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Eldeeb DW, Hommos AM, Taalab MR, Abd El Rehim SS. Immuno-histologic and histomorphometric evaluation of Angelica sinensis adjunctive to ß-tricalcium phosphate in critical-sized class II furcation defects in dogs. BDJ Open 2023; 9:23. [PMID: 37353505 DOI: 10.1038/s41405-023-00150-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVE The study evaluates the effectiveness of Angelica sinensis (As) adjunctive to Beta-tricalcium phosphate (β-TCP) bone graft in the management of induced critical sized class II furcation defects in dogs. MATERIAL AND METHOD A randomized study design was conducted on the third and fourth premolars of six dogs. A total of twenty-four defects were surgically created. After reflecting a mucoperiosteal flap, twelve defects were filled with As granules mixed with β-TCP (Experimental group) while the other twelve defects were filled with β-TCP only (Control group) and both were covered by collagen membrane. At the fourth and eighth weeks, jaw segments were dissected and processed for immune-histological examination and histomorphometry analysis. RESULTS At four and eight weeks after treatment, experimental group showed a statistically significant increase in the height of newly formed interradicular bone (p = 0.001 and p = 0.0001 respectively), its surface area (p = 0.002 and p = 0.02 respectively), and the thickness of its trabeculae (p = 0.0001 and p = 0.001 respectively), when compared to control group. Moreover. alkaline phosphatase immunoreaction showed higher intensity in the osteoblast cells of experimental group compared to control group. CONCLUSION As enhances periodontal regeneration and bone-formation when used in the management of furcation defects.
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Affiliation(s)
- Dina W Eldeeb
- Oral Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ahmed M Hommos
- Oral Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha R Taalab
- Oral Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Abushahba F, Algahawi A, Areid N, Hupa L, Närhi T. Bioactive Glasses in Periodontal Regeneration
A Systematic Review
. Tissue Eng Part C Methods 2023; 29:183-196. [PMID: 37002888 DOI: 10.1089/ten.tec.2023.0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Bioactive glasses (BAGs) are surface-active ceramic materials that can be used in bone regeneration due to their known osteoconductive and osteoinductive properties. This systematic review aimed to study the clinical and radiographic outcomes of using BAGs in periodontal regeneration. The selected studies were collected from PubMed and Web of Science databases, and included clinical studies investigating the use of BAGs on periodontal bone defect augmentation between January 2000 and February 2022. The identified studies were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 115 full-length peer-reviewed articles were identified. After excluding duplicate articles between the databases and applying the inclusion and exclusion criteria, 14 studies were selected. The Cochrane risk of bias tool for randomized trials was used to assess the selected studies. Five studies compared using BAGs with open flap debridement (OFD) without grafting materials. Two of the selected studies were performed to compare the use of BAGs with protein-rich fibrin, one of which also included an additional OFD group. Also, one study evaluated BAG with biphasic calcium phosphate and used a third OFD group. The remaining six studies compared BAG filler with hydroxyapatite, demineralized freeze-dried bone allograft, autogenous cortical bone graft, calcium sulfate β-hemihydrate, enamel matrix derivatives, and guided tissue regeneration. This systematic review showed that using BAG to treat periodontal bone defects has beneficial effects on periodontal tissue regeneration. OSF Registration No.: 10.17605/OSF.IO/Y8UCR.
