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1.
Quintessence Int ; 0(0): 308-316, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33533237

RESUMEN

OBJECTIVES: In-vitro data have shown that cross-linked hyaluronic acid (HA) enhances the proliferative and migratory properties of cells involved in periodontal wound healing/regeneration, stabilizes the blood clot, reduces the inflammatory response, and facilitates angiogenesis. The aim of this study was to histologically evaluate the effects of cross-linked HA alone or combined with a collagen matrix (CM) on the periodontal wound healing/regeneration in intrabony defects. METHOD AND MATERIALS: Two-wall intrabony defects (5 mm wide, 5 mm deep) were surgically created at the distal and mesial aspects of mandibular premolars in six beagle dogs. The 24 defects were randomly treated as follows: open flap debridement (OFD) + HA, OFD + CM, OFD + HA + CM (HA/CM), and OFD alone (control). At 2 months, the animals were euthanized for histologic evaluation. RESULTS: The HA (2.43 ±â€¯1.25 mm) and HA/CM (2.60 ±â€¯0.99 mm) groups yielded statistically significantly (P < .05) greater formation of new attachment (ie, linear length of new cementum adjacent to newly formed bone, with inserting collagen fibers) compared with the OFD (0.55 ± 0.99 mm) group. Among the four treatment groups, the HA/CM group demonstrated the highest amount of regenerated tissues, although no statistically significant differences in any of the histometric parameters were observed between the HA and HA/CM groups. CONCLUSION: Within their limits, it can be concluded that cross-linked HA alone or combined with CM promotes periodontal wound healing/regeneration in two-wall intrabony defects in dogs.


Asunto(s)
Pérdida de Hueso Alveolar , Procedimientos Quirúrgicos Reconstructivos , Pérdida de Hueso Alveolar/cirugía , Animales , Regeneración Ósea , Colágeno , Perros , Regeneración Tisular Guiada Periodontal , Ácido Hialurónico , Cicatrización de Heridas
2.
Quintessence Int ; 0(0): 402-410, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33491386

RESUMEN

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ±â€¯0.5 mm and 0.04 ±â€¯1.1 mm, and -0.65 ±â€¯3.0 mm and -0.73 ±â€¯3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task.


Asunto(s)
Periodontitis Agresiva , Pérdida de Hueso Alveolar , Proteínas del Esmalte Dental , Recesión Gingival , Periodontitis Agresiva/cirugía , Pérdida de Hueso Alveolar/cirugía , Animales , Bovinos , Estudios de Seguimiento , Recesión Gingival/cirugía , Regeneración Tisular Guiada Periodontal , Humanos , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/cirugía , Resultado del Tratamiento
3.
Clin Oral Implants Res ; 32(3): 369-381, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33420723

RESUMEN

OBJECTIVES: To evaluate new lateral bone formation and lateral volume augmentation by guided bone regeneration (GBR) in chronic non-contained bone defects with the use of a non-resorbable TiO2 -block. MATERIALS AND METHODS: Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for 8 weeks before treatment by GBR. Each hemimandible was randomly allocated to 4- or 12-week healing time after GBR, and three intervention groups were assigned by block randomization: TiO2 block: TiO2 -scaffold and a collagen membrane, DBBM particles: Deproteinized bovine bone mineral (DBBM) and a collagen membrane, Empty control: Collagen membrane only. Microcomputed tomography (microCT) was used to measure the lateral bone formation and width augmentation. Histological outcomes included descriptive analysis and histomorphometric measurements. RESULTS: MicroCT analysis demonstrated increasing new bone formation from 4 to 12 weeks of healing. The greatest width of mineralized bone was seen in the empty controls, and the largest lateral volume augmentation was observed in the TiO2 block sites. The DBBM particles demonstrated more mineralized bone in the grafted area than the TiO2 blocks, but small amounts and less than the empty control sites. CONCLUSION: The TiO2 blocks rendered the largest lateral volume augmentation but also less new bone formation compared with the DBBM particles. The most new lateral bone formation outward from the bone defect margins was observed in the empty controls, indicating that the presence of either graft material leads to slow appositional bone growth.


