postoperatively at 6 months. Results: At 6 months following therapy, the Osteogen® group showed a reduction in mean PD from 11.10 ± 1.663 to 8.50 ± 0.850 mm and a change in mean CAL from 6.30 ± 1.160 to 3.40 ± 0.516 mm, whereas in the Ostim® group, the mean PD decreased from 11.20 ± 0.919 to 8.30 ± 0.823 mm and mean CAL decreased from 6.10 ± 0.738 to 3.30 ± 0.483 mm. At 6 months following therapy, denta scan showed a reduction in mean intrabony defect depth in the Osteogen® group from 2.54 ± 0.786 to 1.01 ± 0.448 mm, whereas in the Ostim® group, it was 2.71 ± 0.650 mm to 1.12 ± 0.563 mm. Conclusion: It was concluded that both the HA bone grafts produced statistically significant reduction in pocket depth, in the depth of osseous lesion, and a statistically significant gain in attachment level, irrespective of their physico-chemical properties.
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Affiliation(s)
- Monika Kamboj
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
| | - Ruchika Arora
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
| | - Harinder Gupta
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
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Ashri NY, Ajlan SA, Aldahmash AM. Dental pulp stem cells. Biology and use for periodontal tissue engineering. Saudi Med J 2015; 36:1391-9. [PMID: 26620980 PMCID: PMC4707394 DOI: 10.15537/smj.2015.12.12750] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/22/2015] [Indexed: 12/14/2022] Open
Abstract
Inflammatory periodontal disease is a major cause of loss of tooth-supporting structures. Novel approaches for regeneration of periodontal apparatus is an area of intensive research. Periodontal tissue engineering implies the use of appropriate regenerative cells, delivered through a suitable scaffold, and guided through signaling molecules. Dental pulp stem cells have been used in an increasing number of studies in dental tissue engineering. Those cells show mesenchymal (stromal) stem cell-like properties including self-renewal and multilineage differentiation potentials, aside from their relative accessibility and pleasant handling properties. The purpose of this article is to review the biological principles of periodontal tissue engineering, along with the challenges facing the development of a consistent and clinically relevant tissue regeneration platform. This article includes an updated review on dental pulp stem cells and their applications in periodontal regeneration, in combination with different scaffolds and growth factors.
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Affiliation(s)
- Nahid Y Ashri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Viswambaran M, Thiruvalluvan N. Prosthodontic rehabilitation protocols for immediate implants. Med J Armed Forces India 2015; 71:S440-3. [DOI: 10.1016/j.mjafi.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 06/11/2013] [Indexed: 11/26/2022] Open
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Poi WR, Sonoda CK, Martins CM, Melo ME, Pellizzer EP, de Mendonça MR, Panzarini SR. Storage media for avulsed teeth: a literature review. Braz Dent J 2015; 24:437-45. [PMID: 24474282 DOI: 10.1590/0103-6440201302297] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/01/2013] [Indexed: 11/22/2022] Open
Abstract
Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a wide array of types of wet storage media have been evaluated in laboratory studies and clinical reports, including cell and tissue culture solutions like Hank's Balanced Salt Solution (HBSS); medical/hospital products developed specifically for organ storage purposes, such as Viaspan® and Euro-Collins®; culture media, like Minimum Essential Medium (MEM); saline; natural products like water, saliva, bovine milk and its variations, propolis, green tea, Morus rubra (red mulberry), egg white and coconut water; rehydrating solutions, like Gatorade® and Ricetral, and even contact lens solutions. Based on the literature, it could be stated that, so far, apart from Based on the literature, it could be stated that, so far, apart from solutions designed specifically for storage and culture purposes, regular pasteurized whole milk is the most frequently recommended and with the best prognosis among other solutions that are likely to be available at the scene of an accident, such as water, saline or saliva. Its advantages include its high availability, ready accessibility, physiologically compatible pH and osmolality (fluid pressure) with the root-surface adhered PDL cells, presence of nutrients and growth factors. However, there is not yet a single solution that fulfills all requirements to be considered as the ideal medium for temporary storage of avulsed teeth, and research on this field should carry on.