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Affiliation(s)
- Faleh Abushahba
- University of Turku, 8058, Department of Prosthetic Dentistry and Stomatognathic Physiology, Turku, Varsinais-Suomi, Finland,
| | - Ahmed Algahawi
- University of Turku, 8058, Department of Periodontology, Turku, Varsinais-Suomi, Finland,
| | - Nagat Areid
- University of Turku, 8058, Department of Prosthetic Dentistry and Stomatognathic Physiology Institute of Dentistry, University of Turku, Turku, Finland,
| | - Leena Hupa
- Åbo Akademi University, Johan Gadolin Process Chemistry Centre, Turku, Finland,
| | - Timo Närhi
- University of Turku Faculty of Medicine, 60654, Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, Turku, Finland,
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Histologic and histomorphometric evaluation of Aloe vera adjunctive to β-tricalcium phosphate in class II furcation defects in dogs. Sci Rep 2023; 13:4198. [PMID: 36918622 PMCID: PMC10015024 DOI: 10.1038/s41598-023-31282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Aloe vera has antimicrobial activity and enhances the osseointegration process, thus it may have the potential in treating periodontal defects. This study aimed to evaluate the effect of Aloe vera as an adjunction to Beta-tricalcium phosphate (β-TCP) bone graft in Grade II furcation defects. A randomized study was conducted on six healthy mongrel dogs' premolars. A total of twenty-four Grade II furcation critical-sized defects were surgically created after reflecting a full-thickness flap, twelve defects were filled with β-TCP while the other twelve defects were filled with Aloe vera mixed with β-TCP and both covered by collagen membrane. Animals were euthanized at the end of the fourth and eighth week and defects were analyzed histologically and histomorphometrically. Histologically, Aloe vera mixed with β-TCP resulted in more bone formation and new PDL fibers compared to β-TCP alone. After 2 and 4 weeks, the experimental group had significantly higher newly formed interradicular bone height (p < 0.0001, and p < 0.0001, respectively), bone thickness (p < 0.0001, and p < 0.0001, respectively), and percentage of the surface area (p = 0.009, and p = 0.023, respectively). Aloe vera gel adjunctive to β-TCP is an effective bioactive agent that enhances periodontal tissue regeneration and bone formation in critically sized defects.
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Sallum EA, Ribeiro FV, Ruiz KS, Sallum AW. Experimental and clinical studies on regenerative periodontal therapy. Periodontol 2000 2019; 79:22-55. [PMID: 30892759 DOI: 10.1111/prd.12246] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The recognition of a periodontal therapy as a regenerative procedure requires the demonstration of new cementum, periodontal ligament, and bone coronal to the base of the defect. A diversity of regenerative strategies has been evaluated, including root surface conditioning, bone grafts and bone substitute materials, guided tissue regeneration, enamel matrix proteins, growth/differentiation factors, combined therapies and, more recently, tissue-engineering approaches. The aim of this chapter of Periodontology 2000 is to review the research carried out in Latin America in the field of periodontal regeneration, focusing mainly on studies using preclinical models (animal models) and randomized controlled clinical trials. This review may help clinicians and researchers to evaluate the current status of the therapies available and to discuss the challenges that must be faced in order to achieve predictable periodontal regeneration in clinical practice.
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Affiliation(s)
- Enilson A Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Fernanda V Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Karina S Ruiz
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Antonio W Sallum
- Division of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
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Histologic evidence of periodontal regeneration in furcation defects: a systematic review. Clin Oral Investig 2019; 23:2861-2906. [PMID: 31165313 DOI: 10.1007/s00784-019-02964-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/16/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically review the available histologic evidence on periodontal regeneration in class II and III furcations in animals and humans. MATERIALS AND METHODS A protocol including all aspects of a systematic review methodology was developed including definition of the focused question, defined search strategy, study inclusion criteria, determination of outcome measures, screening methods, data extraction and analysis, and data synthesis. The focused question was defined as follows: "What is the regenerative effect obtained by using or not