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Matsuura T, Mikami R, Mizutani K, Shioyama H, Aoyama N, Suda T, Kusunoki Y, Takeda K, Izumi Y, Aida J, Aoki A, Iwata T. Assessment of bone defect morphology for the adjunctive use of bone grafting combined with enamel matrix derivative: A 3-year cohort study. J Periodontol 2024; 95:809-820. [PMID: 38029354 DOI: 10.1002/jper.23-0538] [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: 09/13/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND There have been limited studies with statistically sufficient sample sizes for assessment of suitable bone defect morphology for combination therapy with enamel matrix derivative (EMD) and bone grafting. The aim of this study was to investigate the appropriate feature of intrabony defects, such as bone defect angle (DA) and the containment by bony wall, for yielding the additional benefit of bone grafting in combination with periodontal regenerative therapy using EMD. METHODS Following periodontal regenerative therapy using EMD with or without autologous bone grafting, 282 intrabony defects of 177 participants were maintained for 3 years. Multilevel linear regression analysis was performed to evaluate the radiographic bony defect depth (RBD) reduction after adjusting for confounders. RESULTS The baseline parameters, except for the proportion of contained bony defects and tooth mobility, did not differ significantly between the groups with and without bone grafts. There was no significant difference in the improvement of clinical parameters between the groups. The 1- and 3-year reduction of RBD showed significant inverse correlations with preoperative DA only in the group without bone graft. Furthermore, multivariate analysis showed a significant interaction between DA at baseline ≥40° and adjunctive bone grafting in the reduction of RBD, regardless of the number of bony walls. CONCLUSION Adjunctive autologous bone grafting with enamel matrix derivative might be significantly beneficial for defect depth improvement in the case of DA at baseline ≥40°.
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Grants
- 20K18497 Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, Tokyo, Japan
- 19K10125 Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan, Tokyo, Japan
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Affiliation(s)
- Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, California, USA
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidehiro Shioyama
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, Kanagawa, Japan
| | - Tomonari Suda
- Department of Oral Surgery, Secomedic Hospital, Chiba, Japan
| | - Yukako Kusunoki
- Department of General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Oral Care Periodontics Center, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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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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Mikami R, Sudo T, Fukuba S, Takeda K, Matsuura T, Kariya T, Takeuchi S, Ochiai A, Kawamoto S, Toyoshima K, Mizutani K, Arakawa S, Aoki A, Iwata T. Prognostic factors affecting periodontal regenerative therapy using recombinant human fibroblast growth factor-2: A 3-year cohort study. Regen Ther 2022; 21:271-276. [PMID: 36092500 PMCID: PMC9440263 DOI: 10.1016/j.reth.2022.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/04/2022] [Accepted: 07/28/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Fibroblast growth factor-2 (FGF-2) has been reported to promote periodontal tissue regeneration. However, no study has investigated the long-term prognosis of periodontal regenerative therapy using FGF-2 to date. The aim of this study was to observe the long-term outcomes as well as to investigate the factors affecting the prognosis of periodontal regenerative therapy using FGF-2. Methods Sixty intrabony defects were prospectively investigated for three years after periodontal regenerative therapy with recombinant human FGF-2 (rhFGF-2) by evaluating probing pocket depth (PPD) and radiographic bone defect depth (RBD). The factors influencing RBD were assessed by conducting a multivariate linear regression analysis after adjusting for confounders. Results The mean age of the participants was 62.4 ± 13.4 years, and baseline PPD and RBD were 6.1 ± 1.9 mm and 4.5 ± 1.8 mm, respectively. At six months, one year, and three years after surgery, PPD and RBD had significantly improved to 4.2 ± 1.7, 3.7 ± 1.4, 4.0 ± 1.9 mm and to 3.08 ± 2.05, 2.73 ± 1.90, 2.51 ± 2.15 mm, respectively. At the three-year examination, a significant positive association was deteced between RBD reduction and RBD at baseline, while the association was not significant between RBD reduction and the radiographic bony angle, number of bony walls of the defect, or the furcation involvement at baseline. Conclusions rhFGF-2 was effective for alveolar bone regeneration in patients with periodontitis and maintained the improved parameters over the three-year observation period. The radiographic bone defect depth at baseline was found to be the factor affecting the periodontal regenerative therapy using rhFGF-2 in the intrabony defects. Trial registration number UMIN000027979. Mid-term observation following periodontal regenerative therapy using rhFGF-2. Reductions in PPD and radiographic defect depth were maintained for 3 years. Evaluation of prognostic factors of rhFGF-2 application in intrabony defects. Preoperative radiographic defect depth predicts postoperative bone fill.
