scholarly journals Effect of systemic antibiotics on the outcomes of regenerative periodontal surgery in intrabony defects: a randomized, controlled, clinical study

Author(s):  
Małgorzata Pietruska ◽  
Ewa Dolińska ◽  
Robert Milewski ◽  
Anton Sculean

Abstract Objectives To assess the potential influence of systemic antibiotic administration on the healing of periodontal intrabony defects treated with deproteinized bovine bone mineral (DBBM) and collagen membrane. Materials and methods Forty-one intrabony defects were treated by means of DBBM and collagen membrane (GTR). Postoperatively, the patients received either systemic antibiotics (i.e., 1 g of amoxicillin, twice daily for 7 days) (test) or no antibiotics (control). Clinical attachment level (CAL), probing depth (PD), and gingival recession (GR) were measured at baseline and at 1 year following regenerative surgery. The depth of the intrabony component (INTRA DD) and its width (INTRA DW) were measured during surgery and after 1 year at reentry. The depth (RxD) and width (RxW) of the intrabony defects were evaluated radiographically at baseline and at 1 year. Results No adverse events were observed in any of the two groups throughout the entire study period. In the test group, mean CAL changed from 8.7 ± 1.4 mm at baseline to 5.0 ± 1.7 mm at 1 year (p < 0.0001), while PD decreased from 7.8 ± 1.5 mm at baseline to 4.0 ± 0.9 mm at 1 year (p < 0.0001). In the control group, mean CAL changed from 8.6 ± 1.9 mm to 5.9 ± 1.6 mm (p < 0.001) and mean PD improved from 7.4 ± 1.3 mm to 4.1 ± 1.3 mm (p < 0.001). Mean CAL gain measured 3.6 ± 1.6 mm in the test and 2.7 ± 1.6 mm in the control group, respectively. Defect fill (i.e., INTRA DD gain) at re-entry measured 3.7 ± 1.8 mm in the test and 2.7 ± 2.1 mm in the control group. A CAL gain of ≥ 3 mm was measured in 76% of the defects in the test group and in 40% of the defects in the control group, respectively. In both groups, all evaluated clinical and radiographic parameters improved statistically significantly compared with baseline, but no statistically significant differences were found between the two groups. Conclusions Within their limits, the present study has failed to show any substantial added clinical benefits following the postoperative administration of amoxicillin in conjunction with regenerative periodontal surgery using DBBM and GTR. Clinical relevance The post-surgically administration of systemic antibiotics does not seem to be necessary following regenerative periodontal surgery.

2004 ◽  
Vol 12 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Maria do Carmo Machado Guimarães ◽  
Euloir Passanezi ◽  
Adriana Campos Passanezi Sant'Ana ◽  
Sebastião Luiz Aguiar Greghi

The purpose of this study was to evaluate the effect of the pool of bovine BMPs on the treatment of intrabony defects. The sample comprised 15 patients aged 26 to 57 years old presenting with 10 pairs of lesions of 2 or 3 walls or 2-3 walls ³5mm, located in the same type teeth (premolar or molar) and same jaw. The test defects were treated with combination of a pool of bovine bone morphogenetic and resorbable hydroxyapatite carrier (BMPs- HA), bovine demineralized bone matrix (MB) and coverage by a bovine collagen barrier membrane. The control defects were treated with MB-HA and covered by a bovine collagen membrane. The clinical measurements at six months after therapy in the test group revealed a reduction in the mean probing pocket depth (PPD) of 1.63 ± 1.41mm (B) and 1.93 ± 0.96mm (L) and a mean change in the clinical attachment level (CAL) of 1.60 ± 1.16mm (B) and 1.46 ± 0.97mm (L). The control group showed a mean reduction of PPD of 1.93 ± 1.34mm (B) and 2.0 ± 1.51mm (L) and a mean change of CAL of 1.03 ± 1.24mm (B) and 1.30 ± 1.14 mm (L). The analysis of variance (ANOVA) demonstrated that the changes in the clinical parameters were statistically significant (p<0.05). There were no significant differences between the test and controls subjects (Student's test, p<0.005). These findings suggest that the use of a pool of bovine BMPs do not provide added effects to GTR in the treatment of intrabony defects.