several biomaterials as adjuncts to open flap surgery in the treatment of periodontal furcation defects as evaluated in animal and human histological studies?" SEARCH STRATEGY Using the MEDLINE database, the literature was searched for articles published up to and including September 2018: combinations of several search terms were applied to identify appropriate studies. Reference lists of review articles and of the included articles in the present review were screened. A hand search of the most important dental journals was also performed. CRITERIA FOR STUDY SELECTION AND INCLUSION Only articles published in English describing animal and human histological studies evaluating the effect of surgical treatment, with or without the adjunctive use of potentially regenerative materials (i.e., barrier membranes, grafting materials, growth factors/proteins, and combinations thereof) for the treatment of periodontal furcation defects were considered. Only studies reporting a minimum of 8 weeks healing following reconstructive surgery were included. The primary outcome variable was formation of periodontal supporting tissues [e.g., periodontal ligament, root cementum, and alveolar bone, given as linear measurements (in mm) or as a percentage of the instrumented root length (%)] following surgical treatment with or without regenerative materials, as determined histologically/histomorphometrically. Healing type and defect resolution (i.e., complete regeneration, long junctional epithelium, connective tissue attachment, connective tissue adhesion, or osseous repair) were also recorded. RESULTS In animals, periodontal regeneration was reported in class II and III defects with open flap debridement alone or combined with various types of bone grafts/bone substitues, biological factors, guided tissue regeneration, and different combinations thereof. The use of biological factors and combination approaches provided the best outcomes for class II defects whereas in class III defects, the combination approaches seem to offer the highest regenerative outcomes. In human class II furcations, the best outcomes were obtained with DFDBA combined with rhPDGF-BB and with GTR. In class III furcations, evidence from two case reports indicated very limited to no periodontal regeneration. CONCLUSIONS Within their limits, the present results suggest that (a) in animals, complete periodontal regeneration has been demonstrated in class II and class III furcation defects, and (b) in humans, the evidence for substantial periodontal regeneration is limited to class II furcations. CLINICAL RELEVANCE At present, regenerative periodontal surgery represents a valuable treatment option only for human class II furcation defects but not for class III furcations.
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Martins L, Valente F, Reis E, Sepúlveda R, Perdigão A, Borges A. Treatment of periodontal disease with guided tissue regeneration technique using a hydroxyapatite and polycaprolactone membrane. ARQ BRAS MED VET ZOO 2016. [DOI: 10.1590/1678-4162-8322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The aim of this study was to evaluate the use of a malleable membrane composed of hydroxyapatite (60%) and polycaprolactone (40%) as treatment of periodontal disease experimentally induced in dogs. A bone defect of standardized dimensions was created between the roots of the third and fourth premolar of 12 dogs for periodontal disease induction. Six dogs had the defect covered by the membrane and six dogs received only standard treatment for periodontal disease, also applied to dogs in the treated group. The animals were clinically monitored during the experiment. Radiographs were taken after surgery and at 60 days after treatment initiation. Clinical attachment level was also assessed in those moments. On the 60th day, dental sample of all animals, containing tooth, defect and periodontal tissues, were harvested, fixed in formalin and analyzed by microtomography and histology. During the experimental period, the animals showed no pain and purulent discharge, however, there was dehiscence in 50% of animals and membrane exposure in five out of six animals in the treated group. Clinical attachment level showed no difference between groups. Radiographs showed radiopacity equal to the alveolar bone in both groups. The microtomography revealed that the control group had higher bone volume in the defect compared to the treated group; however, the furcation was not filled by new alveolar bone in any animal. Histological analysis revealed that junctional epithelium invasion was lighter in the control group. New bone was only observed in the apical edge of the defect in both groups. Although the composite is biocompatible and able to keep the space of the defect, it did not promote periodontal tissue regeneration within 60 days of observation.