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Affiliation(s)
- Risako Mikami
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeaki Sudo
- Institute of Education, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Fukuba
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, CA, USA
| | - Tomoaki Kariya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Shunsuke Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Akane Ochiai
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Sakurako Kawamoto
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Keita Toyoshima
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
- Corresponding author. Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. Fax: +81 3 5803-0196.
| | - Shinichi Arakawa
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Medical and Dental University, Tokyo, Japan
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Predictability and Clinical Stability of Barrier Membranes in Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12104835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The adjunctive use of GTR membranes helps us to achieve predictable periodontal regeneration. The aim of this systematic review was to evaluate and compare the treatment efficacy of resorbable versus non-resorbable barrier membranes used in guided tissue regeneration in the treatment of intrabony defects in chronic periodontitis patients. The following databases were searched: Medline, the Cochrane Central Register of Controlled Trails (CENTRAL), SCOPUS, EMBASE. Randomized clinical trials (RCTs) published in English languages over the past 25 years were included. The primary outcomes assessed were: change of probing pocket depth (PD), change in clinical attachment level (CAL) and gingival recession coverage (GRC), and intrabony defect fill (IBDF). A total of eight RCTs were included for systematic review. The outcome of GR at a six-month interval revealed a significant difference in treatment effect with a mean difference of 0.42, 95% CI [0.02, 0.81]; Z = 2.09, (p = 0.04) favouring the resorbable membrane group. The intrabony defect depth fill at a 12-month interval revealed a significant difference in treatment effect with MD of 0.79, p = 0.00001; favoring the resorbable membrane group. The resorbable membrane showed a significant improvement in gingival recession coverage and intrabony defect fill, owing to its advantage of avoiding the second surgical intervention.
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Mikami R, Mizutani K, Shioyama H, Matsuura T, Aoyama N, Suda T, Kusunoki Y, Takeda K, Izumi Y, Aida J, Aoki A, Iwata T. Influence of aging on periodontal regenerative therapy using enamel matrix derivative: A 3-year prospective cohort study. J Clin Periodontol 2021; 49:123-133. [PMID: 34545600 DOI: 10.1111/jcpe.13552] [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: 07/05/2021] [Revised: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022]
Abstract
AIM To investigate the influence of chronological aging on periodontal regenerative therapy (PRT) outcomes with enamel matrix derivative (EMD). MATERIALS AND METHODS In total, 253 intra-bony defects (151 patients) including 44 furcation involvement were prospectively investigated for 3 years after regenerative therapy with EMD by evaluating probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone defect depth (RBD). The influence of age on these outcomes was assessed using multilevel regression analyses adjusting for confounders. RESULTS Participants' mean age was 55.9 ± 12.3 years (range: 22-85). Baseline PPD, CAL, and RBD were 6.14 ± 1.82, 7.22 ± 2.14, and 5.08 ± 2.04 mm, respectively. Significant improvement was observed with PPD reductions of 2.84 ± 1.73 and 2.87 ± 1.87 mm, CAL gains of 2.40 ± 1.87 and 2.47 ± 1.89 mm, and RBD gains of 1.76 ± 1.98 and 2.39 ± 2.41 mm at 1- and 3-year examinations, respectively. At the 1-year examination, multivariate analysis revealed a significant negative association between age and improvement in PPD and CAL (coefficients: -0.13, -0.23 mm per 10 years). However, by the 3-year examination, no significant association was noted between age and improvement in PPD, CAL, or RBD. CONCLUSION Although the statistical difference was detected with age at 1-year examination, PRT with EMD significantly improved clinical outcomes on long-term observation, irrespective of the patient's age. CLINICAL TRIAL REGISTRATION NUMBER UMIN000039846.
