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Aishwarya R, Priyanka J, Pavan B, Bhairavi K, Deepika M. Evaluating and Comparing the Effectiveness of Nano-HA and HA + β-TCP with A-PRF Clinically and Radiographically in the Treatment of Human Infrabony Defects. J Contemp Dent Pract 2023; 24:500-506. [PMID: 37622630 DOI: 10.5005/jp-journals-10024-3534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
AIM To evaluate and compare the effectiveness of nanocrystalline hydroxyapatite (NcHA) with advanced platelet-rich fibrin (A-PRF) and hydroxyapatite-reinforced beta tricalcium phosphate (HA + β-TCP) with A-PRF in the treatment of human infrabony defects clinically and radiographically using cone-beam computed tomography (CBCT). MATERIALS AND METHODS There were a total of 28 defects, with 14 defects in the test and control groups, respectively. There were total 28 patients were involved in the study. The test group (group A) was treated with NHA and A-PRF, while the control group (group B) was treated with HA + β-TCP and A-PRF. Bone defect fill was the primary result of the investigation. Periodontal pocket depth (PPD), R-CAL, papillary bleeding index (PBI), and PI were the secondary outcome. Clinical and radiographic measurements were recorded at baseline and 6 months postoperatively. RESULTS No significant difference was observed between the two groups in terms of PPD reduction (4.64 ± 0.74 mm vs 4.07 ± 0.99 mm), clinical attachment loss (CAL) gain (4.64 ± 0.74 mm vs 3.92 ± 0.99 mm) and radiographic defect depth reduction (2.41 ± 0.32 mm vs 2.40 ± 0.27 mm) for test and control groups, respectively. CONCLUSION At 6-month post-surgery, both treatment modalities demonstrated statistically significant improvements with regard to CAL gains, PPD reduction, and reduction in radiographic defect depth. CLINICAL RELEVANCE The NcHA and HA + β-TCP with A-PRF is a novel material used in the treatment of infrabony defect for periodontal regeneration. The NcHA and HA + β-TCP with A-PRF need to consider biomaterials for bone defect fill.
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Affiliation(s)
- Rathod Aishwarya
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India, Phone: +91 9834240701, e-mail:
| | - Jaiswal Priyanka
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India
| | - Bajaj Pavan
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India
| | - Kale Bhairavi
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India
| | - Masurkar Deepika
- Department of Periodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India
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Abere DV, Ojo SA, Oyatogun GM, Paredes-Epinosa MB, Niluxsshun MCD, Hakami A. Mechanical and morphological characterization of nano-hydroxyapatite (nHA) for bone regeneration: A mini review. BIOMEDICAL ENGINEERING ADVANCES 2022. [DOI: 10.1016/j.bea.2022.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Shaheen MY. Nanocrystalline hydroxyapatite in periodontal bone regeneration: A systematic review. Saudi Dent J 2022; 34:647-660. [PMID: 36570589 PMCID: PMC9767838 DOI: 10.1016/j.sdentj.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Background Periodontal diseases when persistent, results in periodontal pockets, attachment loss and progressive destruction of the alveolar bone. Grafting periodontal bone defects with bone substitute biomaterials has proven clinical success for accomplishing reconstruction of lost attachment apparatus, especially in deep intra-bony defects. Nanoparticles (NPs) have been considered indispensable in the future of health sciences and NP based alloplastic graft materials such as nanocrystalline hydroxyapatite (NCHA) hold great promise for regeneration of periodontal defects. Therefore the aim of this review is to evaluate the role of NCHA as an effective substitute for periodontal bone regeneration. Material & methods Popular scientific databases such as PubMed (Medline), Cochrane database of clinical trials, Scopus (Elsevier), Web of science (Clarivate Analytics) and Google Scholar, were searched. The literature search was restricted to published reports in English, between January 2000 and December 2021. Database search returned 1227 results which were screened based on title, author names and publication dates. Results Data from the 14 included studies were reviewed and tabulated. In the present review, all the studies reported using commercially available NCHA for periodontal bone regeneration. Conclusion NCHA is a suitable bone substitute material for periodontal bone regeneration, with outcomes comparable to that of conventionally used graft materials such as bovine xenograft and other synthetic alloplastic materials. While grafting with NCHA in intrabony periodontal defects, after any form of periodontal flap surgery or debridement, significantly improves bone regeneration by 6 months, addition of adjuncts like EMD and PRF further enhance the outcomes.
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Nair UP, Shivamurthy R, Nagate RR, Chaturvedi S, Al-Qahtani SM, Magbol MA, Gokhale ST, Tikare S, Chaturvedi M. Effect of Injectable Platelet-Rich Fibrin with a Nano-Hydroxyapatite Bone Graft on the Treatment of a Grade II Furcation Defect. Bioengineering (Basel) 2022; 9:bioengineering9110602. [PMID: 36354513 PMCID: PMC9687493 DOI: 10.3390/bioengineering9110602] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Periodontal diseases lead to bone loss, crestal defects and even loss of the tooth, which also further makes it difficult to replace the tooth. Autogenous bone grafts are considered the gold standard in bone regenerative procedures. This study aimed to compare and evaluate the bone regenerative effects of i-PRF (Injectable- Platelet-rich fibrin) with a bone graft and a bone graft alone in mandibular grade II furcation defects over a period of 9 months. Method: This was a comparative study of 12 participants, who were randomly selected and grouped into two groups: test and control. Following phase I therapy, both groups were subjected to open flap debridement. In the test group, after debridement, a nano-hydroxyapatite bone graft mixed with i-PRF was inserted, whereas in the control group only a nano-hydroxyapatite bone graft was inserted. The clinical parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD) and vertical probing depth (VPD) were recorded at baseline, 3 months, 6 months and 9 months following the surgery. The bone area fill (BAF) was assessed using intraoral periapical radiographs (IOPARs) taken at baseline and 9 months after surgery. Results: At the baseline, there was no statistically significant difference between the tested parameters. After 9 months all the clinical parameters, PI, GI, PPD, CAL, HPD and VPD as well as radiographic bone fill showed a significant increase in both the groups (p < 0.05) (PI-TGr; CGr−VPD—3.5 ± 0.54 to 0.66 ± 0.51; 3.3 ± 0.81 to 2 ± 0.63/BAF—2.9 ± 0.88 to 5.6 ± 1.10; 3.4 ± 1.39 to 3.9 ± 1.4). On comparison the test group showed better results for each clinical parameter. Conclusion: The results showed increased improvement in clinical conditions in both groups, although better results were seen in the group where i-PRF with a nano-HA bone graft was used in the furcation defect.