Asunto(s)
Sustitutos de Huesos , Animales , Regeneración Ósea , Bovinos , Perros , Regeneración Tisular Guiada Periodontal , Porosidad , Titanio , Microtomografía por Rayos X
4.
Clin Oral Investig ; 25(3): 807-821, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33438084

RESUMEN

AIM: The present systematic review appended with meta-analysis aimed to evaluate the efficacy of bone replacement graft (BRG) with guided tissue regeneration (GTR) over BRG or open flap debridement (OFD) alone in the treatment of grade II furcation defects. MATERIALS AND METHODS: An electronic literature search of PubMed, Cochrane Library and Google Scholar databases accompanied with manual searching was done. Randomized controlled trials (RCTs) up to October 2019, comparing BRG+GTR with BRG or OFD in grade II furcation defects, were identified. Clinical attachment level (CAL) gain, changes in gingival marginal level (GML), vertical defect fill (VDF), horizontal defect fill (HDF) and reduction in defect volume were the outcome parameters. RESULTS: Of a total of 12, 9 studies compared BRG+GTR vs BRG while 3 compared BRG+GTR vs OFD. Meta-analysis was carried out for CAL gain, VDF, HDF and GML changes. In the BRG+GTR vs BRG comparison group, out of 9 studies, 6 RCTs showed standardized mean difference (SMD) of 0.513 for VDF, 9 RCTs showed SMD of 0.83 for HDF and 2 RCTs showed SMD of 0.651 for CAL gain, whereas only 2 studies in the same group reported reduction in defect volume. Three studies of the BRG+GTR vs OFD group exhibited significant VDF and CAL gain with SMD of 2.002 and 1.161 respectively. However, no significant change was recorded for GML in both groups. CONCLUSION: The present systematic review indicates supplemental benefits of combination therapy of BRG+GTR over monotherapy in resolving grade II furcation defects. CLINICAL RELEVANCE: In our quest to achieve maximum regeneration in grade II furcation defects, combination therapies such as BRG+GTR have been accepted as treatment choices over other modalities. Clinical situations warranting near-complete regeneration of the tissues in such defects are better suited for combination therapies.


Asunto(s)
Pérdida de Hueso Alveolar , Defectos de Furcación , Pérdida de Hueso Alveolar/cirugía , Regeneración Ósea , Trasplante Óseo , Estudios de Seguimiento , Defectos de Furcación/cirugía , Regeneración Tisular Guiada Periodontal , Humanos , Membranas Artificiales , Pérdida de la Inserción Periodontal , Resultado del Tratamiento
5.
Cient. dent. (Ed. impr.) ; 17(3): 175-181, sept.-dic. 2020. ilus
Artículo en Español | IBECS | ID: ibc-198599

RESUMEN

Se presenta el caso de un paciente varón de 43 años con lesiones periapicales radiolúcidas de origen endodóntico en dientes pilares de rehabilitación fija metalocerámica, que acude a consulta para valorar la posibilidad de mantener sus dientes. Tras la exploración clínica y radiológica mediante radiografías periapicales y tomografía computerizada de haz cónico (CBCT) se decide realizar un abordaje combinado endodóntico-quirúrgico. La evolución clínica fue favorable y los controles radiográficos y tomográficos mostraron la resolución de las lesiones radiolúcidas preexistentes. El retratamiento endodóntico combinado con la microcirugía periapical son herramientas eficaces en el tratamiento conservador de dientes con lesiones periapicales de origen endodóntico


In this case report, we present a 43-year old male patient with multiple periapical radiolucent lesions caused by endodontic failure in teeth supporting a metalloceramic prosthetic rehabilitation, who came to the office asking for any possibility to maintain his teeth. After clinical and radiological exploration with periapical x-rays and cone beam computer tomography (CBCT), we decided to use a combined endodontic-surgical approach. Clinical evolution was favourable, and radiologica - tomographic controls showed complete healing of periapical radiolucent lesions. Endodontic retreatment combined with periapical microsurgery are effective tools for conservative treatment in teeth with periapical lesions caused by endodontic failures


Asunto(s)
Humanos , Masculino , Adulto , Tejido Periapical/lesiones , Tejido Periapical/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Retratamiento , Microcirugia/métodos , Enfermedades Periapicales/patología , Tomografía Computarizada por Rayos X , Endodoncia/métodos , Radiografía Panorámica
6.
Artículo en Inglés | MEDLINE | ID: mdl-33151186