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Affiliation(s)
- Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidehiro Shioyama
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Aichi, Japan
| | - Norio Aoyama
- Department of Periodontology, Kanagawa Dental University, Kanagawa, Japan
| | - Tomonari Suda
- Department of Oral Surgery, Secomedic Hospital, Chiba, Japan
| | - Yukako Kusunoki
- Graduate School of Medical and Dental Sciences, Behavioral Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Oral Care Perio Center, Southern Tohoku Research Institute for Neuroscience Southern Tohoku General Hospital, Fukushima, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Mizutani K, Shioyama H, Matsuura T, Mikami R, Takeda K, Izumi Y, Aoki A, Iwata T. Periodontal regenerative therapy in patients with type 2 diabetes using minimally invasive surgical technique with enamel matrix derivative under 3-year observation: A prospective cohort study. J Periodontol 2020; 92:1262-1273. [PMID: 33301187 DOI: 10.1002/jper.20-0590] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Information regarding periodontal regenerative therapy in patients with diabetes mellitus (DM) is limited. This pilot study compared the regenerative outcomes of minimally invasive periodontal surgery using enamel matrix derivative (EMD) between DM and non-DM patients. METHODS This prospective study included deep intrabony defects in patients with or without type 2 DM. Minimally invasive surgical technique (MIST) or modified MIST (M-MIST) using EMD, without bone graft materials, was performed. Periodontal examination and intraoral radiography were performed at baseline, 6 months, and 1 and 3 years after surgery. RESULTS Ten sites of 10 subjects in the DM group, and 20 sites of 18 subjects in non-DM group were evaluated (mean age; 67.5 ± 7.6 and 63.1 ± 9.7, respectively). Probing depth significantly decreased from 7.1 ± 1.6 and 7.0 ± 1.3 mm to 2.2 ± 0.9 and 2.3 ± 1.1 mm at the 1-year examination in the DM and non-DM groups, respectively. Clinical attachment level (CAL) gain and radiographical defect fill at the 3-year examination were 3.8 ± 1.1 mm and 58.3% ± 10.4%, respectively, in the DM group, and 4.1 ± 1.1 mm and 65.5% ± 18.8%, respectively, in the non-DM group, showing no significant differences between the groups. Multiple regression analysis showed no significant association of CAL gain with DM or age after adjustments for relevant confounders. CONCLUSIONS This is the first documented study of successful periodontal tissue regeneration in patients with DM. Minimally invasive surgery combined with EMD yielded significant clinical attachment gain and bone fill in the DM and non-DM groups at comparable levels.
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Affiliation(s)
- Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hidehiro Shioyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Matsuura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Oral Care Perio Center, Southern Tohoku General Hospital, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Carvalho BAS, Duarte CAB, Silva JF, Batista WWDS, Douglas-de-Oliveira DW, de Oliveira ES, Soares LDG, Galvão EL, Rocha-Gomes G, Glória JCR, Gonçalves PF, Flecha OD. Clinical and radiographic evaluation of the Periodontium with biologic width invasion. BMC Oral Health 2020; 20:116. [PMID: 32299404 PMCID: PMC7164352 DOI: 10.1186/s12903-020-01101-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background The biologic width is defined as the coronal dimension to the alveolar bone that is occupied by healthy gingival tissue. The objective of the present study was to correlate radiographic findings of biologic width invasion with the periodontium status. Methods It were included 14 patients with restored teeth with biological width invasion, on the proximal sites, observed clinically and radiographically. 122 proximal sites were evaluated, 61 in the test group (biological width invasion) and 61 in the control group (adequate biological width). Smokers and patients presenting periodontal disease or restorations with contact in eccentric movements, horizontal over-contour or secondary caries were excluded from the sample. The invasion of the biologic width was diagnosed when the distance from the gingival margin of restoration to the bony crest was less than 3 mm. Intrabony defect and bone crest level, as well as, their vertical and horizontal components were radiographically evaluated when present. Plaque index, bleeding on probing, probing depth, gingival recession height, keratinized gingival height and thickness, and clinical attachment level were clinically evaluated. Data were subjected to Spearman’s Correlation and Wilcoxon’s test. Result The most prevalent tooth with biological width invasion was the first molar. There was a statistically significant correlation between the bone crest (p < 0.001), vertical (p < 0.001) and horizontal (p = 0.001) components. In the test group, there was a statistically significant correlation between bleeding on probing (p < 0.001; r = 0.618) and width of gingival recession (p = 0.030; r = − 0.602) with the intraosseous component; and between keratinized gingival height and bone level (p = 0.037; r = − 0.267). In the control group, there was a correlation between plaque index (p = 0.027; r = − 0.283) with bone level and correlation between keratinized gingival thickness and bone level (p = 0.034; r = − 0.273) and intrabony component (p = 0.042; r = 0.226). Conclusion A statistically significant relationship was found between bleeding on probing and gingival recession in patients who presented intrabony defects due to the invasion of biological width, which may be also related to the thickness of the keratinized gingiva.