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Luo J, Xu J, Cai J, Wang L, Sun Q, Yang P. The In Vitro and In Vivo Osteogenic Capability of the Extraction Socket-Derived Early Healing Tissue. J Periodontol 2016; 87:1057-66. [DOI: 10.1902/jop.2016.160078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Storrer CLM, Deliberador TM, Giovanini AF, Crivellaro V, Zielak JC, Romito GA. Effect of alendronate on the progression of periodontitis induced by Porphyromonas gingivalis and Fusobacterium nucleatum: a study in rats. Clin Oral Investig 2016; 20:2565-2573. [DOI: 10.1007/s00784-016-1769-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/29/2016] [Indexed: 01/03/2023]
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Mayer Y, Zigdon-Giladi H, Machtei EE. Ridge Preservation Using Composite Alloplastic Materials: A Randomized Control Clinical and Histological Study in Humans. Clin Implant Dent Relat Res 2016; 18:1163-1170. [PMID: 26922214 DOI: 10.1111/cid.12415] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/01/2016] [Indexed: 11/28/2022]
Abstract
AIM To evaluate (clinically, histologically, and histo-morphometrically) the use of composite materials (Biphasic calcium sulphate [BCS] with β Tri-Calcium Phosphate (β-TCP) and Hydroxyapatite [HA]) in extraction socket sites and compare it to un-disturbed natural healing. MATERIAL AND METHODS Prospective clinical trial of 36 patients (40 extraction sockets) were randomly assigned to either test or control group. Alveolar ridge horizontal dimension was measured in the middle of the socket at crest and 3 and 6 mm subcrestally. Crestal vertical height was measured at baseline surgery and at 4 month re-entry, at which time bone core biopsies were harvested from the center of the edentulous ridge. Histo-morphometric evaluation of the samples was performed using hematoxylin & eosin stains and morphometric software. RESULTS The change in horizontal ridge width was higher in the control compared to the experimental group: 2.28 ± 2.36 mm versus 0.03 ± 2.32 mm (p = .007) at -3 mm and 2.28 ± 2.43 versus 0.035 ± 3.05 (p = .02) at -6 mm, for the experimental and control sites, respectively. The vertical distance form bone crest to neighboring horizontal line interconnecting the neighboring teeth was minimal in both groups (0.307 ± 2.01 mm versus 0.14 ± 2.03 mm [p = 0.41]). Residual scaffolds occupied 15.99 ± 11.4% of the volume in the grafted (test) sites while bone area fraction was not statistically different among the groups (47.7 ± 10.6% versus 52.6 ± 11.6%, test versus control, respectively p = .39). The percentage of connective tissue in the control group was significantly higher that test group (36.3 ± 19.4% versus 46.7 ± 10.6% test versus control, respectively, p = .013). CONCLUSION Ridge preservation technique using a combination of two synthetic bone grafts β-TCP and HA with BCS resulted in greater stability in the horizontal dimension after 4 months.
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Affiliation(s)
- Yaniv Mayer
- Doctor, School of Graduate Dentistry, Department of Periodontics, Rambam Health Care Campus, Haifa, Israel
| | - Hadar Zigdon-Giladi
- Associate Professor, Head of Lab of Bone Regeneration, School of Graduate Dentistry, Department of Periodontics, Rambam Health Care Campus, Haifa, Israel
| | - Eli E Machtei
- Professor, Head of the School of Graduate Dentistry, Department of Periodontics, Rambam Health Care Campus, Haifa, Israel
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Pamuk F, Cetinkaya BO, Keles GC, Balli U, Koyuncuoglu CZ, Cintan S, Kantarci A. Ankaferd blood stopper enhances healing after osseous grafting in patients with intrabony periodontal defects. J Periodontal Res 2015; 51:540-7. [DOI: 10.1111/jre.12334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 11/27/2022]
Affiliation(s)
- F. Pamuk
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - B. O. Cetinkaya
- Department of Periodontology; Faculty of Dentistry; Ondokuzmayis University; Samsun Turkey
| | - G. C. Keles
- Department of Periodontology; Faculty of Dentistry; Ondokuzmayis University; Samsun Turkey
| | - U. Balli
- Department of Periodontology; Faculty of Dentistry; Bulent Ecevit University; Zonguldak Turkey
| | - C. Z. Koyuncuoglu
- Department of Periodontology; Faculty of Dentistry; Istanbul Aydin University; Istanbul Turkey
| | - S. Cintan
