4.5.23_postdocs Periodontal regen Flashcards
Which study compared GTR with Frozen Radiation-Sterilized bone graft vs. BioOss?
Brodzikowska - J. Clinical Med.
RCT - split-mouth, double-blinded
Inclusion criteria:
* Stage III or IV periodontitis+ 2 teeth with PPD and CAL : >6mm
* Intra-bony angular lesion (interproximal area )on PA - DD :
* > 4mm
Findings:
CAL G - NSSD
PPD R - SSD
LDF (linear defect fill) - SSD
Conclusion:
Similar Radiographic and clinical improvements in both FRSABG and DBBM.
The test graft (frozen radiation-sterilized) enhanced PPD reduction and radiographic LDF
Which study examined rhFGF-2 + DBBM vs. rhFGF-2 only
Seshima, Biomolecules journal
RCT - regeneration of periodontitis infrabony defects
* 32 moderate to severe chronic periodontitis
* sites with probing pocket depth (PPD) >4 mm
* intrabony defect with depth of >3 mm
* 16,Test group, 0.3% rhFGF-2 with DBBM
* 16,Control group, only the rhFGF-2
4-year Results:
Test: CAL +3.5mm
ControL: CAL +2.7mm
Bone graft adds 0.8 mm greater bone fill than rhFGF-2 only
Which study examined 1% metformin gel + PRF vs. PRF only for Class 2 furcation defects?
Swami, JOP
Double-blind, split mouth, randomized controlled clinical trial. n=21
Furcations = 42
Inclusion criteria:
* Stage III periodontitis
* at least one pair of bilateral buccal Grade II furcation in maxilla
* Buccal or lingual FI mandibular
Defect configurations measured by CBCT
Surgical procedure
* Kirkland flap
* Defect site was debrided and exposed root surfaces were scaled and planed
* Group I : PRF (3,000 rpm for 10 minutes) was placed over the furcation defect
* Group II: Metformin (MF) was injected through a blunt cannula into the defect follow by PRF
* All groups: the flap was repositioned and closed with single interrupted suture + periodontal dressing.
Results:
Defect volume change:
PRF: -9.14 mm3
PRF + 1% Metformin: -12.61 mm3
Greater defect reduction overall in the PRF + 1% metformin group
Which study examined 1% metformin gel + PRF vs. PRF only for Class 2 furcation defects?
Swami, JOP
Double-blind, split mouth, randomized controlled clinical trial. n=21
Furcations = 42
Inclusion criteria:
* Stage III periodontitis
* at least one pair of bilateral buccal Grade II furcation in maxilla
* Buccal or lingual FI mandibular
Defect configurations measured by CBCT
Surgical procedure
* Kirkland flap
* Defect site was debrided and exposed root surfaces were scaled and planed
* Group I : PRF (3,000 rpm for 10 minutes) was placed over the furcation defect
* Group II: Metformin (MF) was injected through a blunt cannula into the defect follow by PRF
* All groups: the flap was repositioned and closed with single interrupted suture + periodontal dressing.
Results:
Defect volume change:
PRF: -9.14 mm3
PRF + 1% Metformin: -12.61 mm3
Greater defect reduction overall in the PRF + 1% metformin group
Which study examined the effect of a volume-stable collagen matrix on periodontal regen in 2-wall intrabony defects?
Imber, JCP
Dog study - acute 2 wall defects. n=8 beagle dogs
* Test: VCMX
* Control: nothing (spontaneous healing)
Result: VCMX showed SSD greater results for 1) new continuous cementum, 2) new interrupted cementum, 3) new bone formation
Note: This study was sponsored by Geistlich. Dogs heal quickly ,so acute lesions don’t prove much
What are the substantivities of Puros cancellous, Puros cortical, collagen membrane, B-TCP?
Puros cancellous: 4 mo
Puros cortical: 6mo
Collagen membrane: only needs to be there ~3-4 weeks (per Dr. Wang)
B-TCP: 3 weeks (resorbs too quick - does not hold the space)
What study examined membrane fixation for GBR in calvarial defects?
An, JCP
Rabbit histology study
* Four 8-mm-diameter defects were surgically made in each rabbit calvarium and totally 32 defects randomly allocated into four groups:
* Control (negative control): defects were left untreated
* Unfixed CM: defects were covered with a CM
* Fixed CM: defects were covered with a CM that was stretched and fixed with four bone tacks to maintain a certain tension.
* BG+CM: defects were filled with a bone graft and covered with a CM with no fixation.
Results:
CM fixation enhances the expression of osteogenic factors similar to BG+CM, leading to significantly more new bone formation.
This suggests that the osteogenic potential is greater when membranes are fixed, thereby limiting the necessity of membrane-supporting materials to enhance bone formation
Which systematic review examined minimal invasiveness in the surgical tx of intraosseous defects?
Simonelli, Perio 2000
The concept of “Invasiveness” in periodontal regeneration encompasses postop. morbidity, discomfort, aesthetic impact, chair time and cost.
Focused Questions
A] What is the effect of flap design on the invasiveness of regenerative tx of periodontal intraosseous defects?
* Single vs. Double flap approach:
The single flap approach had less postop pain, less analgesic consumption, better wound closure.
B] What is the effect of regenerative technology on the invasiveness of surgical tx of periodontal intraosseous defects?
* GTR +/- biologics, vs. OFD
* OFD > GTR for edema
* GTR (EMD + DBBM) = longer chairside time (3-8 mins longer)
* Similar CAL gain and PD reduction for both
C] Can specific peri/post-operative clinical or pharmacological protocols reduce the invasiveness of regenerative tx of periodontal intraosseous defects?
* Low level laser biostimulation: Longer chair time needed, and unclear benefits
Which study described the antioxidant effect of EMD for early phase GTR in diabetics?
Takeda, JOP
Rat study
44 surgical defects
* mRNA expression analysis of inflammatory and oxidative stress markers
* Imm/histo analysis of SOD-1
* In vitro- ROS and Alizarin red staining
Conclusion: EMD promoted early-phase wound healing and periodontal tissue regeneration in the surgically created bony defect of STZ-induced diabetic rat through the suppression of hyperglycemia-induced oxidative stress.
Which study looked at systemic antibiotics for regeneration in infrabony defects?
Malgorzata, Clinical Oral Investigations
Aim: To assess systemic antibiotics + membrane + DBBM in intrabony defects.
Test: Amoxicillin 2x daily for 7 days
Control: No antibiotics
Results: NSSD between groups = antibiotics provide no additional benefits