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Affiliation(s)
- Bruna Almeida Silva Carvalho
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - César Augusto Barroso Duarte
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Jaciara Fagundes Silva
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Walter Winícius da Silva Batista
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Dhelfeson Willya Douglas-de-Oliveira
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil.
| | - Evandro Silveira de Oliveira
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Luana de Goés Soares
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Endi Lanza Galvão
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Gabriela Rocha-Gomes
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - José Cristiano Ramos Glória
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Patrícia Furtado Gonçalves
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
| | - Olga Dumont Flecha
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, n° 187. Centro, Diamantina, MG, 39100-000, Brazil
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Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: subtraction radiography outcomes, prognostic variables, and patient morbidity. Clin Oral Investig 2018; 23:3005-3020. [PMID: 30374832 PMCID: PMC7398389 DOI: 10.1007/s00784-018-2712-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
Abstract
Objectives The main objectives of this study were (1) to evaluate bone/graft density alterations by digital subtraction radiography; (2) to determine factors associated with favorable clinical and radiographic outcomes, and (3) to report on patient morbidity after guided tissue regeneration (GTR) in aggressive periodontitis (AgP) patients. Materials and methods Adapting a split-mouth design, 30 comparative intrabony defects in 15 patients were randomly treated with xenogenic graft plus modified perforated membranes (MPM, tests) or xenogenic graft plus standard collagen membranes (CM, controls). The time period of observation was 12 months. Results There were significant improvements in clinical and radiographic parameters within each group, without intergroup differences. However, higher PPD reduction for three-wall defects was noted in MPM sites (5.22 versus 3.62 mm; p = 0.033). Moreover, a significant gain in bone/graft density of 4.9% from 6 to 12 months post-operatively was observed in test sites. Multivariate analysis demonstrated that morphology of intrabony defects was a predictor of CAL gain (p = 0.06), while independent prognostic variables effecting changes in bone/graft density were radiographic defect depth (p = 0.025) and radiographic angle (p = 0.033). The majority of patients reported some discomfort, pain, and edema with mild intensity without any significant differences between treatment modalities. Conclusions This study demonstrated enhanced bone/graft density gain after GTR with MPM, which may indicate greater area of new bone formation. Independent variables effecting treatment outcomes were intrabony defect morphology, radiographic defect depth, and radiographic angle. Clinical relevance This study supports the regenerative treatment of intrabony defects in AgP patients and identifies some variables with prognostic value.
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Nociti FH, Casati MZ, Duarte PM. Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 2000 2015; 67:187-210. [PMID: 25494601 DOI: 10.1111/prd.12063] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 02/05/2023]
Abstract
This literature review provides an overview of the current scenario regarding the impact of smoking on the progression and treatment of periodontitis; clinical, microbiological and immunological data from studies from our and other groups are presented. In general, preclinical and clinical data are unanimous in demonstrating that smokers present increased susceptibility, greater severity and faster progression of periodontal disease compared with nonsmokers. The evidence further demonstrates that smokers lose more teeth and have a less favorable response to therapy than do nonsmokers. Although it is well established that smoking significantly impacts on the onset, progression and outcome of periodontal disease, the mechanisms involved remain unclear. More importantly, some of the reported deleterious effects of smoking on periodontal tissues have been reported to be reversible upon participation in smoking-cessation programs. Therefore, clinicians should strongly advise smokers to enroll in cessation strategies, even temporarily, in order to improve the overall outcome.