- Department of Periodontology; Faculty of Dentistry; Istanbul University; Istanbul Turkey
| | - A. Kantarci
- Department of Periodontology; Forsyth Institute; Cambridge MA USA
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Qin X, Zou F, Chen W, Xu Y, Ma B, Huang Z, Zhu G, Zhou B. Demineralized Dentin as a Semi-Rigid Barrier for Guiding Periodontal Tissue Regeneration. J Periodontol 2015; 86:1370-9. [PMID: 26317665 DOI: 10.1902/jop.2015.150271] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Guided tissue regeneration (GTR) is an accepted approach in the correction of periodontal bone loss. Nonetheless, the deficiencies of commonly applied absorbable membrane, such as flexibility and limited osteoconductive and osteoinductive capability, still leave much room for improvement. Thus, the feasibility of applying demineralized dentin tissue to improve the therapeutic effect of GTR in periodontal regeneration was explored. METHODS Demineralized dentin was harvested after acid treatment, and its physiochemical properties were assessed in terms of mineralization density, contact angle, three-point test, and cell attachment. Because of its similar characteristics with bone tissue, dentin that had been acid-treated for 6 hours was chosen to repair a periodontal defect using an induced-periodontitis canine model. Histologic measurements were taken to compare its therapeutic effects to an absorbable membrane group and an untreated group. RESULTS The demineralized dentin displayed continually decreased hardness and density as the acid etching time was prolonged. Enhanced attachment and spreading of bone marrow mesenchymal stem cells were observed on the 6-hour processed dentin. Furthermore, in the demineralized dentin group, more periodontal tissues were newly formed compared with the biomembrane and untreated groups. CONCLUSION Acid etching represents an easy and promising approach to obtain demineralized dentin with desirable properties, similar to bone, for clinical application to promote periodontal tissue regeneration.
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Affiliation(s)
- Xu Qin
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zou
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weimin Chen
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiwen Xu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhibin Huang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangxun Zhu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Zhou
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Shue L, Yufeng Z, Mony U. Biomaterials for periodontal regeneration: a review of ceramics and polymers. BIOMATTER 2014; 2:271-7. [PMID: 23507891 PMCID: PMC3568111 DOI: 10.4161/biom.22948] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Periodontal disease is characterized by the destruction of periodontal tissues. Various methods of regenerative periodontal therapy, including the use of barrier membranes, bone replacement grafts, growth factors and the combination of these procedures have been investigated. The development of biomaterials for tissue engineering has considerably improved the available treatment options above. They fall into two broad classes: ceramics and polymers. The available ceramic-based materials include calcium phosphate (eg, tricalcium phosphate and hydroxyapatite), calcium sulfate and bioactive glass. The bioactive glass bonds to the bone with the formation of a layer of carbonated hydroxyapatite in situ. The natural polymers include modified polysaccharides (eg, chitosan,) and polypeptides (collagen and gelatin). Synthetic polymers [eg, poly(glycolic acid), poly(L-lactic acid)] provide a platform for exhibiting the biomechanical properties of scaffolds in tissue engineering. The materials usually work as osteogenic, osteoconductive and osteoinductive scaffolds. Polymers are more widely used as a barrier material in guided tissue regeneration (GTR). They are shown to exclude epithelial downgrowth and allow periodontal ligament and alveolar bone cells to repopulate the defect. An attempt to overcome the problems related to a collapse of the barrier membrane in GTR or epithelial downgrowth is the use of a combination of barrier membranes and grafting materials. This article reviews various biomaterials including scaffolds and membranes used for periodontal treatment and their impacts on the experimental or clinical management of periodontal defect.