RESUMEN

This study presents the histomorphometric results of the Wafer Technique, which is based on guided bone regeneration and onlay grafts for 3D bone augmentation. This two-stage technique utilizes autogenous cortical bone plates and collagen membranes, forming a barrier containing a mixture of deproteinized bovine bone matrix, autologous blood, and bone grafted from intraoral sites. Twelve patients were treated. At 6 months postsurgery, histologic analysis of the regenerated areas revealed the presence of compact newly formed bone with no sign of inflammation. The percentages of new bone and native bone (mineralized tissue) were 16.4% (95% CI: 9.5% to 23.2%) and 42.6% (95% CI: 28.2% to 57.0%), respectively. Twenty-five implants were placed. The procedure has been proven to be safe and reliable, and only one transient complication was observed.


Asunto(s)
Aumento de la Cresta Alveolar , Sustitutos de Huesos , Implantes Dentales , Animales , Regeneración Ósea , Trasplante Óseo , Bovinos , Implantación Dental Endoósea , Regeneración Tisular Guiada Periodontal , Humanos , Membranas Artificiales
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 778-782, 2020 Oct 09.
Artículo en Chino | MEDLINE | ID: mdl-33045791

RESUMEN

Minimally invasive surgery develops rapidly in the periodontal treatments, especially in the periodontal regenerative treatment, in recent years. It supplements, to a certain extent, the insufficiency of the conventional periodontal regenerative treatment. The minimally invasive surgery has many advantages such as enhancing the healing process, reducing surgical chair time and minimizing patient discomfort, etc. It has been proved to improve the clinical effect and provide additional benefits compared to conventional approaches. At present, there are many studies on minimally invasive techniques used in tooth extraction or implant placement in China, but there are few reports on the application of periodontal minimally invasive surgical techniques. Thus based on the reviews of the literatures, this article describes the applications, advantages, indications, microsurgical instruments of minimally invasive periodontal surgery on the treatment of intrabony defect, including various minimally invasive surgical procedures. The review also demonstrates the therapeutic effects and research progress of minimally invasive periodontal surgery combined with biomaterials used in the treatments of intrabony defect. The present article may also provide reference for clinicians applying minimally invasive surgeries to treat intrabony defects.


Asunto(s)
Regeneración Tisular Guiada Periodontal , Procedimientos Quirúrgicos Mínimamente Invasivos , China , Atención Odontológica , Humanos , Microcirugia
8.
Medicine (Baltimore) ; 99(40): e22507, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019451

RESUMEN

RATIONALE: In this report, a combination of platelet-rich fibrin (PRF) membrane and semi-open flap technique was used to improve soft tissue regeneration in immediate implant placement in the molar region. PRF, an autologous fibrin matrix, has been widely used for soft tissue wound healing and regeneration. Semi-open flap technique is beneficial to eliminating exudates and relieving the swelling after surgery. PATIENT CONCERNS: Case 1 was a 45-year-old female with a residual crown in the posterior maxillary region that desired a dental implant operation. Case 2 was a 24-year-old male with retained deciduous tooth that requested a restoration of his congenital absent tooth. DIAGNOSES: In case 1, the tooth 16 was diagnosed with a residual crown, while in case 2, a deciduous tooth 75 was a retained deciduous tooth and 35 was congenital absent. INTERVENTIONS: In both cases, immediate implant placement was installed and PRF membranes were made to improve soft tissue augmentation with semi-open flap technique. In case 1, the mixture of an organic bovine bone and blood was filled in the gap between the implant and the socket wall. Subsequently, 2 PRF membranes covered the open wound with semi-open flap. Similarly, in case 2, another 2 PRF membranes were used to improve the soft tissue regeneration, with the same semi-open flap technique as mentioned above. OUTCOMES: In both cases, successfully soft tissue regeneration was obviously observed without postoperative infection. LESSONS: Utilizing the PRF membrane combined with semi-open flap technique can achieve excellent soft tissue augmentation around immediate implant placement in the molar regions.