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Mathur A, Bains VK, Gupta V, Jhingran R, Singh GP. Evaluation of intrabony defects treated with platelet-rich fibrin or autogenous bone graft: A comparative analysis. Eur J Dent 2015; 9:100-108. [PMID: 25713492 PMCID: PMC4319284 DOI: 10.4103/1305-7456.149653] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The primary objective of this study was to compare clinically and radiographically the efficacy of autologous platelet rich fibrin (PRF) and autogenous bone graft (ABG) obtained using bone scrapper in the treatment of intrabony periodontal defects. MATERIALS AND METHODS Thirty-eight intrabony defects (IBDs) were treated with either open flap debridement (OFD) with PRF or OFD with ABG. Clinical parameters were recorded at baseline and 6 months postoperatively. The defect-fill and defect resolution at baseline and 6 months were calculated radiographically (intraoral periapical radiographs [IOPA] and orthopantomogram [OPG]). RESULTS Significant probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, defect fill and defect resolution at both PRF and ABG treated sites with OFD was observed. However, inter-group comparison was non-significant (P > 0.05). The bivariate correlation results revealed that any of the two radiographic techniques (IOPA and OPG) can be used for analysis of the regenerative therapy in IBDs. CONCLUSION The use of either PRF or ABG were effective in the treatment of three wall IBDs with an uneventful healing of the sites.
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Affiliation(s)
- Ashish Mathur
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Vivek Gupta
- Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Rajesh Jhingran
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - G. P. Singh
- Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Kao RT, Nares S, Reynolds MA. Periodontal regeneration - intrabony defects: a systematic review from the AAP Regeneration Workshop. J Periodontol 2014; 86:S77-104. [PMID: 25216204 DOI: 10.1902/jop.2015.130685] [Citation(s) in RCA: 164] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous systematic reviews of periodontal regeneration with bone replacement grafts and guided tissue regeneration (GTR) were defined as state of the art for clinical periodontal regeneration as of 2002. METHODS The purpose of this systematic review is to update those consensus reports by reviewing periodontal regeneration approaches developed for the correction of intrabony defects with the focus on patient-, tooth-, and site-centered factors, surgical approaches, surgical determinants, and biologics. This review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews. A computerized search of the PubMed and Cochrane databases was performed to evaluate the clinically available regenerative approaches for intrabony defects. The search included screening of original reports, review articles, and reference lists of retrieved articles and hand searches of selected journals. All searches were focused on clinically available regenerative approaches with histologic evidence of periodontal regeneration in humans published in English. For topics in which the literature is lacking, non-randomized observational and experimental animal model studies were used. Therapeutic endpoints examined included changes in clinical attachment level, changes in bone level/fill, and probing depth. For purposes of analysis, change in bone fill was used as the primary outcome measure, except in cases in which this information was not available. The SORT (Strength of Recommendation Taxonomy) grading scale was used in evaluating the body of knowledge. RESULTS 1) Fifty-eight studies provided data on patient, tooth, and surgical-site considerations in the treatment of intrabony defects. 2) Forty-five controlled studies provided outcome analysis on the use of biologics for the treatment of intrabony defects. CONCLUSIONS 1) Biologics (enamel matrix derivative and recombinant human platelet-derived growth factor-BB plus β-tricalcium phosphate) are generally comparable with demineralized freeze-dried bone allograft and GTR and superior to open flap debridement procedures in improving clinical parameters in the treatment of intrabony defects. 2) Histologic evidence of regeneration has been demonstrated with laser therapy; however, data are limited on clinical predictability and effectiveness. 3) Clinical outcomes appear most appreciably influenced by patient behaviors and surgical approach rather than by tooth and defect characteristics. 4) Long-term studies indicate that improvements in clinical parameters are maintainable up to 10 years, even in severely compromised teeth, consistent with a favorable/good long-term prognosis.
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Shioyama H, Mizutani K, Aoyama N, Suda T, Tanaka K, Endo A, Kusunoki Y, Yamawaki F, Fujiwara-Takahashi K, Kinoshita A, Arakawa S, Oda S, Izumi Y. Evaluation of Advanced Dental Technology with Enamel Matrix Derivative and Examination of Prognostic Factors in Periodontal Regenerative Therapy. ACTA ACUST UNITED AC 2014. [DOI: 10.2329/perio.56.302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Hidehiro Shioyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
- Oral Health Care Clinic, Dental Hospital, Tokyo Medical and Dental University
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Norio Aoyama
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Tomonari Suda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Keiko Tanaka
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Akiko Endo
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yukako Kusunoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Fumihiro Yamawaki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Kaori Fujiwara-Takahashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Atsuhiro Kinoshita
- Department of Educational Media Development, Institute for Library and Media Information Technology, Tokyo Medical and Dental University
| | - Shinichi Arakawa
- Deparment of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Shigeru Oda
- Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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