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Affiliation(s)
- Uma P. Nair
- Department of Periodontology, JSS Dental College & Hospital, Mysuru 570015, India
| | - Ravindra Shivamurthy
- Department of Periodontology, JSS Dental College & Hospital, Mysuru 570015, India
| | - Raghavendra Reddy Nagate
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Saurabh Chaturvedi
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
- Correspondence: ; Tel.: +966-580697248
| | - Saad M. Al-Qahtani
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammad Al Magbol
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Shankar T. Gokhale
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Shreyas Tikare
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
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Elkholly A, Negm M, Hassan R, Omar N. Healing Assessment of Osseous Defects after Surgical Removal of Periapical Lesions in the Presence of Hydroxyapatite, Nanohydroxyapatite, and a Combination of Nanohydroxyapatite and Platelet-rich Fibrin: A Clinical Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract:
Aim: to evaluate the bone healing in failed endodontically treated teeth after surgical removal of periapical lesions and placement of hydroxyapatite (HA), nanohydroxyapatite (nHA) and a combination of nanohydroxyapatite with platelet rich fibrin (PRF) periapically. Subjects and methods: the study was conducted on twenty-four patients having periapical radiolucency in single rooted teeth. The selected teeth were divided into three groups: Group A, Group B, and Group C; of 8 teeth each. All the teeth were retreated in two visits. In the first visit the old filling was removed using Protaper retreatment files (Dentsply Sirona®) then irrigation with sodium hypochlorite 2.5% was done. All canals were dried and filled with Di-antibiotic paste (metronidazole and ciprofloxacin). In the second visit the canals were obturated with Pro Taper gutta-percha points and root canal sealer (Adseal resin sealer) followed by surgical intervention in the same day. A periapical curettage along with apicoectomy were established. In all the groups, root end cavity was prepared and filled with MTA (ProRoot MTA; DENTSPLY Tulsa Dental Specialties). In Group A, hydroxyapatite powder was packed in the curetted periapical defect. In Group B, nanohydroxyapatite powder was packed in the curetted periapical defect. In Group C, nanohydroxyapatite with PRF were mixed and packed in the curetted periapical defect. In all groups, patients recall visits were scheduled at 1, 3, and 6 months’ time intervals for clinical and radiological evaluation. Results: after one month; there was a statistically significant difference between the median percentage changes in lesions size in the three groups. Pair-wise comparisons between groups revealed that there was no statistically significant difference between group B (nHA) and group C (PRF and nHA) groups. Both showed statistically significantly higher median percentage reduction in lesions size than group A (HA group). After three as well as six months; there was no statistically significant difference between the median percentage decreases in lesions size in the three groups. Conclusion: It was concluded that nHA combination with PRF produced faster periapical healing (bone regeneration) in the first three months than nHA alone. However, HA produce periapical healing (bone regeneration) after six months.
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Mallappa J, Vasanth D, Gowda TM, Shah R, Gayathri GV, Mehta DS. Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects. J Indian Soc Periodontol 2022; 26:359-364. [PMID: 35959304 PMCID: PMC9362812 DOI: 10.4103/jisp.jisp_882_20] [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: 01/28/2021] [Revised: 03/08/2021] [Accepted: 12/12/2021] [Indexed: 11/14/2022] Open
Abstract
Background: Several bone grafting formulations have been given clinically acceptable outcomes in treating intrabony defects. Platelet rich fibrin (PRF), an autologous platelet concentrate holds potential to be used for regenerative treatment. The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with advanced-PRF block (A PRF + i PRF + nanohydroxyapatite [nHA]) compared to nHA alone. Methods: Twenty-eight sites in chronic periodontitis patients having probing pocket depth (PPD) ≥6 mm and 3 walled intrabony defects (depth of ≥3 mm) were selected, randomly allotted into two groups: Group A was treated with A-PRF block and Group B with nHA (Sybograf™). Clinical parameters including plaque index (PI), gingival index (GI), PPD, relative attachment level (RAL) and radiographically linear and volumetric defect fill were assessed using cone beam computed tomography at baseline and 6 months postoperatively. Results: Intragroup comparison using paired t-test and intergroup comparison using unpaired t-test was done. Group A demonstrated significantly higher reduction in PPD and gain in RAL when compared to Group B (P ≤ 0.05) at the end of 6 months. Similarly gain in bone volume was greater in Group A (0.1 ± 0.05) as compared to Group B (0.04 ± 0.02) (P ≤ 0.05). Conclusion: Advanced-PRF block showed significant clinical and radiographic improvement as compared to nHA alone which depicts that, it may be an ideal graft to be used for the treatment of periodontal intrabony defects.