Asunto(s)
Implantes Dentales , Regeneración Tisular Guiada Periodontal/métodos , Diente Molar/cirugía , Fibrina Rica en Plaquetas , Colgajos Quirúrgicos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cicatrización de Heridas
9.
Int J Esthet Dent ; 15(4): 454-473, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33089260

RESUMEN

Ridge defects are a very common finding after tooth extraction. Recent literature has shown that the pattern of bone and soft tissue remodeling can obtain up to 50% of the original volume. Many different surgical approaches have been proposed over the years to correct ridge defects, but the results have often been inconsistent or difficult to reproduce on a daily basis. For some time, surgeons have relied on the guided bone regeneration (GBR) technique, taking advantage of a barrier membrane to protect the blood clot, combined with different combinations of autogenous bone and bone grafts from various sources. If some kind of understanding has been reached and certain guidelines adopted for the treatment of horizontal defects, those for tridimensional and vertical defects still present a challenge. About a decade ago, a new biomaterial became available on the market - a membrane made of collagenated porcine bone called cortical lamina - which proved to be reliable and easy to handle for both horizontal and vertical defects. The aim of this article is to review the current literature on the topic and to discuss the material in its three forms through the presentation of three patient cases of differing complexity, each with its unique indications and characteristics.


Asunto(s)
Aumento de la Cresta Alveolar , Animales , Regeneración Ósea , Trasplante Óseo , Implantación Dental Endoósea , Regeneración Tisular Guiada Periodontal , Humanos , Porcinos
10.
Artículo en Inglés | MEDLINE | ID: mdl-32925999

RESUMEN

The aim of this study was to investigate which factors play a major role in the healing of Class II mandibular furcation defects treated with different surgical techniques. Twenty-five systemically healthy subjects with periodontitis stage III grade B and Class II buccal mandibular furcation involvement received one of the following open flap debridement approaches: Group 1 (n = 10), no further treatment; Group 2 (n = 10), piezoelectric contouring of the furcation roof; Group 3 (n = 9), piezoelectric contouring of the furcation roof and bone grafting; Group 4 (n = 10), piezoelectric contouring of the furcation roof and bone grafting with coronally positioned flap. Clinical and radiologic variables-bleeding on probing, probing depth (PPD), vertical and horizontal bone level (CAL and PH), gingival recession, root trunk length, radicular separation, and furcation perimeter (FP)-were evaluated at baseline and 180 days and 1 year after surgery. All clinical parameters were statistically analyzed. Surgical techniques caused clinical (CAL, PPD, PH) and radiographic (FP) improvements. Regenerative techniques and the coronally positioned flap yielded a major radiographic reduction of furcation areas. All therapies resulted in significant horizontal and vertical PPD reduction and CAL gain.


Asunto(s)
Defectos de Furcación/cirugía , Regeneración Tisular Guiada Periodontal , Humanos , Mandíbula/cirugía , Diente Molar/cirugía , Índice Periodontal , Resultado del Tratamiento
11.
J Int Acad Periodontol ; 22(3): 117-128, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-32655037

RESUMEN

BACKGROUND: This systematic review evaluated the most effective therapeutic approach to treat periodontal furcation defects with a minimum follow-up of 12 months. The primary outcome was clinical attachment level (CAL). Secondary outcomes were probing pocket depth, gingival margin level, gingival index and plaque index. METHODS: A comprehensive search of studies published up to December 2019 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Two reviewers independently searched eligible studies, made a final article selection, and extracted the data of the selected studies to evaluate qualitatively and quantitatively (meta-analysis). RESULTS: Overall, 19 studies were selected for the analysis. Six hundred and eighteen patients (mean age, 45.3) were treated. More commonly used treatment was polytetrafluoroethylene barrier (ePTFE), followed by enamel matrix derivative (EMD) and open-flap debridement (OFD). Only one study evaluated maxillary arch and remaining evaluated mandibular arch. All treatments provided CAL gain, but meta-analysis did not show significant difference among more commonly used treatments and controls (P=0.91; P=0.47; P=0.08, respectively). CONCLUSION: There is no difference on effectiveness of main therapeutic approaches evaluated for treatment of Class II periodontal furcation defects.