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Affiliation(s)
- Li Shue
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
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Chantarawaratit P, Sangvanich P, Banlunara W, Soontornvipart K, Thunyakitpisal P. Acemannan sponges stimulate alveolar bone, cementum and periodontal ligament regeneration in a canine class II furcation defect model. J Periodontal Res 2013; 49:164-78. [DOI: 10.1111/jre.12090] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2013] [Indexed: 12/13/2022]
Affiliation(s)
- P. Chantarawaratit
- Faculty of Dentistry; Dental Biomaterials Program; Graduate School; Chulalongkorn University; Bangkok Thailand
- Department of Materials Science; Faculty of Science; Chulalongkorn University; Bangkok Thailand
| | - P. Sangvanich
- Department of Chemistry; Faculty of Science; Chulalongkorn University; Bangkok Thailand
| | - W. Banlunara
- Department of Pathology; Faculty of Veterinary Science; Chulalongkorn University; Bangkok Thailand
| | - K. Soontornvipart
- Department of Surgery; Faculty of Veterinary Science; Chulalongkorn University; Bangkok Thailand
| | - P. Thunyakitpisal
- Research Unit of Herbal Medicine and Natural Product for Dental Application; Department of Anatomy; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
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Reis ECC, Borges APB, del Carlo RJ, Oliveira PM, Sepúlveda RV, Fernandes NA, Martins LMA, Carvalho TB. Guided tissue regeneration using rigid absorbable membranes in the dog model of chronic furcation defect. Acta Odontol Scand 2013; 71:372-80. [PMID: 22587413 DOI: 10.3109/00016357.2012.680909] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Absorbable membranes are used to promote the regeneration of periodontal defects by Guided Tissue Regeneration (GTR). However, their collapse into the defect is commonly reported, impairing regeneration. Therefore, absorbable but rigid membranes aiming at preventing such collapse were developed and analyzed in periodontal regeneration. MATERIALS AND METHODS Membranes were analyzed in class II furcation defects in dogs; procedures included periodontal disease induction, prophylaxis and GTR (treated groups) or open flap debridement alone (control group). For GTR, the membranes were made of either 25% hydroxyapatite (HA) in polyhydroxybutyrate matrix (PHB) or 35% HA in PHB. Animals were clinically evaluated for gingival recession, clinical attachment level (CAL) and biopsies were collected at 60 and 120 days. Bone volume, trabeculae number, trabecular thickness and trabecular separation were quantified by micro-computed tomography, followed by histology. RESULTS Membrane exposure was observed in both treated groups (25 and 35% HAP) from the 8(th) day after surgery, continuously progressing until 120 days. Mean CAL for all groups remained above normal values for dogs. Bone volumetric values were not significantly different. Partial formation of bone, cementum and periodontal ligament was observed in treated groups. An inflammatory infiltrate was observed in the dense connective tissue that partially filled the center of the treated defects with active osteoclasts on bone surface. CONCLUSION Although partial regeneration of the defect was observed, it was limited by wound contamination. Consequently, rigid absorbable membranes made of HA and PHB failed to improve the regeneration of class II furcation defects in dogs.
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Wohlfahrt JC, Aass AM, Rønold HJ, Heijl L, Haugen HJ, Lyngstadaas SP. Microcomputed Tomographic and Histologic Analysis of Animal Experimental Degree II Furcation Defects Treated With Porous Titanium Granules or Deproteinized Bovine Bone. J Periodontol 2012; 83:211-21. [DOI: 10.1902/jop.2011.110128] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Carlo Reis EC, Borges APB, Araújo MVF, Mendes VC, Guan L, Davies JE. Periodontal regeneration using a bilayered PLGA/calcium phosphate construct. Biomaterials 2011; 32:9244-53. [PMID: 21885122 DOI: 10.1016/j.biomaterials.2011.08.040] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 08/14/2011] [Indexed: 10/17/2022]
Abstract
The regeneration of tissues affected by periodontal disease is a complex process; it encompasses the formation of bone, cementum and periodontal ligament. We developed a semi-rigid PLGA (polylactide-co-glycolide acid)/CaP (calcium phosphate) bilayered biomaterial construct to promote periodontal regeneration, which has a continuous outer barrier membrane and an inner topographically complex component. Our experimental model compared periodontal prophylaxis alone with prophylaxis and biomaterial implantation in the treatment of class II furcation defects in dogs. Clinical evaluation, micro-computed tomography, histology and backscattered electron imaging were used for data analysis. Healing occurred uneventfully and bone volumetric values, trabecular number and trabecular thickness were all significantly greater in the treated group; while trabecular separation was significantly greater in the control group. New cementum, bone, and periodontal ligament with Sharpey fibre insertions were only seen in the treated group. Although periodontal regeneration has been reported elsewhere, the advantages of employing our bilayered PLGA + CaP construct are twofold: 1)it did not collapse into the defect; and, 2) its inner side was able to retain the blood clot throughout the buccal defect. The result was greater periodontal regeneration than has previously been reported with traditional flexible membranes.