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Zanatta FB, de Souza FG, Pinto TMP, Antoniazzi RP, Rösing CK. Do the clinical effects of enamel matrix derivatives in infrabony defects decrease overtime? A systematic review and meta-analysis. Braz Dent J 2015; 24:446-55. [PMID: 24474283 DOI: 10.1590/0103-6440201302192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 09/13/2013] [Indexed: 11/22/2022] Open
Abstract
Previous systematic reviews have demonstrated better results with enamel matrix derivative proteins (EMDP) as compared with open flap debridement (OFD) for the management of infrabony periodontal defects (IPD). The aim of this study was to determine whether these differences vary according to the follow-up and quality of the studies. Cochrane Central Register of Controlled Trials, Medline/PubMed, Lilacs, Embase and Web of Science electronic databases were searched up to August 2013 for randomized clinical trials.Eligible outcomes were changes in probing depth (PD), clinical attachment level (CAL),gingival recession (GR) and bone changes (BC). Studies with follow-up of 12 months showed differences of 0.97 mm (CI95% 0.52 - 1.43) and 1.19 mm (CI95% 0.77 - 1.60) for PD and CAL, respectively, favorable for EMDP. Studies with follow-up ≥ 24 months presented advantages of 1.11 mm (CI95% 0.74 -1.48) for CAL and 0.83 mm (CI95% 0.19 -1.48) for PD,with use of EMDP. Considering the quality of studies, those with low risk of bias showed lower difference between groups, presenting 0.8 mm (CI95% 0.24-1.36) for CAL, favorable for EMDP and without differences for PS (0.51 mm, CI95% -0.21 - 1.23). In conclusion, follow-up time (< or > 2 years) and the risk of bias influence the results of treatment with EMDP in IPD.
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Abstract
Periodontal regeneration-treatment that results in new alveolar bone, cementum, and a functional periodontal ligament-is successful in class II furcation defects. This article examines one aspect of periodontal regeneration-alveolar bone growth in furcation defects-in trying to answer the question, Can bone lost from furcations be regenerated? The best evidence for bone growth is histology but there is limited histologic evidence for bone growth in human furcation defects. There is more evidence from intraoperative measurements for hard tissue growth in treated furcation defects, but the nature of the hard tissue needs to be determined histologically.
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Affiliation(s)
- Joseph J Zambon
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214, USA.
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Rakmanee T, Griffiths GS, Auplish G, Darbar U, Petrie A, Olsen I, Donos N. Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: clinical outcomes at 6 and 12 months. Clin Oral Investig 2015; 20:1217-25. [PMID: 26411859 DOI: 10.1007/s00784-015-1608-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 09/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to compare clinical outcomes between guided tissue regeneration (GTR) and access flap (AF) surgery in patients with aggressive periodontitis (AgP). METHODS Eighteen AgP patients with similar bilateral intrabony defects were treated in this split-mouth, single-blinded, randomised, controlled clinical trial. All patients presented with ≥3 mm intrabony defects and ≥5 mm periodontal pocket depths (PPD). In each patient, one defect was treated with a polyglycolide membrane according to the GTR principle, whereas the contralateral side was treated with AF. For both sides, a simplified papilla preservation flap was used. At baseline, 6 and 12 months post-surgery, the clinical attachment levels (CAL) and PPD were evaluated. RESULTS At 6 and 12 months, at the GTR sites, the mean [95 % CI] CAL gain was 1.7 mm [1.1, 2.3] and 1.6 mm [0.9, 2.1], respectively, while the mean [95 % CI] PPD reduction was 2.3 mm [1.9, 2.8] and 2.4 mm [1.9, 2.8], respectively. Similar CAL (1.6 mm [1.0, 2.2] and 2.1 mm [1.4, 2.7]) and PPD (2.0 mm [1.5, 2.4] and 2.5 mm [2.0, 3.0]) outcomes were observed at the control sites at 6 and 12 months, respectively. Notably, at the GTR-treated sites, 13 subjects presented with various degrees of membrane exposure. CONCLUSIONS Both therapies were effective in the treatment of intrabony defects in AgP patients, and no statistically significant differences between them could be demonstrated, possibly as a result of the differing degrees of membrane exposure at the GTR sites. CLINICAL RELEVANCE Both periodontal regeneration and conventional periodontal surgery are effective treatments for AgP patients.