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Affiliation(s)
- Jayasheela Mallappa
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Deepa Vasanth
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | | | - Rucha Shah
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | | | - Dhoom Singh Mehta
- Department of Periodontology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Metformin-Incorporated Gelatin/Nano-Hydroxyapatite Scaffolds Promotes Bone Regeneration in Critical Size Rat Alveolar Bone Defect Model. Int J Mol Sci 2022; 23:ijms23010558. [PMID: 35008984 PMCID: PMC8745742 DOI: 10.3390/ijms23010558] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023] Open
Abstract
In this study, we fabricated gelatin/nano-hydroxyapatite/metformin scaffold (GHMS) and compared its effectiveness in bone regeneration with extraction-only, Sinbone, and Bio-Oss Collagen® groups in a critical size rat alveolar bone defect model. GHMS was synthesized by co-precipitating calcium hydroxide and orthophosphoric acid within gelatin solution, incorporating metformin, and cross-linked by microbial transglutaminase. The morphology, characterization, and biocompatibility of scaffold were examined. The in vitro effects of GHMS on osteogenic gene and protein expressions were evaluated. In vivo bone formation was assessed in a critical size rat alveolar bone defect model with micro-computed tomography and histological examination by comparing GHMS with extraction-only, Sinbone, and Bio-Oss Collagen®. The synthesized GHMS had a highly interconnected porous structure with a mean pore size of 81.85 ± 13.8 µm. GHMS exhibited good biocompatibility; promoted ALPL, RUNX2, SP7, BGLAP, SPARC and Col1a1 gene expressions; and upregulated the synthesis of osteogenic proteins, including osteonectin, osteocalcin, and collagen type I. In critical size rat alveolar bone defects, GHMS showed superior bone regeneration compared to extraction-only, Sinbone, and Bio-Oss Collagen® groups as manifested by greater alveolar ridge preservation, while more bone formation with a lower percentage of connective tissue and residual scaffold at the defect sites grafted with GHMS in histological staining. The GHMS presented in this study may be used as a potential bone substitute to regenerate alveolar bone. The good biocompatibility, relatively fast degradation, interconnected pores allowing vascularization, and higher bioactivity properties of the components of the GHMS (gelatin, nHA, and metformin) may contribute to direct osteogenesis.
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Shaikh MS, Zafar MS, Alnazzawi A, Javed F. Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis. Ann Anat 2021; 240:151877. [PMID: 34864225 DOI: 10.1016/j.aanat.2021.151877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/09/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone. MATERIALS AND METHODS The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively. RESULTS From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48). CONCLUSIONS The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan.
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, New York 14620, United States
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Shaikh MS, Zafar MS, Alnazzawi A. Comparing Nanohydroxyapatite Graft and Other Bone Grafts in the Repair of Periodontal Infrabony Lesions: A Systematic Review and Meta-Analysis. Int J Mol Sci 2021; 22:12021. [PMID: 34769451 PMCID: PMC8584357 DOI: 10.3390/ijms222112021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the results of periodontal infrabony lesions treated using nanohydroxyapatite (NcHA) graft with other bone grafts (BGs). METHODS Four electronic databases were searched including PubMed (NLM), Embase (Ovid), Medline, and Dentistry and Oral Sciences (EBSCO). The inclusion criteria included randomised controlled clinical trials (RCTs) and controlled clinical trials (CCTs). The clinical results of NcHA were compared with other BGs. For clinical attachment level (CAL) gain, probing pocket depth (PPD) decrease, and gingival recession (REC) change, weighted averages and forest plots were computed. RESULTS Seven RCTs fulfilled the selection criteria that were included. When NcHA was compared to other BGs, no clinically significant differences were found in terms of each outcome assessed, except the REC change for synthetic BGs as compared to NcHA. CONCLUSIONS The use of an NcHA graft showed equivalent results compared to other types of BGs. To further validate these findings, future studies are required to compare the NcHA and various BGs over longer time periods and in furcation deficiencies.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 75510, Pakistan;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia;
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Sharma S, Wadhawan A, Rajan K. Combined endodontic therapy and peri-radicular regenerative surgery in the treatment of dens invaginatus type III associated with apicomarginal defect. J Conserv Dent 2018; 21:696-700. [PMID: 30546221 PMCID: PMC6249934 DOI: 10.4103/jcd.jcd_311_18] [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] [Indexed: 11/04/2022] Open
Abstract
Dens invaginatus (DI) is a dental developmental abnormality, probably resulting from an infolding of the dental papilla during tooth development. The following case report presents a case of Type III DI with apicomarginal defect and peri-radicular lesion, diagnosed with cone-beam computed tomography scan and treated with combined orthograde endodontic therapy and peri-radicular regenerative surgery. Follow-up examination at 2 years revealed uneventful healing and improvement in the status of the tooth-supporting structures.
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Affiliation(s)
- Sidhartha Sharma
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Wadhawan
- Department of Periodontics, Subharti Dental College, Meerut, Uttar Pradesh, India
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Dewi AH, Ana ID. The use of hydroxyapatite bone substitute grafting for alveolar ridge preservation, sinus augmentation, and periodontal bone defect: A systematic review. Heliyon 2018; 4:e00884. [PMID: 30417149 PMCID: PMC6218667 DOI: 10.1016/j.heliyon.2018.e00884] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/16/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES We determined and structurally analyzed the reported effect of hydroxyapatite (HA) bone substitute on alveolar bone regeneration. To the best of our knowledge, no systematic reviews have previously reported the bone regenerative effect of the HA bone substitute. MATERIALS AND METHODS A literature search was performed for articles published up to August 2015 using MEDLINE with the search terms "hydroxyapatite," "bone regeneration," and "alveolar bone" as well as their known synonyms. The inclusion criteria were set up for human trials with at least five patients. The literature search, eligible article selection, and data extraction were independently performed by two readers, and their agreement was reported by κ value. RESULTS Of the 504 studies found using the MEDLINE literature search, 241 were included for further steps (inter-reader agreement, κ = 0.968). Abstract screening yielded 74 studies (κ = 0.910), with 42 completely fulfilling the inclusion criteria (κ = 0.864). In a final step, 42 studies were further analyzed, with 17 and 25 studies with and without statistical analysis, respectively. The 17 studies reporting similar outcome measures were compared using the calculated 95% confidence intervals. The effect of HA on ridge preservation could not be evaluated. CONCLUSIONS The use of the HA bone substitute interfered with the normal healing process, with significant differences found for sinus augmentation but not for periodontal bone defects. Thus, a bone substitute with optimal bone regenerative properties for alveolar ridge or socket preservation, sinus augmentation, and periodontal bony defect should be developed.
