01172023_JOP_Freya

Question 1

For anterior implants, is there a difference between DBBM + Autogenous vs. FDBA?

Answer 1

Tsai JOP
“Comparison of 2 different bone graft techniques for anterior implants” = used CBCT. Compared contour changes of Autogenous + DBBM vs. FDBA at 1 year
o Findings: NSSD

Question 2

What did Schlagenhauf find about his 2-stage SRP protocol, using subgingival Airflow and then SRP?

Answer 2

Schlagenhauf JOP:
“2 stage [SubG air polishing, then SRP] protocol and CAL gain after perio therapy”.
o Findings: NSSD – the protocol does not work

It doesn’t work

Question 3

How does vestibule depth affect root coverage?

Answer 3

Blasi JOP
“Vestibule depth for root coverage outcomes”
o Findings: Vestibule depth is associated with the %RC. Each 1mm increase in depth = 2.75X more likely to have CRC

Question 4

What did Avila-Ortiz say in his AAP best evidence consensus about biologics?

Answer 4

• Avila-Ortiz et al. “AAP best evidence consensus of the use of biologics in clinical situations.”
  Biologics: defined as “blood products, PRF, stem cells, bioactive molecules such as EMD, PDGF, FGF, etc

Clinic situation 1: Biologics in root coverage & gingival augmentation
 Findings: Biologics aid the initial postop healing and have no negative effects. However, they seem to provide no additional benefits

Clinic situation 2: Biologics & infrabony defects
 Findings: Combination therapy is best (graft + biologic or membrane). However, don’t use a membrane if also using biologic since biologics help with chemotaxis.
* No negative side effects noted for PDGF/EMD
* Biologics may improve graft handling

Clinic situation 3: Biologics & ridge preservation / ISD (?)
 Findings: Biologics enhance healing (especially in poor healers), better graft handling, enhances osteogenesis

So, when to use biologics?
 Impaired healing
 Low predictability defects
 Esthetic zone
 For surgical reattempts

Question 5

What study examined OFD, Autogenous, and L-PRF in Mn molar Grade 2 furcations?

Answer 5

Serroni JOP
“L-PRF & autogenous grafts for grade 2 furcation defects in Mn molars”
o 3 groups (18 patients in each): OFD, OFD + autogenous, OFD + autogenous + PRF
o 6 mo followup, nonstandard probing, and only 2D xrays to determine bone fill.

o Finding: L-PRF + Autogenous + OFD leads to significantly greater CAL & PD reduction compared to the other 2 groups.
 L-PRF group: CAL +2.3 (about 2)
 OFD + autogenous: CAL +1.6 (about 1.5)
 OFD only: CAL +0.9 (about 1)

Question 6

What did Tavelli say in the AAP review about biologics in infrabony defects?

Answer 6

“Biologics for infrabony defects – AAP best evidence review”. Examined via a systematic review & meta-analysis the effects of biologics on infrabony defects regeration.
Examined 150 RCT’s.

** Barrier membranes are beneficial in combination with bone grafts, but not beneficial with biologics.** (So, use biologics with graft but without membranes).
o Conclusions: Combination therapy (either bone graft + biologics, or bone graft + membrane) are the most effective treatment currently for infrabony defects, and **gain ~0.5 mm CAL. **Biologics do provide benefit. rhPDGF-BB and PRF are better outcomes than EMD and PRP. Allogeneic & xenogeneic > autogenous & synthetic grafts. For gingival margin stability, best combination was xenogeneic + (rhPDGF-BB or PRF.)
 More details: PD = significantly improved compared to baseline by using bone grafts (allogenic, autogenous, xenogeneic) (~0.8mm PD reduction), membranes (~0.7 mm PD reduction), and biologics (~0.7mm PD reduction)
 Recession = significantly improved compared to baseline for xenogeneic grafts (CAL +0.4mm), PDGF (CAL + 1.05), PRF (CAL + 0.8)
 Radiographic bone fill = significant from baseline for synthetic bone graft, Biologics, membranes) (All improve by about 20%)
 Early wound healing index = NSSD among groups

Question 7

How does photodynamic therapy compare to OFD in periodontal pockets?

Answer 7

Andere JOP
RCT comparing photodynamic therapy vs. OFD in residual periodontal pockets.
o Findings: Moderate pockets were NSSD, but OFD had slightly more recession (about 0.5 mm more – this is within probing error). OFD was better for deep pockets.

So, photodynamic therapy might be a good alternative to OFD in moderate pockets.

Question 8

Is there a recent study comparing various methods of soft tissue measurement?

Answer 8

Ferry JOP

5 human cadavers (30 teeth total). Accuracy of different soft tissue measurement methods were compared: Bone sounding, CBCT, and CBCT + STL.
o The Gold standard was histologic measurement.
o Findings: DICOM + STL was NSSD to histology. Bone sounding overestimated by 0.22 mm. CBCT underestimated by 0.23 mm.