Management of Grade II Furcation Defect in Mandibular Molars with Allograft and Alloplastic Bone Graft: A Clinico- Radiographic Study

2021 ◽  
Author(s):  
Teh Chai Liu
Keyword(s):  
Bone Density ◽  
Bioactive Glass ◽  
Bone Allograft ◽  
Radiographic Evaluation ◽  
Defect Depth ◽  
Pocket Depth ◽  
Group I ◽  
Furcation Defects ◽  
Grade Ii ◽  
Attachment Level

Aim: The present study was carried out to compare clinically and radiographically the efficacy of regenerative potential of Demineralizedfreeze-dried bone allograft (DFDBA) and Bioactive glass putty (Novabone© dental putty) in mandibular grade II furcation defects. Methods: In 34 Patients, 60 mandibular grade II furcation defects were treated using DFDBA and Bioactive glass putty. 30 furcations were treated using DFDBA, while bioactive glass putty was used to treat remaining 30 furcation defect. Clinical parameters evaluated were Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative vertical attachment level (RVAL), Relative horizontal attachment level (RHAL) at baseline, 3 months and 6 months. Radiographic parameters recorded were linear measurement of defect depth and bone density in gray scale at baseline and 6 months. Results: Both the group showed significant reduction in mean (P≤0.05) GI, PI, PPD, RVAL and RHAL at 6 months. Group I showed greater reduction in PPD. Radiographic evaluation showed significant (P≤0.05) reduction in defect depth and increase in bone density in both groups. Conclusions: Bioactive glass putty showed comparable regeneration to that of DFDBA in the treatment of mandibular grade II furcation defect. Additional putty consistency of bioactive glass makes it easier and more convenient to use.

scholarly journals Comparative evaluation of platelet-rich fibrin versus beta-tri-calcium phosphate in the treatment of Grade II mandibular furcation defects using cone-beam computed tomography

2016 ◽  
Vol 10 (04) ◽  
pp. 496-506 ◽  
Author(s):  
Zeba Rahman Siddiqui ◽  
Rajesh Jhingran ◽  
Vivek Kumar Bains ◽  
Ruchi Srivastava ◽  
Rohit Madan ◽  
...  
Keyword(s):  
Cone Beam ◽  
Clinical Parameters ◽  
Clinical Attachment Level ◽  
Platelet Rich Fibrin ◽  
Group I ◽  
Furcation Defects ◽  
Grade Ii ◽  
Group Ii ◽  
Attachment Level ◽  
Vertical Height

ABSTRACT Objective: The objective of the study was to evaluate clinically and radiographically the efficacy of platelet-rich fibrin (PRF) versus β-tri-calcium phosphate (β-TCP) in the treatment of Grade II mandibular furcation defects. Materials and Methods: Forty-five Grade II furcation defect in mandibular molars which were assigned to open flap debridement (OFD) with PRF Group I (n = 15), to OFD with β-TCP Group II (n = 15), and to OFD alone Group III (n = 15) were analyzed for clinical parameters (probing pocket depth [PPD], vertical clinical attachment level [VCAL], horizontal clinical attachment level [HCAL], gingival recession, relative vertical height of furcation [r-VHF], and relative horizontal depth of furcation [r-HDF]) and radiographical parameters (horizontal depth of furcation [H-DOF], vertical height of furcation [V-HOF]) using cone-beam computed tomography (CBCT) at 6 months interval. Results: For clinical parameters, reduction in PPD and gain in VCAL and HCAL were higher in Group II as compared to Group I. Change in r-VHF and r-HDF was greater in Group II as compared to Group I. Mean percentage clinical vertical defect fill was higher in Group II as compared to Group I (58.52% ± 11.68% vs. 53.24% ± 13.22%, respectively). On CBCT, mean change at 6 months for all parameters showed nonsignificant difference between the two experimental groups. Mean change in V-HOF was higher in Group I as compared to Group II, but mean change in H-DOF and furcation width was more in Group II as compared to Group I. Conclusion: For both experimental and control groups, there was statistically significant improvement at 6 months follow-up from baseline values.

scholarly journals Soft Tissue Healing and IL-6 Cytokine Levels in Microsurgical and Conventional Open Flap Debridement in Patients with Chronic Periodontitis - A Randomized Clinico-Biochemical Trial

2021 ◽  
Vol 10 (34) ◽  
pp. 2928-2933
Author(s):  
Peddireddy Bhavani
Keyword(s):  
Soft Tissue Healing ◽  
Pocket Depth ◽  
Probing Pocket Depth ◽  
Gingival Bleeding ◽  
Group I ◽  
Tissue Healing ◽  
Cytokine Levels ◽  
Early Healing ◽  
Open Flap Debridement ◽  
Attachment Level