Asunto(s)
Defectos de Furcación , Índice de Placa Dental , Estudios de Seguimiento , Defectos de Furcación/cirugía , Regeneración Tisular Guiada Periodontal , Humanos , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/cirugía , Índice Periodontal , Colgajos Quirúrgicos , Resultado del Tratamiento
13.
Quintessence Int ; 51(10): 822-837, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32661522

RESUMEN

OBJECTIVES: Regeneration of intrabony defects is a challenging target of periodontal therapy. The biologic rationale for regeneration not only is based on incorporating the regenerative material, but also takes into consideration the defect's inherent healing capacity. The present study was carried out to evaluate the efficacy of decortication or intramarrow penetration performed with demineralized freeze-dried bone allograft (DFDBA) in the management of intrabony defects. METHOD AND MATERIALS: Forty chronic periodontitis (stage II and III periodontitis) patients having 40 intrabony defects were randomly assigned into test group (intrabony defect filled with DFDBA after intramarrow penetration along with open flap debridement [OFD+IMP+ DFDBA]) and control group (DFDBA along with open flap debridement [OFD+DFDBA]). Primary outcome measures included probing pocket depth, clinical attachment level, and percentage bone fill (%BF). All parameters were recorded at baseline, 6 months, and 9 months postsurgical follow-up. RESULTS: Mean reduction in probing depth and gain in clinical attachment level was statistically significantly higher at the interdental defect site in the test group compared to the control group at 9 months follow-up (P = .02 and .04, respectively). In radiographic parameters, statistically significant improvements in defect depth and gain in defect area were found in the test group (P = .00 and .03, respectively). Statistically significant improvements in %BF and linear bone growth (P = .02 and .00, respectively) were also observed in the experimental group (39.47 ± 13.92% and 1.41 ± 0.54 mm) in comparison with the control group (19.29 ± 14.24%, 0.62 ± 0.49 mm). CONCLUSION: Addition of intramarrow penetration with DFDBA in surgical periodontal therapy may enhance the healing potential of periodontal intrabony defects, as observed by greater improvement in clinical and radiographic outcomes.


Asunto(s)
Pérdida de Hueso Alveolar , Trasplante Óseo , Regeneración Tisular Guiada Periodontal , Aloinjertos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Humanos , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/cirugía , Resultado del Tratamiento
14.
Int J Periodontics Restorative Dent ; 40(4): e137-e146, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32559031

RESUMEN

Furcation involvement (FI) is one of the most detrimental factors affecting tooth survival rate over time. Several authors have used the severity of FI for assessing the prognosis of the tooth and the complexity of periodontal disease. While many approaches have been shown to improve the prognosis of furcation-involved teeth, clinical guidelines recommending one treatment or another (based on the horizontal and vertical component of the furcation defects) have not yet been proposed. To this aim, the present article introduces recommendations for the treatment of molars with FI and discusses different treatment options with their potential regenerative approaches. Patient-related factors, together with hard and soft-tissue conditions that may affect the outcomes of periodontal regeneration, are discussed.


Asunto(s)
Defectos de Furcación/cirugía , Diente , Regeneración Tisular Guiada Periodontal , Humanos , Diente Molar/cirugía , Regeneración
15.
AAPS PharmSciTech ; 21(5): 173, 2020 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-32548717

RESUMEN

Innovative strategies for periodontal regeneration have been the focus of research clusters across the globe for decades. In order to overcome the drawbacks of currently available options, investigators have suggested a novel concept of functionally graded membrane (FGM) templates with different structural and morphological gradients. Chitosan (CH) has been used in the past for similar purpose. However, the composite formulation of composite and tetracycline when cross-linked with glutaraldehyde have received little attention. Therefore, the purpose of the study was to investigate the drug loading and release characteristics of novel freeze gelated chitosan templates at different percentages of glutaraldehyde. These were cross-linked with 0.1 and 1% glutaraldehyde and loaded with doxycycline hyclate. The electron micrographs depicted porous morphology of neat templates. After cross-linking, these templates showed compressed ultrastructures. Computerized tomography analysis showed that the templates had 88 to 92% porosity with average pore diameter decreased from 78 to 44.9 µm with increasing concentration. Fourier transform infrared spectroscopy showed alterations in the glycosidic segment of chitosan fingerprint region which after drug loading showed a dominant doxycycline spectral composite profile. Interestingly, swelling profile was not affected by cross-linking either at 0.1 and 1% glutaraldehyde and template showed a swelling ratio of 80%, which gained equilibrium after 15 min. The drug release pattern also showed a 40 µg/mL of release after 24 h. These doxycycline-loaded templates show their tendency to be used in a functionally graded membrane facing the defect site.