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Affiliation(s)
- Thanasak Rakmanee
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.,Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Gareth S Griffiths
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.,School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Gita Auplish
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Ulpee Darbar
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK
| | - Irwin Olsen
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - Nikolaos Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK. .,Department of Periodontology, UCL-Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD, UK.
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Barreras US, Méndez FT, Martínez REM, Valencia CS, Rodríguez PRM, Rodríguez JPL. Chitosan nanoparticles enhance the antibacterial activity of chlorhexidine in collagen membranes used for periapical guided tissue regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 58:1182-7. [PMID: 26478419 DOI: 10.1016/j.msec.2015.09.085] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 09/14/2015] [Accepted: 09/23/2015] [Indexed: 01/12/2023]
Abstract
Endodontic failure is mainly associated with the persistence of microbial infection in the root canal system and/or the periradicular area. Microorganisms and their toxins located in the root canal system may trigger apical periodontitis and tissue destruction. Tissue regeneration in periapical surgery by using membrane barriers has shown an improved healing and bone closure. However, bacterial membrane contamination is a main reason of failure. In this in vitro study, different brands of chlorhexidine, a combination of chitosan nanoparticles containing chlorhexidine were tested against Enterococcus faecalis on agar plate's cultures and infected collagen membranes. Our results indicated that chitosan nanoparticles acted synergistically with chlorhexidine, inhibiting and eliminating significantly a greater amount of colony former units in both BHI-agar cultures and infected collagen membranes. These results suggested that chitosan nanoparticles could be used to improve regenerative procedures in periapical surgery.
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Elkhatat EI, Elkhatat AE, Azzeghaiby SN, Tarakji B, Beshr K, Mossa H. Clinical and radiographic evaluation of periodontal intrabony defects by open flap surgery alone or in combination with Biocollagen(®) membrane: A randomized clinical trial. J Int Soc Prev Community Dent 2015; 5:190-8. [PMID: 26236678 PMCID: PMC4515801 DOI: 10.4103/2231-0762.159956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Guided tissue regeneration (GTR) is often incorporated in regenerative periodontal surgical procedures. However, the actual benefits of adding GTR to such a procedure remain undocumented. The purpose of this randomized controlled trial was to investigate the contribution of GTR to the outcomes of open flap debridement (OFD) in the treatment of intrabony defects. MATERIALS AND METHODS A total of 16 patients of both sexes satisfying the criteria of chronic periodontitis and each of whom displayed one intrabony defect were randomly assigned to two groups, i.e. either treated with open flap surgery and GTR (group 1) or with open flap surgery alone (group 2), in this parallel-arm study. The soft tissue and hard tissue measurements, including probing pocket depth (PD), clinical attachment level (CAL), and bone mineral density were recorded at baseline and 3,6 and 12 months after surgery. The differences with a P < 0.05 were considered significant. RESULTS Results showed that the membrane group showed significant difference when compared with open flap surgery alone, in relation to the degree of periodontal pocket, clinical attachment loss, and bone density. CONCLUSION The findings of this study suggest that biocollagen membrane could be considered as an option in the treatment of intrabony defects. Biocollagen membrane alone gives favorable clinical results in the treatment of intrabony defects. Open flap debridement resulted in acceptable clinical results in the treatment of intrabony defects.