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Affiliation(s)
- Emily C Carlo Reis
- Departamento de Veterinária, Universidade Federal de Viçosa, Campus Universitário s/n, Viçosa, Minas Gerais, CEP 36570-000, Brazil
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de Brito Bezerra B, Mendes Brazão MA, de Campos MLG, Casati MZ, Sallum EA, Sallum AW. Association of hyaluronic acid with a collagen scaffold may improve bone healing in critical-size bone defects. Clin Oral Implants Res 2011; 23:938-42. [PMID: 21689163 DOI: 10.1111/j.1600-0501.2011.02234.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the effects of a 1% hyaluronic acid (HA) gel in combination with an absorbable collagen sponge (ACS) in the healing of critical-size calvaria defects in rats. MATERIAL AND METHODS Thirty-two adult Wistar rats were used. Two 5-mm-diameter critical-size defects were created and the treatments were randomly distributed as follows: (1) 1% HA; (2) 1% HA gel-soaked ACS; (3) control (blood clot); and (4) ACS. The animals were sacrificed 60 days post-surgery, when biopsies were collected and processed for histology and histometric analysis. Bone fill was measured as the difference between the initial and the final defect sizes. Non-parametric tests were used to analyze differences between treatments (α=1%) and a t-test for body weight gain in each treatment group (α=5%). RESULTS Histological analysis showed bone formation on the edges of the defects, although very limited, and a thin layer of connective tissue occupying the midportion of the defects in the control and the ACS groups. Defects filled with a 1% HA gel and 1% HA gel+ACS had a thicker layer of connective tissue and more new bone formed in the margins of the defects. Linear histometric measures showed no significant differences in the initial defect sizes between the groups (P>0.05). The association 1% HA gel+ACS (0.96 ± 0.14 mm) had significantly greater bone fill than the control (0.5 ± 0.02 mm) and ACS (0.56 ± 0.05 mm)-treated groups (P=0.0043 and 0.0173, respectively). Treatment with a 1% HA gel (0.7 ± 0.14 mm) showed no significant differences when compared with the other treatments. CONCLUSION Within the limits of this study, a 1% HA gel associated with a collagen scaffold can improve new bone formation in critical-size defects. However, this treatment never resulted in complete closure of the defects and healing in the major portion of the defects was characterized by fibrous tissue.
