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Ye L, Mashrah MA, Ge L, Fang Y, Guo X, Ge Q, Wang L. Network meta-analysis of platelet-rich fibrin in periodontal intrabony defects. J Oral Pathol Med 2023; 52:206-215. [PMID: 36793244 DOI: 10.1111/jop.13409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/08/2023] [Accepted: 01/23/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To evaluate the effect of platelet-rich fibrin alone or in combination with different biomaterials for the treatment of periodontal intra-bony defect. METHODS Up to April 2022, Cochrane library, Medline, EMBASE, and Web of Science databases were searched for randomized clinical trials. The outcomes of interest were probing pocket depth reduction, clinical attachment level gain, bone gain, and bone defect depth reduction. Bayesian network meta-analysis with 95% credible intervals was calculated. RESULTS Thirty-eight studies with 1157 participants were included. Platelet-rich fibrin alone or platelet-rich fibrin +biomaterials showed a statistically significant difference when compared with open flap debridement (p < 0.05, low to high certainty evidence). Neither biomaterials alone nor platelet-rich fibrin +biomaterials showed a statistically significant difference when compared to platelet-rich fibrin alone (p > 0.05, very low to high certainty evidence). Platelet-rich fibrin +biomaterials showed insignificant differences as compared to biomaterials alone (p > 0.05, very low to high certainty evidence). Allograft +collagen membrane ranked the best in probing pocket depth reduction while platelet-rich fibrin +hydroxyapatite ranked the best in bone gain. CONCLUSION It seems that (1) platelet-rich fibrin with/without biomaterials were more effective than open flap debridement. (2) Platelet-rich fibrin alone provides a comparable effect to biomaterials alone and platelet-rich fibrin +biomaterials. (3) Platelet-rich fibrin +biomaterials provide a comparable effect to biomaterials alone. Although allograft +collagen membrane and platelet-rich fibrin +hydroxyapatite ranked the best in terms of probing pocket depth reduction and bone gain respectively, the difference between different regenerative therapies remains insignificant, and therefore, further studies are still needed to confirm these results.
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Affiliation(s)
- Lianmei Ye
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
- Department of Stomatology, Dongguan TungWah Hospital, Dongguan, Guangdong, China
| | - Mubarak Ahmed Mashrah
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Linhu Ge
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Ying Fang
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Xueqi Guo
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Qing Ge
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Liping Wang
- Department of Oral Implant, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
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Zhang X, Xu M, Xue Q, He Y. A modified method for constructing experimental rat periodontitis model. Front Bioeng Biotechnol 2023; 10:1098015. [PMID: 36714614 PMCID: PMC9873956 DOI: 10.3389/fbioe.2022.1098015] [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: 11/14/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Background: Periodontitis is a prevalent disease caused teeth lost. The present rat models inducing periodontitis with thread ligature and metal steel ligature have some disadvantages. Methods: We modified the existing rat ligature periodontitis model by fixing the thread ligature on the metal steel ligature passed through the gap between the first and second molars of rats with detailed modeling steps and illustrations. We research the pathological process of the periodontitis induced by the modified model, and briefly compared the modified model with the thread ligature model and the metal steel ligature model. Result: Our experimental results showed that there was an aggravation in inflammatory infiltration and alveolar bone resorption in modeling area within 14 days of initial induction. After that, the inflammatory infiltration was reduced. And no significant increase in alveolar bone destruction appeared. The modified model was more reliable compared to the thread ligature model, and had greater ability of bacterial aggregation compared to the metal steel ligature model. Conclusion: The modified method covered pathological process of the periodontitis, and showed sufficient efficiency and reliability in inducing rat periodontitis.
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Affiliation(s)
- Xuyang Zhang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China,Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Minglu Xu
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China,Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Xue
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China,Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yao He
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Yao He,
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Development of a Computational Tool for the Estimation of Alveolar Bone Loss in Oral Radiographic Images. COMPUTATION 2022. [DOI: 10.3390/computation10010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The present study evaluated a newly developed computational tool (CT) to assess the alveolar bone space and the alveolar crest angle and compares it to dentist assessment (GT). The novel tool consisted of a set of processes initiated with image enhancement, points localization, and angle and area calculations. In total, we analyzed 148 sites in 39 radiographic images, and among these, 42 sites were selected and divided into two groups of non-periodontitis and periodontitis. The alveolar space area (ASA) and alveolar crest angle (ACA) were estimated. The agreement between the computer software and the ground truth was analyzed using the Bland–Altman plot. The sensitivity and specificity of the computer tool were measured using the ROC curve. The Bland–Altman plot showed an agreement between the ground truth and the computational tool in all of the parameters assessed. The ROC curve showed 100% sensitivity and 100% specificity for 12.67 mm of the alveolar space area. The maximum percentage of sensitivity and specificity were 80.95% for 13.63 degrees of the alveolar crest angle. Computer tool assessment provides accurate disease severity and treatment monitoring for evaluating the alveolar space area (ASA) and the alveolar crest angle (ACA).