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Affiliation(s)
- Essam I. Elkhatat
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Amr E. Elkhatat
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Saleh N. Azzeghaiby
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Khaled Beshr
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
| | - Hossam Mossa
- Department of Oral Maxillofacial Sciences, Al-Farabi College, Riyadh, Saudi Arabia
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Sanz M, Jepsen K, Eickholz P, Jepsen S. Clinical concepts for regenerative therapy in furcations. Periodontol 2000 2015; 68:308-32. [DOI: 10.1111/prd.12081] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
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Pradeep AR, Nagpal K, Karvekar S, Patnaik K, Naik SB, Guruprasad CN. Platelet-rich fibrin with 1% metformin for the treatment of intrabony defects in chronic periodontitis: a randomized controlled clinical trial. J Periodontol 2015; 86:729-37. [PMID: 25762357 DOI: 10.1902/jop.2015.140646] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that releases various growth factors that promote tissue regeneration. Metformin (MF), a member of the biguanide group, has been shown to facilitate osteoblast differentiation and thus may exhibit a favorable effect on alveolar bone. The current study is designed to evaluate the efficacy of open-flap debridement (OFD) combined with PRF, 1% MF gel, and PRF + 1% MF gel in the treatment of intrabony defects (IBDs) in patients with chronic periodontitis (CP). METHODS One hundred twenty patients with single defects were categorized into four treatment groups: OFD alone, OFD with PRF, OFD with 1% MF, and OFD with PRF plus 1% MF. Clinical parameters such as site-specific plaque index (PI), modified sulcus bleeding index (mSBI), probing depth (PD), relative attachment level (RAL), and gingival marginal level (GML) were recorded at baseline (before surgery) and 9 months postoperatively. Percentage radiographic IBD depth reduction was evaluated using computer-aided software at baseline and 9 months. RESULTS PRF, 1% MF, and PRF + 1% MF groups showed significantly more PD reduction and RAL gain than the OFD-only group. Mean PD reduction and mean RAL gain were found to be greater in the PRF + 1% MF group compared to just PRF or MF at 9 months. Furthermore, PRF + 1% MF group sites showed a significantly greater percentage of radiographic defect depth reduction (52.65% ± 0.031%) compared to MF (48.69% ± 0.026%), PRF (48% ± 0.029%), and OFD alone (9.14% ± 0.04%) at 9 months. CONCLUSION The PRF + 1% MF group showed greater improvements in clinical parameters, with greater percentage radiographic defect depth reduction compared to MF, PRF, or OFD alone in treatment of IBDs in patients with CP.
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Affiliation(s)
- A R Pradeep
- *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Kanika Nagpal
- *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Shruti Karvekar
- *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Kaushik Patnaik
- *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Savitha B Naik
- †Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute
| | - C N Guruprasad
- *Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India
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Reynolds MA, Kao RT, Nares S, Camargo PM, Caton JG, Clem DS, Fiorellini JP, Geisinger ML, Mills MP, Nevins ML, Rosen PS. Periodontal Regeneration - Intrabony Defects: Practical Applications From the AAP Regeneration Workshop. Clin Adv Periodontics 2015; 5:21-29. [PMID: 32689725 DOI: 10.1902/cap.2015.140062] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/04/2014] [Indexed: 11/13/2022]
Abstract
Focused Clinical Question: What are important considerations for selecting a predictable regenerative surgical approach for intrabony defects? Summary: The predictable regeneration of intrabony defects remains an important goal in the management of periodontitis. Clinical and histologic evidence of periodontal regeneration has been shown for multiple regenerative therapies, including bone replacement grafts, guided tissue regeneration, and biologics, when used alone or in combination. Regenerative therapies improve periodontal health, as evidenced by gains in clinical attachment level, reductions in probing depth, and gains in radiographic bone fill. Important patient-related factors (e.g., smoking) and defect/site-related factors (e.g., defect morphology and gingival biotype) can influence the potential to achieve periodontal regeneration. The regeneration of intrabony defects generally becomes more challenging with increasing loss of height, proximity, and number of bony walls. Therefore, combination therapies may be necessary to achieve predictable regeneration. Clinical improvements after regenerative therapy can be maintained over extended periods (≥10 years) with professional maintenance at appropriate intervals and adequate home care. Conclusions: Periodontal regeneration of intrabony defects is possible using a variety of regenerative strategies. Management should be coupled with an effective oral hygiene and supportive periodontal maintenance program for long-term success.