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Affiliation(s)
| | - Ika Dewi Ana
- Department of Dental Biomedical Sciences, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
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Debnath K, Chatterjee A. Treatment of horizontal defect with and without platelet-rich fibrin matrix: A randomized comparative clinical study. J Indian Soc Periodontol 2018; 22:406-413. [PMID: 30210189 PMCID: PMC6128136 DOI: 10.4103/jisp.jisp_129_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/14/2018] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the present study was to assess the clinical and radiographical parameters in horizontal bone defects in patients with chronic periodontitis. MATERIALS AND METHODS In this randomized, controlled clinical trial study, nine individuals with 94 sites having moderate to deep periodontitis were selected and distributed to Group A - open flap debridement (OFD), Group B - open flap debridement and intra marrow penetration (OFD + IMP) and Group C - Open flap debridement + Intramarrow penetration + platelet rich fibrin matrix (OFD + IMP + PRFM). Plaque index (PI) and gingival index (GI) were evaluated at baseline, 6 months, and 9 months after surgery. Probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 9 months after surgery. Radiographic assessment was carried out to measure the periodontal defect depth and defect fill percentage (DF%) at baseline and 9 months after the surgery using radiovisiography. RESULTS The statistical evaluation obtained after 9 months showed no significant difference between PI and GI at 9 months interval. Intergroup comparison of PPD and CAL has shown significant difference in Group C as compared to Group A and B with P < 0.05. The defect depth was statistically significant at 9 months in all the groups, and DF percentage (DF%) has shown statistically significant results in Group C as compared to A and B with P = of 0.001. CONCLUSION The addition of PRFM to horizontal type of periodontal defects has shown promising results over a 9-month follow-up period.
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Affiliation(s)
- Koel Debnath
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Anirban Chatterjee
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
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Histologic and Histomorphometric Comparison between Sintered Nanohydroxyapatite and Anorganic Bovine Xenograft in Maxillary Sinus Grafting: A Split-Mouth Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9489825. [PMID: 28845435 PMCID: PMC5563399 DOI: 10.1155/2017/9489825] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/25/2017] [Indexed: 12/30/2022]
Abstract
The presence of vital bone after maxillary sinus augmentation is crucial to enhance the quality of bone-implant interface, ensuring predictable long-term results. The aims of this RCT with split-mouth design were the histologic and histomorphometric comparison of two different biomaterials in sinus elevation after 6 months of healing and the evaluation of the clinical outcomes of implants inserted in the augmented areas after 12 months of prosthetic loading. Twenty-eight patients (10 females, 18 males) were treated with bilateral sinus floor elevation with lateral approach. Pure sintered nanohydroxyapatite (NHA) and anorganic bovine bone (ABB) were used as test and active control, respectively. After six months, 52 bone biopsies were harvested from 26 patients, and 107 implants were inserted in the augmented areas. Histomorphometry showed that, in the two groups, vital bone percentages were 34.9 ± 15% (NHA) and 38.5 ± 17% (ABB) (p = 0.428), marrow spaces percentages were 44.5 ± 18% (NHA) and 43.5 ± 23% (ABB) (p = 0.866), and residual graft percentages were 20.6 ± 13% (NHA) and 22.3 ± 12% (ABB) (p = 0.638). After 6 months of healing, no statistically significant difference was present in histomorphometric outcomes between NHA and ABB groups. Implant survival rate in NHA group after 12 months of loading was 96.4%, showing no statistically significant differences with ABB group.
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Sun Y, Wang C, Chen Q, Liu H, Deng C, Ling P, Cui FZ. Effects of the bilayer nano-hydroxyapatite/mineralized collagen-guided bone regeneration membrane on site preservation in dogs. J Biomater Appl 2017; 32:242-256. [DOI: 10.1177/0885328217715150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Yi Sun
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Chengyue Wang
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Qixin Chen
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Hai Liu
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Chao Deng
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Peixue Ling
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
| | - Fu-Zhai Cui
- School of Stomatology, Wannan Medical college, WuHu, Anhui, PR China
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Mehrali M, Thakur A, Pennisi CP, Talebian S, Arpanaei A, Nikkhah M, Dolatshahi-Pirouz A. Nanoreinforced Hydrogels for Tissue Engineering: Biomaterials that are Compatible with Load-Bearing and Electroactive Tissues. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2017; 29:1603612. [PMID: 27966826 DOI: 10.1002/adma.201603612] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/14/2016] [Indexed: 05/20/2023]
Abstract
Given their highly porous nature and excellent water retention, hydrogel-based biomaterials can mimic critical properties of the native cellular environment. However, their potential to emulate the electromechanical milieu of native tissues or conform well with the curved topology of human organs needs to be further explored to address a broad range of physiological demands of the body. In this regard, the incorporation of nanomaterials within hydrogels has shown great promise, as a simple one-step approach, to generate multifunctional scaffolds with previously unattainable biological, mechanical, and electrical properties. Here, recent advances in the fabrication and application of nanocomposite hydrogels in tissue engineering applications are described, with specific attention toward skeletal and electroactive tissues, such as cardiac, nerve, bone, cartilage, and skeletal muscle. Additionally, some potential uses of nanoreinforced hydrogels within the emerging disciplines of cyborganics, bionics, and soft biorobotics are highlighted.