2021 ◽  
Author(s):  
Boroka Klara Csifo-Nagy ◽  
Eleonora Solyom ◽  
Vera Lili Bognar ◽  
Annamaria Nevelits ◽  
Ferenc Dori

Abstract Background: The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivatives (EMD). Methods: Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n=15) or EMD (control, n=15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). After debridement the intrabony defects were filled with A-PRF+ in the test group, respectively with EMD in the control group, and fixed with sutures to ensure wound closure and stability.Results: Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains six months post-operatively. No statistically significant differences were found between the two groups as the mean CAL gain was 2.33±1.58 mm in the A-PRF+ group, respectively 2.60±1.18 mm in the EMD group (p < 0.001).Conclusion: Within the limits of this study the new-generation platelet-rich fibrin seems to be as clinically effective as EMD in the surgical treatment of intrabony defects. Treatment with A-PRF+ or EMD resulted in reliable clinical outcomes. The use of A-PRF+ as a human autologous product can give a positive impact on periodontal healing.Clinical Relevance: A-PRF+ may be suitable for the treatment of intrabony periodontal defects. Trial registration number (TRN): NCT04404374 (ClinicalTrials.gov ID)Date of registration: 19.05.2020., retrospectively registered


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Boróka Klára Csifó-Nagy ◽  
Eleonóra Sólyom ◽  
Vera Lili Bognár ◽  
Annamária Nevelits ◽  
Ferenc Dőri

Abstract Background The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivative (EMD). Methods Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n = 15) or EMD (control, n = 15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). After debridement the intrabony defects were filled with A-PRF+ in the test group, respectively with EMD in the control group, and fixed with sutures to ensure wound closure and stability. Results Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains six months post-operatively. No statistically significant differences were found between the two groups as the mean CAL gain was 2.33 ± 1.58 mm in the A-PRF+ group, respectively 2.60 ± 1.18 mm in the EMD group (p < 0.001). Conclusion Within the limits of this study the new-generation platelet-rich fibrin seems to be as clinically effective as EMD during surgical treatment of intrabony defects. Treatment with A-PRF+ or EMD resulted in reliable clinical outcomes. The use of A-PRF+ as a human autologous product can give a positive impact on periodontal healing. Clinical Relevance A-PRF+ may be suitable for the treatment of intrabony periodontal defects. Trial registration number (TRN) NCT04404374 (ClinicalTrials.gov ID).


2015 ◽  
Vol 41 (5) ◽  
pp. 586-595 ◽  
Author(s):  
Nilufer Bolukbasi ◽  
Selim Ersanlı ◽  
Nurullah Keklikoglu ◽  
Cansu Basegmez ◽  
Tayfun Ozdemir

The purpose of this study was to compare the efficacy between the use of bovine bone graft material and platelet-rich fibrin (PRF) mixture (test group) and bovine bone graft material and collagen membrane combination (control group) in 2-stage maxillary sinus augmentation. According to specific inclusion/exclusion criteria, patients treated between 2008 and 2012 were selected. Panoramic radiographs were used for radiologic assessments. To evaluate the relationship between sinus-graft height and each implant, the bone level (BL) was divided by implant length (IL). To evaluate the change in the height of grafted sinus, the grafted sinus floor above the lowest part of the original sinus height (GSH) was divided by the original sinus height (OSH). Samples taken during implant surgery were used for histologic and histomorphometric analyses. Twenty-five patients, 32 augmentation surgeries, and 66 one-stage implants were included in the study. No implant loss or complication was observed in either group. There were no statistical differences according to new bone formation (P = .61) and biomaterial remnant (P = .87). During the evaluation period, the test group showed statistically less change in the BL/IL ratio (P = .022). The difference of GSH/OSH ratio was found to be insignificant between groups (P = .093). It was observed that the grafted sinus covering the implant apex and sinus floor was above the original sinus height in both groups. It may be concluded from this study that both combinations can be successfully used for sinus augmentation. Further studies evaluating different graft materials and PRF combinations in the early phases of healing would be beneficial.