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Affiliation(s)
- Mark A Reynolds
- Department of Periodontics, School of Dentistry, University of Maryland, Baltimore, MD
| | - Richard T Kao
- Division of Periodontology, School of Dentistry, University of California at San Francisco, San Francisco, CA.,Private practice, Cupertino, CA
| | - Salvador Nares
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL
| | - Paulo M Camargo
- Section of Periodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, CA
| | - Jack G Caton
- Division of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | | | - Joseph P Fiorellini
- Department of Periodontics, College of Dentistry, University of Pennsylvania, Philadelphia, PA
| | - Maria L Geisinger
- Department of Periodontology, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Michael P Mills
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | | | - Paul S Rosen
- Department of Periodontics, School of Dentistry, University of Maryland, Baltimore, MD.,Private practice, Yardley, PA
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Arzate H, Zeichner-David M, Mercado-Celis G. Cementum proteins: role in cementogenesis, biomineralization, periodontium formation and regeneration. Periodontol 2000 2014; 67:211-33. [DOI: 10.1111/prd.12062] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 12/11/2022]
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Kukreja BJ, Dodwad V, Kukreja P, Ahuja S, Mehra P. A comparative evaluation of platelet-rich plasma in combination with demineralized freeze-dried bone allograft and DFDBA alone in the treatment of periodontal intrabony defects: A clinicoradiographic study. J Indian Soc Periodontol 2014; 18:618-23. [PMID: 25425824 PMCID: PMC4239752 DOI: 10.4103/0972-124x.142457] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 02/10/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The aim of the present clinical trial was to compare PRP combined with a DFDBA to DFDBA mixed with a normal saline solution in the treatment of human intrabony defects. MATERIALS AND METHODS Twenty interproximal intrabony osseous defects in twenty non-smoking, healthy subjects diagnosed with chronic periodontitis were treated in this study. Ten subjects each were randomly assigned to the test group (PRP + DFDBA) or the control group (DFDBA + saline). Clinical and radiographic measurements were made at baseline, three month and at six-month evaluation. RESULTS The results at three and six months, when compared to the baseline, indicated that both treatment modalities resulted in significant changes in all clinical parameters (gingival index, bleeding on probing, probing depth, clinical attachment level and gingival recession; P < 0.01) and radiographic parameters (hard-tissue fill and bone-depth reduction; P < 0.01). However, the test group exhibited statistically significantly greater changes compared to the control group in plaque index at three months (P = 0.00), probing depth reduction at 6 months (P = 0.02) and the radiographic defect fill at 6 months (P = 0.01). CONCLUSIONS Treatment with a combination of PRP and DFDBA led to a statistically significantly greater improvement in plaque index at 3 months, probing depth at 6 months and radiographic defect fill at 6 months in intrabony periodontal defects as compared to DFDBA with normal saline.
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Affiliation(s)
- Bhavna Jha Kukreja
- Department of Periodontology, I.T.S Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Vidya Dodwad
- Department of Periodontology, I.T.S Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Pankaj Kukreja
- Department of Oral and Maxillofacial Surgery, I.T.S Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Sakshi Ahuja
- Department of Private Practice in Periodontology, I.T.S Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Praful Mehra
- Department of Prosthodontics, I.T.S Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Soheilifar S, Soheilifar S, Bidgoli M, Torkzaban P. Barrier Membrane, a Device for Regeneration: Properties and Applications. ACTA ACUST UNITED AC 2014. [DOI: 10.17795/ajdr-21343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Periodontal responses to augmented corticotomy with collagen membrane application during orthodontic buccal tipping in dogs. BIOMED RESEARCH INTERNATIONAL 2014; 2014:873918. [PMID: 25276824 PMCID: PMC4174977 DOI: 10.1155/2014/873918] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 05/27/2014] [Accepted: 06/10/2014] [Indexed: 11/18/2022]
Abstract
This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60° and 28.12 ± 11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.
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