Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.
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http://dx.doi.org/10.1590/0103-6440201302169 | DOI Listing |
Background: The adjunctive use of connective tissue grafts (CTGs) in the periodontal regeneration of intrabony defects has been proposed to prevent or limit postoperative gingival recession. However, there is limited evidence regarding the long-term clinical performance of this approach.
Methods: This article presents the five-year follow-up outcomes of a combination therapy using CTG, bone substitutes, and biologics for the treatment of deep intrabony defects associated with gingival recession.
Clin Adv Periodontics
December 2024
Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Background: Recombinant human fibroblast growth factor-2 (rhFGF-2) has been shown to effectively promote the formation of new periodontal tissues, and its efficacy has been demonstrated in clinical settings. Moreover, the clinical and radiographic outcomes in the treatment of periodontal infrabony defects can be improved by using rhFGF-2 in combination with a bone substitute. Here, we present a case of four-wall bone defect in a tooth treated by combination regenerative therapy using rhFGF-2 and beta-tricalcium phosphate (β-TCP).
View Article and Find Full Text PDFJ Evid Based Dent Pract
December 2024
Assistant Professor, Department of Restorative Dentistry, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, PA.
Background: The objective of this systematic review is to assess the clinical outcomes of intrabony and furcation defects treated using a regenerative approach with calcium phosphate (CP) grafts combined plus guided tissue regeneration (GTR) membrane in comparison to open flap debridement (OFD).
Method: A review protocol was created under PRISMA checklist to find randomized clinical trials (RCTs) in English that compared CPs plus GTR with OFD in humans with intrabony and/or furcation defects. Both electronic and manual searches were conducted.
Ther Adv Chronic Dis
November 2024
Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA.
Growth factors were introduced to increase predictability in periodontal regeneration and have since been widely applied in dentistry. This narrative review article highlights histological and latest findings of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human fibroblast growth factor-2 (rhFGF-2) for periodontal regeneration. rhPDGF-BB enhances the proliferation and chemotaxis of periodontal ligament and alveolar bone cells.
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