Author(s):  
Ranjita Shrestha Gorkhali ◽  
Shaili Pradhan ◽  
Rejina Shrestha ◽  
Shweta Agrawal ◽  
Krishna Lamicchane ◽  
...  

Introduction: Treatment of periodontal diseases done by surgical therapy depends upon extent and severity of disease. The ultimate goal of periodontal reconstructive surgery is to regenerate tissues destroyed during periodontal disease. Objective: To evaluate the effectiveness of bovine-derived xenograft with collagen membrane in treatment of intrabony defects by comparing it with open flap debridement alone. Methods: This non-randomised controlled trial was conducted after ethical clearance, at Bir hospital from 2018 March to 2019 April. The study recruited 38 patients by convenience sampling, age from 25-44 years, with chronic periodontitis, and willing to sign informed consent. Intrabony defects were treated by open flap debridement with bovine-derived xenograft and bioresorbable collagen membrane (Test group) and open flap debridement alone (Control group). Probing pocket depth, clinical attachment level, gingival recession, oral hygiene status, and gingival status were assessed at baseline and six months. Results: Six months after therapy, in Test group probing pocket depth reduction was 5.2 mm and gain in mean clinical attachment level was 4.3 mm. In Control group, mean probing pocket depth reduction was 3.8 mm and mean gain in clinical attachment level was 2.7 mm. The test treatment resulted in statistically higher probing pocket depth reduction and clinical attachment level gain than Control group. Conclusion: Both therapies resulted in significant probing pocket depth reductions and clinical attachment gains, and treatment with open flap debridement with bovine-derived xenografts and collagen membrane resulted in significantly higher probing pocket depth reduction and clinical attachment gain than treatment with open flap debridement alone.


2013 ◽  
Vol 14 (3) ◽  
pp. 434-439 ◽  
Author(s):  
James Manohar Mopur ◽  
T Rama Devi ◽  
Syed Muhammad Ali ◽  
TS Srinivasa ◽  
V Gopinath ◽  
...  

ABSTRACT Background and objectives The primary goal of periodontal therapy is to restore the tooth supporting tissues lost due to periodontal disease. The aim of the present study was to compare the efficacy of combination of GTR membrane and alloplastc bone graft with open flap debridement (OFD) in treatment of periodontal intrabony defects. Methods Twenty paired intrabony defects were surgically treated using split mouth design. The defects were randomly assigned to treatment with OFD, GTR membrane + bone graft (test) or OFD alone (control). The clinical efficacy of two treatment modalities was evaluated at 6 months postoperatively by clinical, radiographical parameters. The measurements included probing pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), bone fill (BF), bone density (BD). Results The mean reduction in PD at 0 to 6 months was 3.20 ± 0.82 mm and CAL gain of 3.10 ± 1.51 mm occurred in the GTR membrane + bone graft (test) group; corresponding values for OFD (control) were 2.10 ± 0.63 mm and 1.90 ± 0.57 mm. Similar pattern of improvement was observed when radiographically postoperative evaluation was made. All improvement in different parameters was statistically significant (p < 0.01). Conclusion Treatment with a combination of collagen membrane and bone graft led to a significantly more favorable clinical outcome in intrabony defects as compared to open flap debridement alone. How to cite this article Mopur JM, Devi TR, Ali SM, Srinivasa TS, Gopinath V, Salam ART. Clinical and Radiographic Evaluation of Regenerative Potential of GTR Membrane (Biomesh®) along with Alloplastic Bone Graft (Biograft®) in the Treatment of Periodontal Intrabony Defects. J Contemp Dent Pract 2013;14(3):434-439.