Asunto(s)
Materiales Biocompatibles/química , Quitosano/química , Reactivos de Enlaces Cruzados/química , Congelación , Regeneración Tisular Guiada Periodontal/métodos , Materiales Biocompatibles/farmacocinética , Quitosano/farmacocinética , Reactivos de Enlaces Cruzados/farmacocinética , Liberación de Fármacos , Geles , Glutaral/química , Glutaral/farmacocinética , Porosidad , Espectroscopía Infrarroja por Transformada de Fourier/métodos
16.
J Contemp Dent Pract ; 21(1): 36-40, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32381798

RESUMEN

AIM: Aim of the present study was to evaluate the loading of clindamycin with injectable-guided tissue regeneration (GTR) will prevent the colonization of Porphyromonas gingivalis and to compare and assess the quantitative changes in P. gingivalis colony forming units (CFUs) by real-time polymerase chain reaction (PCR) analysis. MATERIALS AND METHODS: Thirty microbiological samples were pooled from the deepest periodontal pockets from the thirty sites from the two groups: group I-injectable GTR placed in the defect filled with demineralized freeze-dried bone allograft (DFDBA) and group II-clindamycin loaded injectable GTR placed in the defect filled with DFDBA. The total number of P. gingivalis CFUs was estimated using real-time PCR at baseline and 4 weeks after therapy. RESULTS: A significant reduction in P. gingivalis CFUs at the end of 4 weeks was seen in both groups. Comparative evaluations between both groups at 4 weeks were with a mean of 4.44 ± 2.28 and 4.75 ± 3.32, respectively. Though there was a significant reduction in group II, the difference was statistically insignificant. CONCLUSION: The results suggest that clindamycin is beneficial in reducing microbial infection and can potentiate regeneration through host modulation. CLINICAL SIGNIFICANCE: Injectable GTR has the ability to mold according to the defect size and shape and eliminates the need to manipulate the membrane as required for the conventional membrane.


Asunto(s)
Clindamicina , Porphyromonas gingivalis , Trasplante Óseo , Regeneración Tisular Guiada Periodontal , Reacción en Cadena en Tiempo Real de la Polimerasa
17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(2): 346-352, 2020 Apr 18.
Artículo en Chino | MEDLINE | ID: mdl-32306021

RESUMEN

OBJECTIVE: Tissues loss due to periodontal disease is typically treated by a variety of regenerative treatment modalities, including bone grafts, guided tissue regeneration (GTR) and growth factors, to reform the supporting tissues of teeth. Concentrated growth factors (CGF) are produced by centrifuging blood samples at alternating and controlled speeds using a special centrifuge. The purpose of this study was to evaluate whether GTR could improve the effect of CGF combined with bone graft in the treatment of classII furcations of mandibular molars. METHODS: In the present study, thirty-five classII furcation involvements were included and randomly divided into two groups. The experimental group (n=17) accepted GTR combined with CGF and bone graft therapy, and the controlled group (n=18) accepted CGF combined with bone graft therapy. The clinical examinations and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery. Comparisons of clinical and CBCT data before and after operation between the experimental group and the control group were made. RESULTS: The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, the clinical parameters of both groups were significantly improved (P<0.001). The probing depths of the experimental group were (4.81±1.95) mm and (3.56±1.94) mm, respectively, significantly higher than the changes of the control group (P<0.001). The vertical and horizontal attachment gains of the experimental group were (4.11±1.98) mm and (3.84±1.68) mm, respectively, significantly higher than the changes of the control group (P<0.001). At the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with those of the control group: (3.84±1.68) and (3.88±2.12) mm, respectively (P<0.001). CONCLUSION: Within the limitation of the present study, GTR showed positive role in the effect of CGF combined with bone graft in the treatment of classII furcation involvements of mandibular molars.