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Shukla S, Chug A, Mahesh L, Singh S, Singh K. Optimal management of intrabony defects: current insights. Clin Cosmet Investig Dent 2019; 11:19-25. [PMID: 30697083 PMCID: PMC6340362 DOI: 10.2147/ccide.s166164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Periodontitis is the most common condition, which causes bony defects. Intrabony defects thought not as common as the horizontal bone loss pose a risk of disease progression and thus should be managed optimally; however, it does not mean all the intrabony defects can be treated and all the mobile teeth saved! But, with the advent of new biomaterials prognosis of teeth can be improved. The objective of this article is to discuss old and new concepts toward the optimal management of intrabony defects.
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Affiliation(s)
- Sagrika Shukla
- Department of Dentistry (Periodontology), All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India,
| | - Ashi Chug
- Department of Dentistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | | | | | - Kuldeep Singh
- Department of Conservative Dentistry & Endodontics, RR Dental College, Udaipur, India
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Rams TE, Listgarten MA, Slots J. Radiographic alveolar bone morphology and progressive periodontitis. J Periodontol 2018; 89:424-430. [DOI: 10.1002/jper.17-0279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/30/2017] [Accepted: 10/01/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Thomas E. Rams
- Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA
- Department of Microbiology and Immunology; Temple University School of Medicine; Philadelphia PA
| | - Max A. Listgarten
- Department of Periodontics; University of Pennsylvania School of Dental Medicine; Philadelphia PA
| | - Jørgen Slots
- Division of Periodontology; Diagnostic Sciences and Dental Hygiene; University of Southern California School of Dentistry; Los Angeles CA
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Shivashankar VY, Johns DA, Maroli RK, Sekar M, Chandrasekaran R, Karthikeyan S, Renganathan SK. Comparison of the Effect of PRP, PRF and Induced Bleeding in the Revascularization of Teeth with Necrotic Pulp and Open Apex: A Triple Blind Randomized Clinical Trial. J Clin Diagn Res 2017; 11:ZC34-ZC39. [PMID: 28765825 DOI: 10.7860/jcdr/2017/22352.10056] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 03/06/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Treatment of a tooth with necrotic pulp and open apex is a special challenge to the clinicians. Apexification with calcium hydroxide and MTA barrier technique fails to induce continued root maturation which makes the tooth susceptible to root fracture. Hence, an ideal outcome for such a tooth should be regeneration of pulp like tissue into the root canal capable of continuing normal root maturation. AIM This study aims to compare the effect of Platelet Rich Fibrin (PRF), induced bleeding technique and Platelet Rich Plasma (PRP) in the revascularization of tooth with necrotic pulp and open apex. The main objectives of the study were to: (a) Radiographically evaluate the continuation of root development, increase in the dentin wall thickness and narrowing of canal space, apical closure and resolution of the periapical lesion; and to (b) To clinically evaluate the response to pulp sensibility testing and response to percussion and palpation tests. MATERIALS AND METHODS Sixty patients (6 to 28 years) with necrotic immature permanent tooth were randomly categorised into three groups after the root canal disinfection procedure. PRF as scaffolding material (Group A: n=20), revascularization with conventional induced bleeding technique (Group B: n=20), and PRP as the biomaterial (Group C: n=20). The primary outcome variable was measured using Periapical Index (PAI) (for periapical healing), Chen and Chen index (for apical responses), Schei's ruler (for root lengthening and root thickening) and other clinical parameters. The Chi-square test was used to interpret the data among the three groups at the end of 12 months for the variables root lengthening and lateral wall thickness. ANOVA test was performed to compare the mean of the PAI scores of the three groups at preoperative stage and 12 months. If statistically significant, Bonferroni test was done to compare the outcome among the three groups. The significant level was set at p<0.05. Kappa agreement was used to see whether the clinical criteria of success (asymptomatic) were in agreement with radiographic criteria. RESULTS At the end of 12 months, patients presented with no pain and no signs of reinfection or no radiographic enlargement of the pre-existing apical pathosis in all the three groups. PRP was better than PRF and induced bleeding technique with respect to periapical wound healing when used in the regenerative endodontic procedures. The groups were comparable on grounds of root lengthening and lateral wall thickening. Type 3 apical response was the most common apical response in all the three groups. CONCLUSION On analysing the pros and cons of the techniques performed, it is wise to establish induced bleeding technique as the standard endodontic procedure for revascularization of a non vital immature permanent tooth.