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Affiliation(s)
- Mehdi Mehrali
- Technical University of Denmark, DTU Nanotech, Center for Nanomedicine and Theranostics, 2800 Kgs, Ørsteds Plads, Kongens Lyngby, Denmark
| | - Ashish Thakur
- Technical University of Denmark, DTU Nanotech, Center for Nanomedicine and Theranostics, 2800 Kgs, Ørsteds Plads, Kongens Lyngby, Denmark
| | - Christian Pablo Pennisi
- Laboratory for Stem Cell Research, Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 3B, Aalborg, 9220, Denmark
| | - Sepehr Talebian
- Department of Mechanical Engineering and Center of Advanced Material, University of Malaya, 50603, Persiaran Universiti 2, Kuala Lumpur, Malaysia
| | - Ayyoob Arpanaei
- Department of Industrial and Environmental Biotechnology, National Institute of Genetic Engineering and Biotechnology, Tehran - Karaj Highway, Tehran, Iran
| | - Mehdi Nikkhah
- Engineering Center G Wing 334 School of Biological Health and Systems Engineering (SBHSE), Arizona State University, Tempe, AZ, 85287, USA
| | - Alireza Dolatshahi-Pirouz
- Technical University of Denmark, DTU Nanotech, Center for Nanomedicine and Theranostics, 2800 Kgs, Ørsteds Plads, Kongens Lyngby, Denmark
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Bayani M, Torabi S, Shahnaz A, Pourali M. Main properties of nanocrystalline hydroxyapatite as a bone graft material in treatment of periodontal defects. A review of literature. BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1281760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Mojtaba Bayani
- Periodontics Department, Dental Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Sepehr Torabi
- Periodontics Department, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aysan Shahnaz
- Periodontics Department, Dental Faculty, Qom University of Medical Science, Qom, Iran
| | - Mohammad Pourali
- Periodontics Department, Dental Faculty, Qom University of Medical Sciences, Qom, Iran
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Yajamanya SR, Chatterjee A, Hussain A, Coutinho A, Das S, Subbaiah S. Bioactive glass versus autologous platelet-rich fibrin for treating periodontal intrabony defects: A comparative clinical study. J Indian Soc Periodontol 2017; 21:32-36. [PMID: 29386798 PMCID: PMC5767987 DOI: 10.4103/0972-124x.201628] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: To compare treatment modalities: Open flap debridement (OFD) alone (Group I), OFD in combination with PerioGlas® (Group II), and OFD in combination with autologous platelet-rich fibrin (PRF) (Group III) for periodontal intrabony defects (IBDs). Aim: To evaluate on clinical and radiographic basis, effectiveness of PerioGlas®, and PRF in treating IBDs. Settings and Design: IBDs selected on the basis of the inclusion criteria were randomly assigned to Groups I, II, and III by coin toss method. Materials and Methods: The study was conducted on patients reporting to the department of periodontology and oral implantology. Thirty-eight patients with ninety periodontal IBDs of moderate to severe periodontitis were selected and assigned to Groups I, II, and III. In each patient, a minimum number of two sextants were present with pocket depths ≥5 mm in at least three teeth. Statistical Analysis: Statistical analysis based on mean values, standard deviation, and P values. Results: Compared to baseline, 9 months postoperatively: (1) mean probing pocket depth reduction for Group I was 3.68 mm ± 0.72, for Group II was 5.57 mm ± 1.10, and for Group III was 6.11 mm ± 0.92. (2) The mean relative attachment level gain for Group I was 4.14 mm ± 0.76, for Group II was 6.57 mm ± 1.45, and for Group III was 6.74 mm ± 1.55. (3) Mean radiographic IBD fill for Group I was 69.29% mm ± 7.73, for Group II was 74.44% mm ± 8.57, and for Group III was 75.01% mm ± 7.85. Conclusion: This study shows marked improvements in the clinical parameters and radiographic outcomes with both PerioGlas® and autologous PRF to treat periodontal IBDs as compared to OFD alone.
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Affiliation(s)
- Shravanthi Raghav Yajamanya
- Department of Periodontology and Oral Implantology, Pandit Deendayal Upadhyay Dental College, Solapur, Maharashtra, India
| | - Anirban Chatterjee
- Department of Periodontology and Oral Implantology, The Oxford Dental College, Bangalore, Karnataka, India
| | - Ahad Hussain
- Department of Periodontology and Oral Implantology, The Oxford Dental College, Bangalore, Karnataka, India
| | - Amita Coutinho
- Department of Periodontology and Oral Implantology, The Oxford Dental College, Bangalore, Karnataka, India
| | - Sushma Das
- Department of Periodontology and Oral Implantology, The Oxford Dental College, Bangalore, Karnataka, India
| | - Shobha Subbaiah
- Department of Periodontology and Oral Implantology, The Oxford Dental College, Bangalore, Karnataka, India
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18
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Sali DD, Pauline George J. Demineralized Freeze Dried Bone Allograft With Amniotic Membrane in the Treatment of Periodontal Intrabony Defects - 12 Month Randomized Controlled Clinical Trial. J Periodontol 2016:1-18. [PMID: 27834121 DOI: 10.1902/jop.2016.160260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The goal of randomized controlled clinical study was to compare the clinical and radiological outcomes of the combination of Open flap debridement, Amniotic membrane and Demineralized Freeze Dried bone Allograft with Open flap debridement and Demineralized Freeze Dried bone Allograft alone in the management of periodontal intrabony defects. METHOD 10 patients with bilaterally similar intrabony defects were selected. Each of the intrabony defects were randomly allocated for control and test groups. Control group (n= 10) received open flap debridement (OFD) and Demineralized Freeze Dried bone Allograft (DFDBA) while the test group (n=10) received OFD, DFDBA and Amniotic membrane. Pocket Probing Depth reduction (PPD), Clinical Attachment Level (CAL) gain and radiographic bone gain were assessed. RESULTS Both the groups demonstrated statistically significant PPD reduction, CAL gain and radiographic bone gain. The Intrabony defect (IBD) reduction of 1.78 ± 0.04 mm in radiovisiography (RVG) and 2.02 ± 0.83 mm in cone beam computed tomography (CBCT) with defect resolution of 58.28 % (RVG) and 58.24 % (CBCT) was noted in test group when compared to control group. CONCLUSION All the parameters measured showed similar improvement such as PPD reduction, CAL gain, IBD reduction and defect resolution with OFD + DFDBA + AM and OFD + DFDBA, no statistical significant difference was observed between the two groups .