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Affiliation(s)
- Beatriz de Brito Bezerra
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
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Kim CS, Um YJ, Chai JK, Cho KS, Moon IS, Choi SH, Jung UW, Lee DW, Kim CK. A canine model for histometric evaluation of periodontal regeneration. Periodontol 2000 2011; 56:209-26. [DOI: 10.1111/j.1600-0757.2010.00372.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Simsek SB, Keles GC, Baris S, Cetinkaya BO. Comparison of mesenchymal stem cells and autogenous cortical bone graft in the treatment of class II furcation defects in dogs. Clin Oral Investig 2010; 16:251-8. [PMID: 21086003 DOI: 10.1007/s00784-010-0486-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 10/28/2010] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to compare the effectiveness of mesenchymal stem cells (MSCs) with platelet-rich plasma (PRP) as scaffold and autogenous cortical bone (ACB) graft with and without PRP in the regenerative treatment of class II furcation defects in dogs. The mandibular second, third, and fourth premolars (P2, P3, P4) and maxillary P3 and P4 of both sides in three dogs were selected for experimentation. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, scaling + root planning (group 1), PRP (group 2), ACB (group 3), combination of ACB/PRP (group 4), and combination of MSCs/PRP (group 5) treatments were performed during open flap debridement. The percentage of cementum and alveolar bone formation was evaluated by histomorphometric analysis after a healing period of 8 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 3, 4, and 5 compared to the control group (P < 0.05) with no significant difference between groups 2, 3, 4, and 5. Alveolar bone formation was similar in all groups (P > 0.05). It can be concluded that periodontal regeneration with complete filling of class II furcation defects with cementum, alveolar bone, and periodontal ligament is obtained 8 weeks after ACB, ACB/PRP, and MSCs/PRP treatments; however, efficacy of none is higher than another.
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Thomas MV, Puleo DA. Calcium sulfate: Properties and clinical applications. J Biomed Mater Res B Appl Biomater 2009; 88:597-610. [DOI: 10.1002/jbm.b.31269] [Citation(s) in RCA: 211] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Paolantonio M, Perinetti G, Dolci M, Perfetti G, Tetè S, Sammartino G, Femminella B, Graziani F. Surgical Treatment of Periodontal Intrabony Defects With Calcium Sulfate Implant and Barrier Versus Collagen Barrier or Open Flap Debridement Alone: A 12-Month Randomized Controlled Clinical Trial. J Periodontol 2008; 79:1886-93. [DOI: 10.1902/jop.2008.080076] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Sculean A, Nikolidakis D, Schwarz F. Regeneration of periodontal tissues: combinations of barrier membranes and grafting materials - biological foundation and preclinical evidence: A systematic review. J Clin Periodontol 2008; 35:106-16. [DOI: 10.1111/j.1600-051x.2008.01263.x] [Citation(s) in RCA: 281] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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de Andrade PF, de Souza SLS, de Oliveira Macedo G, Novaes AB, de Moraes Grisi MF, Taba M, Palioto DB. Acellular Dermal Matrix as a Membrane for Guided Tissue Regeneration in the Treatment of Class II Furcation Lesions: A Histometric and Clinical Study in Dogs. J Periodontol 2007; 78:1288-99. [PMID: 17608584 DOI: 10.1902/jop.2007.060325] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate acellular dermal matrix (ADM) as a membrane for guided tissue regeneration (GTR) in the treatment of mandibular Class II furcation lesions and to compare it to a bioabsorbable membrane. METHODS Class II furcation lesions were created surgically and chronified in six mongrel dogs on the buccal surfaces of mandibular third and fourth premolars, bilaterally. After 1 month, GTR was performed. Each side was assigned randomly to the control group (CGr: bioabsorbable membrane made of polyglycolic acid: trimethylene carbonate) or the test group (TGr: ADM as a membrane). Clinical measurements of the width and thickness of the keratinized tissue (WKT and TKT, respectively) were made before GTR. The dogs were sacrificed 12 weeks following GTR, and histomorphometric analysis was performed. Area measurements were taken of new tissue, epithelium, connective tissue, and new bone; bone height and new cementum were measured. RESULTS The formation of new bone, cementum, and periodontal ligament were similar in both groups. There were no statistically significant differences between the groups for any histomorphometric measurement. The TGr had a statistically significant increase in WKT and TKT after 3 months. The mean TKT gain was 1.03 mm for the TGr and 0.26 mm for the CGr (P <0.05). CONCLUSION The ADM demonstrated histomorphometric results similar to the bioabsorbable membrane and resulted in a greater increase in the thickness of the keratinized tissue.
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Affiliation(s)
- Patrícia Freitas de Andrade
- Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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