Clinical and Experimental Medical Journal
Volume/Issue:
Volume 3: Issue 1
Effect of combined therapeutical methods on healing of intrabony defects in regenerative periodontal surgery
Author:
Ferenc Dőri Doctoral School of Clinical Medical Sciences, Semmelweis University, Budapest, Hungary
Üllői u. 26, H-1085, Budapest, Hungary

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Pages:
187–194
Online Publication Date:
01 Mar 2009
Publication Date:
01 Mar 2009
Article Category:
Research Article
DOI:
https://doi.org/10.1556/CEMED.3.2009.28500
Keywords:
periodontal disease; tissue regeneration; platelet-rich plasma; bone grafts; CAL, clinical attachment level; EMD, enamel matrix derivative (Emdogain®); e-PTFE, expanded polytetrafluoroethylene; GDFs, growth and differentiation factors; GTR, guided tissue regeneration; NBM, natural bone mineral; NS, not statistically significant; PPD, probing pocket depth; PRP, platelet-rich plasma; TCP, tricalcium-phosphate
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Abstract

Several methods are available to enhance the healing and regeneration of periodontal tissues after surgical therapy of intrabony defects. The main indications for the use of combined regenerative procedures are the extent and morphology of the osseous lesions. The six studies of the present dissertation focused on the clinical effect of different barrier techniques, bone substitutes, enamel matrix derivatives and one growth factors containing adjuvant used in various combinations on the healing of severe periodontal intrabony impairments. Synthetic, xenogeneic and autologous materials were used in these randomized clinical studies. Mechanical barriers (polytetrafluoroethylene and collagen membranes) for GTR, biological barriers/enamel matrix proteins (EMD), synthetic (β-TCP) and xenogeneic (NBM) bone grafts and autologous platelet-rich plasma (PRP) were combined in the test and control groups of the trials. Main clinical variable was the clinical attachment level (CAL) and a subsidiary was the probing pocket depth (PPD), estimated at baseline and after one year. The summation of the results after the statistical analysis takes cognizance of the followings: a) each of the eleven regenerative methods evaluated (ten combined procedures) leads to significant CAL gain and PPD decrease; b) using β-TCP or NBM with EMD or with PRP + GTR and GTRs, the difference between the parameters of the test and control groups were not statistically significant; c) in four studies it was confirmed that the addition of PRP to graft materials has not increased significantly the positive outcomes independent of the type of barrier or graft; d) upon adding platelet-rich plasma to natural bone mineral no benefit was observed from the point of view of the clinical variables; e) the polypeptide proteins of the platelet-rich plasma do not enhance the clinical regenerative effect of enamel matrix proteins. In conclusion, the option of the periodontal surgeon between these methods depends mainly on the defect morphology, the patient's approach to the different types of materials, the medical concept of the physician, technical possibilities and the clinical experience of the periodontist.

  • [1]. J. Gottlow S. Nyman J. Lindhe et al.1986 New attachment formation in the human periodontium by guided tissue regeneration J. Clin. Periodontol. 13 604–616.

    • Search Google Scholar
    • Export Citation

  • [2]. W. Becker B. E. Becker J. F. Prichard et al.1987 A surgical and suturing method: three case reports J. Periodontol. 12 819–826.

  • [3]. R. Pontoriero S. Nyman J. Lindhe et al.1987 Guided tissue regeneration in the treatment of furcation defects in man J. Clin. Periodontol. 14 618–620.

    • Search Google Scholar
    • Export Citation

  • [4]. S. Nyman J. Gottlow T. Karring et al.1982 The regenerative potential of the periodontal ligament J. Clin. Periodontol. 9 257–265.

  • [5]. S. Nyman J. Lindhe T. Karring et al.1982 New attachment following surgical treatment of human periodontal disease J. Clin. Periodontol. 9 290–296.

    • Search Google Scholar
    • Export Citation

  • [6]. J. Gottlow S. Nyman T. Karring et al.1984 New attachment formation as result of controlled tissue regeneration J. Clin. Periodontol. 11 494–503.

    • Search Google Scholar
    • Export Citation

  • [7]. L. Hammarström L. Heijl S. Gestrelius 1997 Periodontal regeneration in a buccal dehiscence model in monkeys after application of enamel matrix proteins J. Clin. Periodontol. 24 669–677.

    • Search Google Scholar
    • Export Citation

  • [8]. M. A. Brunsvold J. Mellonig 2000 Bone grafts and periodontal regeneration Periodontology 1 80–91.

  • [9]. Position Paper of American Academy of Periodontology 1996 The potential role of growth and differentiation factors in periodontal regeneration J. Periodontol. 67 545–553.

    • Search Google Scholar
    • Export Citation

  • [10]. E. Anitua 1999 Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants Int. J. Oral. Maxillofac. Implants 14 529–535.

    • Search Google Scholar
    • Export Citation

  • [11]. R. E. Marx E. R. Carlson R. M. Eichstaedt et al.1998 Platelet-rich plasma: growth factor enhancement for bone grafts Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 85 638–646.

    • Search Google Scholar
    • Export Citation

  • [12]. F. Dőri N. Arweiler I. Gera et al.2005 Clinical evaluation of an enamel matrix protein derivative combined with either a natural bone mineral or beta-tricalcium phosphate J. Periodontol. 76 2236–2243.

    • Search Google Scholar
    • Export Citation

  • [13]. F. Dőri T. Huszár D. Nikolidakis et al.2007 Effect of platelet rich plasma on the healing of intrabony defects treated with a natural bone mineral and a collagen membrane J. Clin. Periodontol. 34 254–261.

    • Search Google Scholar
    • Export Citation

  • [14]. F. Dőri T. Huszár D. Nikolidakis et al.2007 Effect of platelet rich plasma on the healing of intrabony defects treated with an anorganic bovine bone mineral and expanded polytetrafluoroethylene membranes J. Periodontol. 78 983–990.

    • Search Google Scholar
    • Export Citation

  • [15]. F. Dőri D. Nikolidakis T. Huszár et al.2008 Effect of platelet-rich plasma on the healing of intrabony defects treated with an enamel matrix protein derivative and a natural bone mineral J. Clin. Periodontol. 35 44–50.

    • Search Google Scholar
    • Export Citation

  • [16]. F. Dőri T. Huszár D. Nikolidakis et al.2008 Effect of platelet rich plasma on the healing of intrabony defects treated with a β-tricalcium phosphate and expanded polytetrafluoroethylene membranes J. Periodontol. 79 660–669.

    • Search Google Scholar
    • Export Citation
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Cover Clinical and Experimental Medical Journal
Clinical and Experimental Medical Journal
Print ISSN:
2060-6249
Online ISSN:
2060-968X

Clinical and Experimental Medical Journal
Language English
Size  
Year of
Foundation		 2007
Publication
Programme		 ceased
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per Year		  
Issues
per Year		  
Publisher Akadémiai Kiadó
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Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245
Responsible
Publisher		 Chief Executive Officer, Akadémiai Kiadó
ISSN 2060-6249 (Print)
ISSN 2060-968X (Online)

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