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Affiliation(s)
- Vasundara Yayathi Shivashankar
- Lecturer, Department of Conservative Dentistry and Endodontics, Srm Dental College, Ramapuram, Chennai, Tamilnadu, India
| | - Dexton Antony Johns
- Consultant Endodontist, Abhilash Dental Clinic, Mukkam, Calicut, Kerela, India
| | - Ramesh Kumar Maroli
- Professor and Head, Department of Conservative Dentistry and Endodontics, Government Dental College, Calicut, Kerala, India
| | - Mahalaxmi Sekar
- Professor and Head, Department of Conservative Dentistry and Endodontics, Srm Dental College, Ramapuram, Chennai, Tamilnadu, India
| | | | | | - Senthil Kumar Renganathan
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Srm Dental College, Ramapuram, Chennai, Tamilnadu, India
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Joseph V R, Sam G, Amol NV. Clinical evaluation of autologous platelet rich fibrin in horizontal alveolar bony defects. J Clin Diagn Res 2014; 8:ZC43-7. [PMID: 25584315 DOI: 10.7860/jcdr/2014/9948.5129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 08/27/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Horizontal bone loss is the most common periodontal problem confronting the clinician but has received little attention. Platelet rich fibrin (PRF) is a second generation platelet concentrate. The platelets, leucocytes, growth factors and cytokines contained within PRF make it a healing biomaterial with tremendous potential for bone and soft tissue regeneration. AIM This interventional clinical trial evaluates the clinical effectiveness of Autologous Platelet Rich Fibrin (PRF) in the management of horizontal bony defects. SETTINGS AND DESIGN Department of Periodontics. Design was Non Randomized Clinical Trial with split mouth design. MATERIALS AND METHODS A total of 45 sites with horizontal bone loss in 15 patients were studied, 15 sites were treated with PRF gel (experimental group I) and 15 sites were treated with PRF gel and PRF membrane (experimental group II). Control group (15 sites) were treated with open flap debridement. STATISTICAL ANALYSIS All the parameters were assessed at baseline and after nine months which included Pocket Depth (PD), Clinical Attachment level (CAL), Gingival Recession (REC) and Relative Crest Height (RCH). The mean changes at baseline and after 9 months within each group were compared using Wilcoxon Signed Ranks Test. The mean changes for each parameter between groups were compared using Kruskal Wallis Test. RESULTS Re-evaluation at nine months revealed that all groups showed a significant reduction in probing depth (1.1±0.38 mm in control, 1.73±0.53 mm in group I, 1.7±0.45 mm in group II)(p<0.05) and clinical attachment gain (0.86±0.58 mm in control, 1.56±0.62 mm in group I, 1.7±0.52 in group II)(p<0.05) as compared to baseline. Intergroup comparisons of reduction in probing depth and clinical attachment gain showed significant differences in the experimental groups as compared to control (p<0.05), but there was no significant difference between the experimental groups (p>0.05). There was no significant difference in gingival recession and radiographic bone levels at 9 months post surgery (p>0.05) in all the three groups. CONCLUSION Within the limitations of this study, it can be concluded that, clinically the use of PRF in both gel and membrane form is more effective than open flap debridement alone in the management of horizontal periodontal defects at nine months post surgery.
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Affiliation(s)
- Rosamma Joseph V
- Professor, Department of Periodontics, Government Dental College Calicut, Kerala, India
| | - George Sam
- Senior Resident, Department of Periodontics, Government Dental College , Kottayam, Kerala, India
| | - Nagrale Vijay Amol
- Senior Resident, Department of Periodontics, Government Dental College , Calicut, Kerala, India
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Moutinho RP, Coelho L, Silva A, Lobo Pereira JA, Pinto M, Baptista IP. Validation of a dental image-analyzer tool to measure the radiographic defect angle of the intrabony defect in periodontitis patients. J Periodontal Res 2012; 47:695-700. [DOI: 10.1111/j.1600-0765.2012.01483.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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