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Affiliation(s)
- Deepthi D Sali
- Post Graduate Student, Department of Periodontology Krishnadevaraya College of Dental Sciences and Hospital, Hunsamaranahalli, International Airport Road, Bangalore - 562157, India
| | - Joann Pauline George
- Professor, Department of Periodontology Krishnadevaraya College of Dental Sciences and Hospital, Hunsamaranahalli, International Airport Road, Bangalore - 562157, India
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19
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Kamboj M, Arora R, Gupta H. Comparative evaluation of the efficacy of synthetic nanocrystalline hydroxyapatite bone graft (Ostim ®) and synthetic microcrystalline hydroxyapatite bone graft (Osteogen ®) in the treatment of human periodontal intrabony defects: A clinical and denta scan study. J Indian Soc Periodontol 2016; 20:423-428. [PMID: 28298825 PMCID: PMC5341318 DOI: 10.4103/0972-124x.184036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: To evaluate the relative efficacy of synthetic nanocrystalline hydroxyapatite (HA) (Ostim®) and microcrystalline HA (Osteogen®) bone grafts in the treatment of human periodontal intrabony defects clinically and radiographically through denta scan. Materials and Methods: Ten chronic periodontitis patients with bilateral intrabony periodontal defects of ≥2 mm radiographic defect depth below 55 years of age were selected randomly and treated with synthetic nanocrystalline HA (Ostim®) or synthetic microcrystalline HA (Osteogen®) bone graft. Clinical parameters including probing depth (PD) and clinical attachment level (CAL) were measured preoperatively and postoperatively at 3 and 6 months for each of the defects using an occlusal acrylic stent. Radiographic parameters were measured with the help of denta scan preoperatively and postoperatively at 6 months. Results: At 6 months following therapy, the Osteogen® group showed a reduction in mean PD from 11.10 ± 1.663 to 8.50 ± 0.850 mm and a change in mean CAL from 6.30 ± 1.160 to 3.40 ± 0.516 mm, whereas in the Ostim® group, the mean PD decreased from 11.20 ± 0.919 to 8.30 ± 0.823 mm and mean CAL decreased from 6.10 ± 0.738 to 3.30 ± 0.483 mm. At 6 months following therapy, denta scan showed a reduction in mean intrabony defect depth in the Osteogen® group from 2.54 ± 0.786 to 1.01 ± 0.448 mm, whereas in the Ostim® group, it was 2.71 ± 0.650 mm to 1.12 ± 0.563 mm. Conclusion: It was concluded that both the HA bone grafts produced statistically significant reduction in pocket depth, in the depth of osseous lesion, and a statistically significant gain in attachment level, irrespective of their physico-chemical properties.
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Affiliation(s)
- Monika Kamboj
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
| | - Ruchika Arora
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
| | - Harinder Gupta
- Department of Periodontology, Government Dental College and Hospital, Amritsar, Punjab, India
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20
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Sun Y, Wang CY, Wang ZY, Cui Y, Qiu ZY, Song TX, Cui FZ. Test in canine extraction site preservations by using mineralized collagen plug with or without membrane. J Biomater Appl 2015; 30:1285-99. [PMID: 26721867 DOI: 10.1177/0885328215625429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to discuss the feasibility of porous mineralized collagen plug and bilayer mineralized collagen-guided bone regeneration membrane in site preservation in extraction sockets. The third mandibular premolars on both sides were extracted from four dogs, thus there were 16 alveolar sockets in all dogs and were randomly assigned into three groups. Group A had six alveolar sockets, and groups B and C had five alveolar sockets, respectively. Each alveolar socket of group A was immediately implanted with a porous mineralized collagen plug and covered with a bilayer mineralized collagen-guided bone regeneration membrane after tooth extraction. Alveolar sockets of group B were implanted with porous mineralized collagen plug only, and group C was set as blank control without any implantation. The healing effects of the extraction sockets were evaluated by gross observation, morphological measurements, and X-ray micro-computed tomography after twelve weeks. Twelve weeks after operation, both groups A and B had more amount of new bone formation compared with group C; in terms of the degree of alveolar bone height, group A was lower than groups B and C with significant differences; the bone mineral density in the region of interest and bone remodeling degree in group A were higher than those of groups B and C. As a result, porous mineralized collagen plug could induce the regeneration of new bone in extraction socket, and combined use of porous mineralized collagen plug and bilayer mineralized collagen guided bone regeneration membrane could further reduce the absorption of alveolar ridge and preserve the socket site.