BACKGROUND The present study was conducted to compare clinical outcomes and gingival crevicular fluid (GCF) interleukin (IL)-6 cytokine levels in microsurgical and conventional open flap debridement procedure. METHODS Thirty sites in chronic periodontitis patients were randomly assigned into Group I (microsurgical) and Group II (conventional) open flap debridement in a split-mouth design. Gingival bleeding index (GBI), probing pocket depth (PPD), relative attachment level (RAL) were recorded at baseline and 3 months. GCF IL-6 cytokine levels were assessed at baseline and on 3rd day postoperatively. Pain perception using visual analog score (VAS) and soft tissue healing using early healing index (EHI) were assessed after on 7th day post-surgery. RESULTS There was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups. Intergroup gingival bleeding index scores were statistically significant at the end of 3 months. The difference in visual analog scores between the two groups was found to be statistically insignificant whereas early healing index scores between the groups was found to be statistically significant. Group I showed lower levels of IL-6 on 3rd day postoperatively. It was also found that there was positive correlation of IL-6 levels with clinical parameters such as PPD and RAL. CONCLUSIONS Open flap debridement using microsurgical approach can substantially improve clinical parameters and wound healing compared with conventional macrosurgical approach. IL-6 levels were lower in microsurgical group indicating less invasive surgical approach. KEY WORDS Open Flap Debridement, Periodontal Microsurgery, Wound Healing, IL-6, Cytokine, GCF.

scholarly journals Clinical Evaluation of Intrabony Defects in Localized Aggressive Periodontitis Patients with and without Bioglass- An In-vivo Study

2012 ◽  
Vol 10 (1) ◽  
pp. 7-10
Author(s):  
KV Satyanarayana ◽  
BR Anuradha ◽  
G Srikanth ◽  
P Mohan Chandra ◽  
T Anupama ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Test Group ◽  
Gingival Recession ◽  
Aggressive Periodontitis ◽  
Control Group ◽  
Defect Depth ◽  
Clinical Attachment Level ◽  
Probing Depth ◽  
Localized Aggressive Periodontitis ◽  
Attachment Level

Background Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as “rapid attachment loss, bone destruction” and “familial aggregation”. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. Objective The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. Methods Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth ? 2 mm, preoperative probing depths ? 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. Results After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P <0.001) and a gain in clinical attachment level of 4.42+0358mm (P <0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P<0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P <0.001) in the test group and by 0.1792 + 0.031mm (P <0.001) in the control group. Changes in gingival recession showed no significant differences. . Conclusion Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 11-15 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6906

scholarly journals COMPARATIVE STUDY OF BIOACTIVE GLASS AND FREEZE DRIED BONE ALLOGRAFT IN CLASS II FURCATION DEFECTS

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Anant Raghav Sharma ◽  
Spoorti Pattanashetty ◽  
Pradnya Wagh Kamat ◽  
Ramisetty Sabitha ◽  
Nidhi Chhaparia
Keyword(s):  
Bioactive Glass ◽  
Bone Allograft ◽  
Class Ii ◽  
Success Rates ◽  
Post Surgery ◽  
Probing Depth ◽  
Freeze Dried ◽  
Furcation Defects ◽  
The Mean ◽  
Clinical Measurements

Background: In periodontal therapy, furcation defects are one of the most therapeutically challenging periodontal therapies. Till now various treatment methods have been tried which have shown different success rates. The present study was undertaken to compare the efficacy of bioactive glass (alloplast) with Freeze dried bone allograft (FDBA) in the treatment of Class II furcation defects. Materials and Methods: Twenty patients were selected for the study which had bilateral Class II furcation defects in molars from which ten patients were male and ten patients sere female in the age group of 45-55 years. Various clinical measurements were recorded at three times i.e. at baseline, at one month and at six months post surgery which included the Turesky-Glimore-Glickman modification of the Quigley Hein plaque index, the Loe and silness gingival index, relative clinical attachment level vertical probing depth in the mid-furcation area, and horizontal probing depth in the furcation area. The statistical analysis was done using SPSS version 23.0. Results: In the relative clinical attachment levels, the mean gain in the test and control groups was 2.45 and 1.58 mm, respectively at the end of six months. In the horizontal probing depth values, the mean change in the bioactive glass graft and freeze dried bone allograft was 1.45 and 1.33 mm, respectively. Conclusion: From our study it was concluded that efficacy of Bioactive glass is much better as compared to Freeze dried bone allograft in the treatment of Class II furcation defects. Keywords: Bioactive glass, Freeze dried bone allograft, furcation defects

scholarly journals Adjunctive Systemic Antimicrobial Therapy vs Asepsis in Conjunction with Guided Tissue Regeneration: A Randomized, Controlled Clinical Trial