Asunto(s)
Diente Molar , Trasplante Óseo , Tomografía Computarizada de Haz Cónico , Defectos de Furcación , Regeneración Tisular Guiada Periodontal , Humanos , Pérdida de la Inserción Periodontal
18.
J Int Acad Periodontol ; 22(2): 28-40, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32224548

RESUMEN

BACKGROUND AND OBJECTIVES: Applications of porous titanium granule (PTG) in periodontal (furcation defects) and non-periodontal treatments have shown promising results. However, its role in periodontal intrabony defects still remains unexplored. Thus, we aim to assess the feasibility of PTG in obtaining reconstruction in intrabony defects and compare the outcome with that of open flap debridement (OFD). METHODS: Ten patients (three females and seven males) with a mean age of 34.7 years who constituted twenty (20) bilateral intrabony defects were recruited. Each patient contributed to two defects which were randomly treated by OFD alone (control group) or by OFD followed by grafting with PTG (test group). All the clinical and radiological parameters were recorded at baseline, three, six and nine months and statistically analyzed. RESULTS: The results of this study demonstrated that in clinical parameters there is no significant differences in the improvement from baseline to nine months. However, regarding the radiographic defect fill, there was significant gain from baseline to nine months only in the PTG sites. CONCLUSION: Within the limits of our study, the results of this trial indicate that reconstructive periodontal surgery with PTG offers minimal radiographic defect resolution with no significant improvements in clinical endpoints compared to open flap debridement.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Regeneración Tisular Guiada Periodontal , Adulto , Desbridamiento , Femenino , Humanos , Masculino , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/cirugía , Porosidad , Titanio , Resultado del Tratamiento
19.
Artículo en Inglés | MEDLINE | ID: mdl-32233186

RESUMEN

Dental implant therapy often requires bone augmentation to facilitate stable implantation with a predictable outcome. Traditionally, this is accomplished through guided bone regeneration (GBR), which is a series of surgical procedures that use barrier membrane technology to direct the growth of new hard and soft tissues in sites with insufficient volumes for the purpose of placing dental implants. GBR and implant placement can be performed in either one or two surgeries. This article will focus on a novel simultaneous approach that utilizes a custom milled cancellous allograft bone ring that is stabilized through the graft preparation and apical threads of the dental implant. Indications include simultaneous implant placement in a deficient sinus as well as horizontal and vertical four-, three-, two-, and one-wall defects.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Aloinjertos , Regeneración Ósea , Trasplante Óseo , Implantación Dental Endoósea , Regeneración Tisular Guiada Periodontal
20.
Int. j interdiscip. dent. (Print) ; 13(1): 30-34, abr. 2020. graf
Artículo en Español | LILACS | ID: biblio-1114890

RESUMEN

INTRODUCCIÓN: La valoración particular de sitios severamente comprometidos, involucra considerar los tiempos necesarios de cicatrización, así como evidencia actual en términos de biomateriales y técnicas quirúrgicas con el fin de lograr un tratamiento exitoso. MATERIAL Y MÉTODO: Paciente sexo femenino, 28 años, asiste por dolor e infección en diente 2.1 al Postítulo de Periodoncia UDD. Se observa defecto extenso y lesión que compromete tanto las tablas óseas vestibular como palatina. El tratamiento consistió en: exodoncia y regeneración ósea, instalación del implante 6 meses después de la exodoncia y cirugía de conexión 7 meses después más injerto de tejidos blandos. RESULTADOS: El tratamiento de defectos combinados (tejidos duros y blandos), asociados a procesos infecciosos de larga data, mediante rehabilitación implanto soportada puede ser muy predecible y exitoso en la medida que se respeten los tiempos de regeneración de diferentes estructuras.


INTRODUCTION: The specific assessment of a severely compromised sites involves: the consideration of healing time according to the different kinds of tissues involved and the knowledge of the evidence available concerning biomaterials and surgical techniques. MATERIAL AND METHODS: Female patient attends the postgraduate school of periodontics, UDD University in Santiago de Chile, because of pain and chronic infection compromising tooth 2.1. At clinical evaluation, the site has an extensive defect, with active fistula that compromises the buccal and palatal bone plates. The treatment consisted of exodontia and guided bone regeneration, implantation six months after initial exodontia and abutment connection surgery seven months after implant insertion. RESULTS: the treatment of combined defects associated with a long-standing infectious process can be very predictable and successful, only if the measures of time and tissue handling are considered and applied.


Asunto(s)
Humanos , Femenino , Adulto , Extracción Dental , Regeneración Tisular Guiada Periodontal/métodos , Implantación Dental Endoósea/métodos , Estética Dental , Factores de Tiempo , Regeneración Ósea , Toma de Decisiones , Proceso Alveolar
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