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Affiliation(s)
- Yi Sun
- Department of Prosthodontics, Affiliated Stomatological Hospital of Liaoning Medical University, JinZhou, China
| | - Cheng-Yue Wang
- Department of Prosthodontics, Affiliated Stomatological Hospital of Liaoning Medical University, JinZhou, China
| | - Zhi-Ying Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Liaoning Medical University, JinZhou, China
| | - Yun Cui
- Beijing Allgens Medical Science and Technology Co. Ltd, China
| | - Zhi-Ye Qiu
- Beijing Allgens Medical Science and Technology Co. Ltd, China
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
| | - Tian-Xi Song
- Beijing Allgens Medical Science and Technology Co. Ltd, China
| | - Fu-Zhai Cui
- School of Materials Science and Engineering, Tsinghua University, Beijing, China
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21
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Elgendy EA, Abo Shady TE. Clinical and radiographic evaluation of nanocrystalline hydroxyapatite with or without platelet-rich fibrin membrane in the treatment of periodontal intrabony defects. J Indian Soc Periodontol 2015; 19:61-5. [PMID: 25810595 PMCID: PMC4365160 DOI: 10.4103/0972-124x.148639] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 06/12/2014] [Indexed: 01/20/2023] Open
Abstract
Background: Nano-sized ceramics may represent a promising class of bone graft substitutes due to their improved osseointegrative properties. Nanocrystalline hydroxyapatite (NcHA) binds to bone and stimulate bone healing by stimulation of osteoblast activity. Platelet-rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. The present study aims to explore the clinical and radiographical outcome of NcHA bone graft with or without PRF, in the treatment of intrabony periodontal defects. Materials and Methods: In a split-mouth study design, 20 patients having two almost identical intrabony defects with clinical probing depth of at least 6 mm were selected for the study. Selected sites were randomly divided into two groups. In Group I, mucoperiosteal flap elevation followed by the placement of NcHA was done. In Group II, mucoperiosteal flap elevation, followed by the placement of NcHA with PRF was done. Clinical and radiographic parameters were recorded at baseline and at 6-month postoperatively. Results: Both treatment groups showed a significant probing pocket depth (PPD) reduction, clinical attachment gain, increase bone density 6-month after surgery compared with baseline. However, there was a significantly greater PPD reduction and clinical attachment gain when PRF was added to NcHA. Conclusion: The NcHA bone graft in combination with PRF demonstrated clinical advantages beyond that achieved by the NcHA alone.
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Affiliation(s)
- Enas Ahmed Elgendy
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, October 6 University, Giza, Egypt
| | - Tamer Elamer Abo Shady
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Tanta University, Tanta, Egypt
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22
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Pepla E, Besharat LK, Palaia G, Tenore G, Migliau G. Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature. ANNALI DI STOMATOLOGIA 2014; 5:108-114. [PMID: 25506416 PMCID: PMC4252862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study aims to critically summarize the literature about nano-hydroxyapatite. The purpose of this work is to analyze the benefits of using nano-hydroxyapatite in dentistry, especially for its preventive, restorative and regenerative applications. We also provide an overview of new dental materials, still experimental, which contain the nano-hydroxyapatite in its nano-crystalline form. Hydroxyapatite is one of the most studied biomaterials in the medical field for its proven biocompatibility and for being the main constituent of the mineral part of bone and teeth. In terms of restorative and preventive dentistry, nano-hydroxyapatite has significant remineralizing effects on initial enamel lesions, certainly superior to conventional fluoride, and good results on the sensitivity of the teeth. The nano-HA has also been used as an additive material, in order to improve already existing and widely used dental materials, in the restorative field (experimental addition to conventional glass ionomer cements, that has led to significant improvements in their mechanical properties). Because of its unique properties, such as the ability to chemically bond to bone, to not induce toxicity or inflammation and to stimulate bone growth through a direct action on osteoblasts, nano-HA has been widely used in periodontology and in oral and maxillofacial surgery. Its use in oral implantology, however, is a widely used practice established for years, as this substance has excellent osteoinductive capacity and improves bone-to-implant integration.
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Affiliation(s)
- Erlind Pepla
- Corresponding author: Erlind Pepla, Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Viale Regina Elena 278/a, 00198 Rome, Italy, E-mail:
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23
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Singh A, Daing A, Anand V, Dixit J. Two dimensional alveolar ridge augmentation using particulate hydroxyapatite and collagen membrane: A case report. J Oral Biol Craniofac Res 2014; 4:151-4. [PMID: 25737935 DOI: 10.1016/j.jobcr.2014.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 01/08/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Ridge augmentation procedures require bone regeneration outside of the existing bony walls or housing and are therefore often considered to be the most challenging surgical procedures. The bony deficiencies can be managed with GBR techniques involving bone grafting material and membrane while vertical augmentation may require the use of space-creating support mechanisms. Non-degradable membranes have been used for ridge augmentation with encouraging results however; requirement of second surgery for its removal and associated infection on exposure may compromise the desired results. These problems can be overcome by employing resorbable collagen membranes. Different bone graft materials are also used in combination with resorbable membranes, for prevention of membrane collapse and maintenance of space, as they lack sufficient rigidity. Particulate hydroxyapatite bone graft may be better alternative, because it treats the underlying bone defect to restore the natural support of the tissue architecture. Moreover, its use avoids potential donor site complications associated with autogenous block grafts. METHOD Patient described in this report presented with missing right maxillary incisor with ridge deficiency. A treatment approach involving localised ridge augmentation with particulate hydroxyapatite and collagen membrane was used. RESULT Six month post-operative periapical radiograph demonstrated a significant vertical bone fill. CONCLUSION The clinical and radiographic findings of the present case suggests that HA in conjunction with a resorbable collagen membrane may be an acceptable alternative to the autogenous block graft and non-resorbable membrane in the treatment of compromised alveolar ridge deficiencies.