2016 ◽  
Vol 17 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Mahmoud Abu-Ta'a
Keyword(s):  
Clinical Trial ◽  
Tissue Regeneration ◽  
Bone Allograft ◽  
Guided Tissue Regeneration ◽  
Controlled Clinical Trial ◽  
Pocket Depth ◽  
Freeze Dried ◽  
Attachment Level ◽  
Preservation Technique ◽  
Postoperative Discomfort

ABSTRACT Aim This randomized clinical trial compares the usefulness of adjunctive antibiotics, while strict asepsis was followed during periodontal surgery involving guided tissue regeneration. Materials and methods Two groups of 20 consecutive patients each with advanced periodontal disease were randomly assigned to treatment. They displayed one angular defect each with an intrabony component ≥3 mm, probing pocket depth and probing attachment level (PAL) ≥7 mm. Test group included 13 males, mean age 60 years, treated with enamel matrix derivative (EMD) and demineralized freeze-dried bone allograft with modified papilla preservation technique, received oral amoxicillin 1 gm, 1 hour preoperatively and 2 gm for 2 days postoperatively. Control group included 10 males, mean age 57 years, treated with EMD and demineralized freeze-dried bone allograft with modified papilla preservation technique, received no antibiotics. Outcome measures were clinical attachment level (CAL) gain, residual periodontal pocket depth (res. PD), gingival recession (GR), bleeding on probing (BOP), adverse events and postoperative complications. Patients were followed up to 12 months after periodontal surgery involving guided tissue regeneration. Results There were no significant differences between both groups for CAL gain, res. PD, GR, BOP nor other clinical parameters, though patients’ subjective perception of postoperative discomfort was significantly smaller in the group receiving antibiotics. Conclusion Antibiotics do not provide significant advantages concerning clinical periodontal parameters nor concerning postoperative infections in case of proper asepsis. It does, on the contrary, reduce postoperative discomfort. Clinical significance Regarding the results of this study, adjunctive systemic antibiotics in combination with guided tissue regeneration may be useful in reducing postoperative discomfort but may not be helpful for improving periodontal regeneration outcomes. How to cite this article Abu-Ta'a M. Adjunctive Systemic Antimicrobial Therapy vs Asepsis in Conjunction with Guided Tissue Regeneration: A Randomized, Controlled Clinical Trial. J Contemp Dent Pract 2016;17(1):3-6.

Comparative Evaluation of Bioactive Glass (Putty) and Platelet Rich Fibrin in Treating Furcation Defects

2016 ◽  
Vol 42 (5) ◽  
pp. 411-415 ◽  
Author(s):  
Shriparna Biswas ◽  
Savita Sambashivaiah ◽  
Rithesh Kulal ◽  
Shivaprasad Bilichodmath ◽  
Gregori M Kurtzman
Keyword(s):  
Bioactive Glass ◽  
Plaque Index ◽  
P Value ◽  
Gingival Index ◽  
Platelet Rich Fibrin ◽  
Group I ◽  
Probing Depth ◽  
Furcation Defects ◽  
Mandibular Molar ◽  
Depth Reduction

The aim of this study was to compare a second-generation bioactive glass putty biomaterial against platelet rich fibrin in treating grade II furcation defects. Subjects were 15 systemically healthy patients (10 males and 5 females, ages 20–50 with a mean age of 38.33) with 20 mandibular molar class II furcation defects according to Glickman's classification. The 20 mandibular molar furcation defects were randomly allocated as follows: Group I, 10 furcation defects were treated using bioactive glass (NovaBone) bone graft putty material; Group II, 10 furcation defects were treated using platelet rich fibrin (PRF). Customized acrylic stents were fabricated on study casts and trimmed to the height contour of the teeth to serve as a fixed reference point for measurements. The following measurements were collected: gingival index, plaque index, vertical probing depth (from gingival margin to base of the pocket), clinical attachment level (CEJ to the base of the pocket), and horizontal probing depth of furcation involvement (using stent). Results showed that both groups had improvement in gingival index (GI) and plaque index (PI) at the recall intervals. There was an overall reduction in both vertical and horizontal probing depth in both groups; however, the Putty group (Group I) showed consistently more vertical probing depth reduction than the PRF group (Group II) at the end of third month (P-value = 0.0004), sixth month (P-value = 0.00001), and ninth month (P-value = 0.0004). Our conclusion was that use of bioactive glass osteostimulative biomaterial yields superior clinical results, including increased pocket depth reduction of class II furcation defects as compared to an autologous platelet concentrate. The clinical significance of our findings include the ease of use and superior biologic performance of second-generation putty bioglass biomaterials in furcation defects.

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