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Seiko Min ◽  
Taewan Kim ◽  
Oksu Kim ◽  
Carames Goncalo ◽  
Tadahiko Utsunomiya ◽  
...  

Introduction. The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. Materials and Methods. The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. Results. 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups. Histologic and histomorphometric analyses demonstrated that in anti-BMP-2 mAb-treated sites, total tissue volume was significantly higher in the coronal part of the alveolar bone crest compared with control sites. In anti-BMP-2 mAb-treated sites, bone formation was observed under the barrier membrane. Conclusion. Functionalization of the ABBM-C scaffold and CM appeared to have led to bone formation within healing alveolar bone sockets.


Symmetry ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1293
Author(s):  
Paulo Wilson Maia ◽  
Marcelo Lucchesi Teixeira ◽  
Luís Guilherme Scavone de Macedo ◽  
Antonio Carlos Aloise ◽  
Celio Amaral Passos Junior ◽  
...  

Platelet-rich fibrin (PRF) is an autologous material used to improve bone regeneration when associated with bone grafts. It affects tissue angiogenesis, increasing the healing process and, theoretically, presenting potential to increase bone neoformation. The aim of this study was to verify, histomorphometrically, the effects of the association of PRF to a xenograft. Twelve adult white New Zealand rabbits were randomly assigned into two groups containing six animals each. After general anesthesia of the animals, two critical defects of 12 mm were created in the rabbit calvaria, one on each side of the sagittal line. Each defect was filled with the following biomaterials: in the control group (CG), xenograft hydrated with saline solution filling one defect and xenograft hydrated with saline solution covered with collagen membrane on the other side; in the test group (TG), xenograft associated with PRF filling the defect of one side and xenograft associated with PRF covered with collagen membrane on the other side. After eight weeks the animals were euthanized and a histomorphometric analysis was performed. The results showed that in the sites that were covered with collagen membrane, there was no statistically significant difference for all the analyzed parameters. However, when comparing the groups without membrane coverage, a statistically significant difference could be observed for the vital mineralized tissue (VMT) and nonmineralized tissue (NMT) parameters, with more VMT in the test group and more NMT in the control group. Regarding the intragroup comparison, the use of the membrane coverage presented significant outcomes in both groups. Therefore, in this experimental model, PRF did not affect the levels of bone formation when a membrane coverage technique was used. However, higher levels of bone formation were observed in the test group when membrane coverage was not used.


Materials ◽  
2019 ◽  
Vol 13 (1) ◽  
pp. 18 ◽  
Author(s):  
Jungwon Lee ◽  
Young-Jun Lim ◽  
Bongju Kim ◽  
Ki-Tae Koo ◽  
Yong-Moo Lee

The purpose of this study was to compare the histologic and radiologic differences between single- and double-layer collagen membrane techniques in flapless ridge preservation. The mandibular fourth premolar and first molar of four beagle dogs were used in the experiment. Mesial roots of the teeth were extracted and root canal treatment was performed at the distal roots. Ridge preservation was performed at the extraction sites using synthetic bone graft material. A single layer (control group) or double layer (test group) of non-crosslinked collagen membrane was applied following bone graft application. Three months later, the animals were sacrificed and micro-computed tomography (micro-CT) and histomorphometric analyses were conducted. Nonparametric Mann–Whitney test was performed to compare between the control and test groups. The vertical difference between buccal and lingual crests of control and test groups was 1.28 ± 0.41 and 0.53 ± 0.37 mm, respectively (p = 0.026). The mineralized bone area in control and test groups was 31.48% ± 7.41% and 42.25% ± 9.73%, respectively (p = 0.041). Within the limit of this study, ridge preservation using the double-layer membrane technique showed a reduced buccal bone resorption and improved new-bone formation in the ridge compared to that using the single-layer membrane technique.


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