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Affiliation(s)
- Aparna Singh
- Senior Resident, Department of Periodontology, Faculty of Dental Sciences, King George Medical College, Lucknow, Uttar Pradesh, India
| | - Anika Daing
- Senior Resident, Department of Periodontology, Faculty of Dental Sciences, King George Medical College, Lucknow, Uttar Pradesh, India
| | - Vishal Anand
- Senior Resident, Department of Periodontology, Faculty of Dental Sciences, King George Medical College, Lucknow, Uttar Pradesh, India
| | - Jaya Dixit
- Head of Department, Department of Periodontology, Faculty of Dental Sciences, C.S.M. Medical University (Upgraded KGMC), Lucknow, Uttar Pradesh, India
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24
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Clinical outcomes after treatment of periodontal intrabony defects with nanocrystalline hydroxyapatite (Ostim) or enamel matrix derivatives (Emdogain): a randomized controlled clinical trial. BIOMED RESEARCH INTERNATIONAL 2014; 2014:786353. [PMID: 24689056 PMCID: PMC3932837 DOI: 10.1155/2014/786353] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 12/05/2013] [Accepted: 12/25/2013] [Indexed: 12/04/2022]
Abstract
Introduction. Periodontitis is an inflammatory process in response to dental biofilm and leads to periodontal tissue destruction. The aim of this study was the comparison of outcomes using either an enamel matrix derivative (EMD) or a nanocrystalline hydroxyapatite (NHA) in regenerative periodontal therapy after 6 and 12 months. Methods. Using a parallel group, prospective randomized study design, we enrolled 19 patients in each group. The primary outcome was bone fill after 12 months. Attachment gain, probing pocket depth (PPD) reduction, and recession were secondary variables. Additionally, early wound healing and adverse events were assessed. Data analysis included test of noninferiority of NHA group (test) compared to EMD group (reference) in bone fill. Differences in means of secondary variables were compared by paired t-test, frequency data by exact χ2 test. Results. Both groups showed significant bone fill, reduction of PPD, increase in recession, and gain of attachment after 6 and 12 months. No significant differences between groups were found at any time point. Adverse events were comparable between both groups with a tendency of more complaints in the NHA group. Conclusion. The clinical outcomes were similar in both groups. EMD could have some advantage compared to NHA regarding patients comfort and adverse events. The trial is registered with ClinicalTrials.gov NCT00757159.
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25
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Stoecklin-Wasmer C, Rutjes A, da Costa B, Salvi G, Jüni P, Sculean A. Absorbable Collagen Membranes for Periodontal Regeneration. J Dent Res 2013; 92:773-81. [DOI: 10.1177/0022034513496428] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Guided tissue regeneration (GTR) with bioabsorbable collagen membranes (CM) is commonly used for the treatment of periodontal defects. The objective of this systematic review of randomized clinical trials was to assess the clinical efficacy of GTR procedures with CM, with or without bone substitutes, in periodontal infrabony defects compared with that of open flap debridement (OFD) alone. Primary outcomes were tooth loss and gain in clinical attachment level (CAL). Screening of records, data extraction, and risk-of-bias assessments were performed by two reviewers. Weighted mean differences were estimated by random effects meta-analysis. We included 21 reports on 17 trials. Risk of bias was generally high. No data were available for the primary outcome tooth loss. The summary treatment effect for change in CAL for GTR with CM compared with OFD was 1.58 mm (95% CI, 1.27 to 1.88). Despite large between-trial heterogeneity (I2 = 75%, p < .001), all trials favored GTR over OFD. No differences in treatment effects were detected between trials of GTR with CM alone and trials of GTR with CM in combination with bone substitutes ( p for interaction, .31). GTR with CM, with or without substitutes, may result in improved clinical outcomes compared with those achieved with OFD alone. Our findings support GTR with CM for the treatment of infrabony periodontal defects.
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Affiliation(s)
- C. Stoecklin-Wasmer
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - A.W.S. Rutjes
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- Centre for Aging Sciences (Ce.S.I.), G. d’Annunzio University Foundation, Palazzina SEBI 3° livello, Campus Universitario Chieti Scalo, 66100 Chieti Scalo, Italia
| | - B.R. da Costa
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- CTU Bern, Department of Clinical Research, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - G.E. Salvi
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - P. Jüni
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- CTU Bern, Department of Clinical Research, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - A. Sculean
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
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26
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Verma PK, Srivastava R, Gupta KK, Chaturvedi TP. Treatment strategy for guided tissue regeneration in various class II furcation defect: Case series. Dent Res J (Isfahan) 2013; 10:689-94. [PMID: 24348631 PMCID: PMC3858748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Periodontal regeneration is a main aspect in the treatment of teeth affected by periodontitis. Periodontal regeneration in furcation areas is quite challenging, especially when it is in interproximal region. There are several techniques used alone or in combination considered to achieve periodontal regeneration, including the bone grafts or substitutes, guided tissue regeneration (GTR), root surface modification, and biological mediators. Many factors may account for variability in response to regenerative therapy in class II furcation. This case series describes the management of class II furcation defect in a mesial interproximal region of a maxillary tooth and other with a buccal class II furcation of mandibular tooth, with the help of surgical intervention including the GTR membrane and bone graft materials. This combined treatment resulted in healthy periodontium with a radiographic evidence of alveolar bone gain in both cases. This case series demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the combined treatment modalities will restore health and function of the tooth with the severe attachment loss.
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Affiliation(s)
- Pushpendra Kumar Verma
- Faculty of Dental Sciences, I.M.S., Banaras Hindu University, Varanasi, Uttar Pradesh, India,Address for correspondence: Dr. Pushpendra Kumar Verma, Faculty of Dental Sciences, I.M.S., Banaras Hindu University, Varanasi - 221005, Uttar Pradesh, India. E-mail:
| | - Ruchi Srivastava
- Faculty of Dental Sciences, I.M.S., Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - K K Gupta
- Department of Periodontology & Implantology, Sardar Patel Post-graduate Institute of Dental & Medical Sciences, Lucknow, Uttar Pradesh, India
| | - T P Chaturvedi
- Faculty of Dental Sciences, I.M.S., Banaras Hindu University, Varanasi, Uttar Pradesh, India
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27
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Abstract
Dental tissue injury and regeneration affects the daily lives of almost everyone. Tissue engineering is emerging as a promising therapy to regenerate missing teeth and dental tissues. The aim of regenerative dental therapies is to restore patients to full oral health. This means restoring normal function to missing or damaged tissue. Regeneration approaches use a combination of scaffolds, stem cells, growth factors, tissue engineering, organ tissue culture, transplantation, and tissue grafting. There are 8 key elements to create and use tissue constructs for tissue regeneration. These will be described in detail in this article.
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Affiliation(s)
- Peter E Murray
- Department of Endodontics, College of Dental Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328-2018, USA.
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