Effect of basic fibroblast growth factor (FGF-2) in combination with beta tricalcium phosphate on root coverage in dog.

OBJECTIVE: In root coverage treatment, periodontal regeneration in gingival recession-type defects is an important challenge for the periodontist. The aim of this study was to histometrically investigate the effect of combined use of basic fibroblast growth factor (FGF-2) and beta tricalcium phosphate (ß-TCP) on root coverage in dogs. MATERIALS AND METHODS: Sixteen adult beagle dogs were used. Buccal gingival recession defects were surgically created bilaterally in the maxillary canines. The defects in each animal were randomly assigned to: (1) an FGF-2 alone (control) group or (2) FGF-2/ß-TCP (experimental) group. At 2, 4 or 8 weeks following surgery, specimens were obtained and subjected to microscopic examination and histometric assessment. RESULTS: Inhibition of epithelial down-growth was observed in both groups. At week 2, in the newly formed connective tissue at the coronal portion, the FGF-2/ß-TCP group showed significantly greater numbers of proliferating cell nuclear antigen-positive cells than the FGF-2 group (55.8 ± 4.8 vs 12.0 ± 1.4, p < 0.01). In the FGF-2/ß-TCP group, new attachment was observed at 8 weeks and the extent of new bone and cementum formation was significantly greater in the FGF-2/ß-TCP group than that in the FGF-2 alone group. In both groups, the dentin surface beneath the new cementum presented minor irregularities, but no replacement resorption was observed. CONCLUSIONS: FGF-2 used in combination with ß-TCP enhances formation of new bone and cementum without significant root resorption in root coverage in this dog model. This combination warrants further investigation in periodontal regeneration in root coverage treatment.

A collaborative approach to care for patients with periodontitis and diabetes.

As periodontal disease and diabetes mellitus (DM) have bidirectional interactions, an effective approach to periodontal treatment for patients with diabetes in the clinical setting is essential. This paper reports an effort in collaborative care for patients with periodontitis and diabetes between dental and medical professionals, and provides a preliminary evaluation regarding the clinical outcomes. We have introduced a clinical pathway program at our institution applicable to patients with periodontitis and DM. Physicians and dentists utilize the clinical pathway to share medical and dental information in order to provide the optimal care for each patient. So far, this clinical pathway has been applied to the treatment of 50 patients. We analyzed clinical outcomes in 10 patients with the chief complaint of periodontal problems who had also been diagnosed with type 2 DM. After initial periodontal therapy and diabetes care, a significant improvement in the mean value of glycated hemoglobin and fasting plasma glucose was observed, accompanied by clinical resolution of periodontal parameters. Within the limitations of the present study, the results suggest that collaborative care between periodontists and physicians based on the clinical pathway is effective in glycemic control of patients with periodontitis and type 2 DM. This indicates the need for closer collaboration between medical and dental professionals in improving the management of these diseases.

Effect of platelet-derived growth factor-BB on root resorption after reimplantation of partially denuded tooth in dog.

The prognosis for a reimplanted tooth depends largely on the condition of the root. Platelet-derived growth factor (PDGF)-BB has been shown to regenerate periodontal tissue in animal and human clinical studies. However, information regarding the effect of PDGF-BB on tooth reimplantation is limited. The objective of this study was to investigate the effect of PDGF-BB on root resorption after reimplantation of a partially denuded tooth in dog. A total of 15 healthy female beagle dogs were used. Mandibular third and fourth premolars were endodontically treated and then extracted as atraumatically as possible. The coronal portion of each root was carefully scaled and planed. The roots on the right side of the mandible were treated with PDGF-BB and reimplanted, while the roots on the left side served as controls. After 2, 4, or 8 weeks, specimens were collected and processed for histopathological examination. By the 4th week after reimplantation, new periodontal ligament (PDL)-like tissue had formed around the PDGF-BB-treated root surfaces and new bone. By the 8th week, healing of the PDGF-BB-treated roots was characterized by newly formed PDL with inserting attachment formation. In contrast, control roots showed multiple areas of replacement resorption. Immunohistochemical staining of proliferating cell nuclear antigen (PCNA) performed at 2 weeks after reimplantation showed that the number of PCNA-positive cells in the connective tissue area was statistically significantly greater in the PDGF-BB-treated group than in the control group (P < 0.001). The application of PDGF-BB resulted in a significantly lower occurrence and extent of root resorption and ankylosis. These results suggest that the use of PDGF-BB reduces occurrence of ankylosis and root resorption in tooth reimplantation.

Coverage of gingival recession defects using acellular dermal matrix allograft with or without beta-tricalcium phosphate.

The aim of this study was to investigate the effect of beta-tricalcium phosphate (ß-TCP) particles in combination with acellular dermal matrix (ADM) allograft in gingival recession. Experimental gingival recession defects were created in beagle dogs and randomly assigned to one of the following groups: ADM, ADM + ß-TCP, or coronally positioned flap (CPF; control). Tissues were histologically examined at 4, 8, or 16 weeks following treatment. A greater thickness of gingiva was observed at the sites treated in both the ADM + ß-TCP and ADM groups than in the CPF group. The ADM + ß-TCP group showed a statistically significant increase in both new bone and cementum formations compared to the ADM group. The results suggest that the combination of ß-TCP and ADM is more effective in promoting new bone and cementum formations than ADM graft alone.