A comparative evaluation of the effectiveness of guided tissue regeneration by using a collagen membrane with or without decalcified freeze-dried bone allograft in the treatment of infrabony defects: A clinical and radiographic study

Efficacy of Guided Tissue Regeneration Using Frozen Radiation-Sterilized Allogenic Bone Graft as Bone Replacement Graft Compared with Deproteinized Bovine Bone Mineral in the Treatment of Periodontal Intra-Bony Defects: Randomized Controlled Trial

(1) Background: The aim of this study was to compare the clinical and radiographic outcomes of guided tissue regeneration (GTR) using two biomaterials as bone replacement grafts in the treatment of periodontal intra-bony defects. (2) Methods: Using a split-mouth design, 30 periodontal intra-bony defects were treated with either frozen radiation-sterilized allogenic bone grafts (FRSABG tests) or deproteinized bovine bone mineral (DBBM, controls) combined with a bioabsorbable collagen membrane in 15 patients. Clinical attachment level gains (CAL-G), probing pocket depth reductions (PPD-R), and radiographic changes in linear defect fill (LDF) were evaluated 12 months postoperatively. (3) Results: The CAL, PPD, and LDF values improved significantly in both groups 12 months after the surgery. However, in the test group, the PPD-R and LDF values were significantly higher compared to the controls (PPD-R 4.66 mm versus 3.57 mm, p = 0.0429; LDF 5.22 mm versus 4.33, p = 0.0478, respectively). Regression analysis showed that baseline CAL was a significant predictor for PPD-R (p = 0.0434), while the baseline radiographic angle was a predictor for CAL-G (p = 0.0026) and LDF (p = 0.064). (4) Conclusions: Both replacement grafts when used for GTR with a bioabsorbable collagen membrane yielded successful clinical benefits in teeth with deep intra-bony defects 12 months postoperatively. The use of FRSABG significantly enhanced PPD reduction and LDF.

Comparative evaluation of open flap debridement alone and in combination with anorganic bone matrix/cell-binding peptide in the treatment of human infrabony defects: A randomized clinical trial

Background:

The synthetic anorganic bone matrix/cell-binding peptide (ABM/P-15) has displayed an increased fibroblast migration and attachment with bone graft material, thus enhancing periodontal regeneration. The objective of the present study was to evaluate and to correlate the efficacy of open flap debridement (OFD) with and without ABM/P-15 in the treatment of human infrabony periodontal defects.

Materials and Methods:

A total of 20 chronic periodontitis patients with equal number infrabony defects were randomly selected and assigned into two groups depending on the treatment received: Control group (treated with OFD) and Test group (treated with OFD + ABM/P-15). Clinical parameters recorded included plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), gingival recession, and radiographic defect depth (RDD) which were evaluated at baseline and 6 months postsurgically.

Results:

When compared to baseline, both the treatment groups demonstrated improvements in the clinical parameters at 6 months. Test group exhibited a mean PPD reduction of 4.15 ± 1.04 mm, CAL gain of 3.10 ± 1.42 mm, and reduction in RDD of 1.90 ± 0.72 mm postoperatively at 6 months. In contrast to Control group, the Test group showed greater reduction in PPD (P < 0.05) which was statistically significant, greater CAL gain and greater mean RDD reduction (P < 0.001) which was highly significant.

Conclusion:

In the surgical management of periodontal infrabony defects, Test group elicited in statistically significant PPD reduction, CAL gain, and better infrabony defect fill at 6 months’ postoperatively.

Pure Titanium Membrane (Ultra - Ti®) in the Treatment of Periodontal Osseous Defects: A Split-Mouth Comparative Study

INTRODUCTION

Although many different types of Guided Tissue Regeneration (GTR) membranes (resorbable/non-resorbable, including titanium mesh) have been used in the field of Periodontics till now, but this is the first and only clinical study testing the effectiveness of an ultra thin pure Titanium Membrane (Ultra Ti) as a GTR membrane in infra-bony periodontal defects.

AIM

To compare the efficacy of GTR in intra-bony defects with newly introduced non-resorbable barrier membrane, made of titanium called "Ultra-Ti ^® GTR Membrane" versus open flap debridement.

MATERIALS AND METHODS

A prospective, randomized, controlled, clinical split mouth study was designed wherein each patient received both the control and test treatment. Two similar defects were selected in each of the 12 patients and were randomly assigned to one of the two treatments. Both the surgeries consisted of identical procedures except for the omission of the barrier membrane in the control sites. Full mouth Plaque Index (PI), Gingival Index (GI), Pocket Probing Depth (PPD) and Relative Attachment Level (RAL) were recorded before surgery and after 6 months and 9 months along with hard tissue measurements at the time of surgery and then at re-entry after 9 months. Radiographs were also taken before surgery and 9 months post operatively. Student's paired t-test and unpaired t-test (SPSS software version 9) were used to analyze the results.

RESULTS

Nine months after treatment, the test defects gained 4.375 ± 1.189mm of RAL, while the control defects yielded a significantly lower RAL gain of 3.417 ± 0.996mm. Pocket reduction was also significantly higher in the test group (4.917 ± 0.996mm) when compared with the controls (3.83 ± 0.718mm). There was a significant bone fill (54.69% of defect fill) obtained in the test site, unlike the control site (8.91%).

CONCLUSION

The present study demonstrated that GTR with "Ultra-Ti^® GTR Membrane" resulted in a significant added benefit in comparison with open flap debridement.

Advances in collagen, chitosan and silica biomaterials for oral tissue regeneration: from basics to clinical trials

Different materials have distinct surface and bulk characteristics; each of them potentially useful for the treatment of a particular wound or disease.