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A Clinical Comparison of Cerabone (A Decalcified Freeze-dried Bone Allograft) with Autogenous Bone Graft in the Treatment of Two- and Three-wall Intrabony Periodontal Defects: A Human Study with Six-month Reentry  [cached]
Nader Abolfazli,Fariba Saleh Saber,Ardeshir Lafzi,Amir Eskandari
Journal of Dental Research, Dental Clinics, Dental Prospects , 2008,
Abstract: Background and aims. Complete and predictable regeneration of tissue lost as a result of infection or trauma is the ultimate goal of periodontal therapy. Various graft materials have been successfully used in the treatment of intrabony defects. The purpose of this study was to evaluate the use of a decalcified freeze-dried bone allograft (Cerabone) with the autogenous bone graft as a gold standard in the treatment of human two- or three-wall intrabony periodontal defects. Materials and methods. This split-mouth study was done on 10 pairs of matched two- or three-wall intrabony periodontal defects with 5 mm or more probing depth and 3 mm or more depth of intrabony component following phase I therapy. In the control sites autogenous bone graft and in the test sites decalcified freeze-dried bone allograft were used. Results. At baseline, no significant differences were found in terms of oral hygiene and defect characteristics. At six months, analysis showed a significant improvement in soft and hard tissue parameters for both treatment groups as compared to preoperative measurements. There were no statistical differences in clinically-measured parameters between treatment groups after 6 months except for crestal resorption that increased significantly in control group (P = 0.25). Defect resolution and bone fill in the test and control groups were 2.5 ± 0.46 mm versus 2.7 ± 0.73 mm and 2 ± 0.62 mm versus 2.20 ± 0.52 mm, respectively. Conclusion. The results of this study demonstrated that both graft materials improved clinical parameters. The comparison of the two treatment groups did not show any significant differences in clinical parameters after six months. However, because of the limited amount of intra-oral donor bone, it is preferable to use decalcified freeze-dried bone allograft.
Clinical and radiographic evaluation of pure beta-tricalcium phosphate and autogenous bone graft in treatment of two to three-wall periodontal defects
Soleymani Shayeste Y,Khorsand A,Mahvidy Zade S,Nasiri M
Journal of Dental Medicine , 2010,
Abstract: "nBackground and Aims: Intrabony periodontal defects are one of the important problems in periodontal diseases. Treatment of intrabony periodontal defects with synthetic materials such as Cerasorb has been shown to enhance periodontal regeneration. The aim of this study was to compare the effect of Cerasorb with autogenous bone graft (A.B.G) as a gold standard in treatment of two to three wall periodontal defects."nMaterials and Methods: In this interventional or randomized clinical trial study, 24 two to three wall intrabony defects were selected in a double blind manner. Defects were randomly (with tossing a coin) divided into two groups (test and control). Defects in test group were treated with flap surgery and Cerasorb. In control group, defects were treated with flap surgery and autogenous bone graft. At baseline and 3-month, 6-month and one-year follow up evaluations; clinical and radiographic assessments were performed. Data were statistically analyzed using the paired t test, Wilcoxon and Mann-whiteny. The level of significance was set at P<0.05. "nResult: At the 3-month, 6-month and one-year visits, the parameters of probing pocket depth (PPD), probing attachment level (PAL), bone level (distance between CEJ and alveolar crest), and bone density were not significantly difference in test and control groups (P>0.05). However, in each group there was significant difference in 4 parameters before and after surgery (P<0.05)."nConclusion: Treatment with Cerasorb compared to A.B.G produced the same results of improvement in two to three-wall intrabony defects. So the use of Cerasorb can be suggested for treatment of intrabony periodontal defects.
Clinical evaluation of regenerative potential of type I collagen membrane along with xenogenic bone graft in the treatment of periodontal intrabony defects assessed with surgical re-entry and radiographic linear and densitometric analysis  [cached]
Sowmya N,Tarun Kumar A,Mehta D
Journal of the Indian Society of Periodontology , 2010,
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 type I collagen (GTR membrane) and xenogenic bone graft with open flap debridement (OFD) in treatment of periodontal intrabony defects. Materials and Methods: Twenty paired intrabony defects were surgically treated using split mouth design. The defects were randomly assigned to treatment with OFD + collagen membrane + bone graft (Test) or OFD alone (Control). The clinical efficacy of two treatment modalities was evaluated at 9 month postoperatively by clinical, radiographical, and intrasurgical (re-entry) parameters. The measurements included probing pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), bone fill (BF), bone density (BD) and intra bony component (INTRA). Results: The mean reduction in PD at 0-9 month was 3.3±0.82 mm and CAL gain of 3.40±1.51 mm occurred in the collagen membrane + bone graft (Test) group; corresponding values for OFD (Control) were 2.20±0.63 mm and 1.90±0.57 mm. Similar pattern of improvement was observed when radiographical and intra-surgical (re-entry) post operative evaluation was made. All improvement in different parameters was statistically significant (P< 0.01). Interpretation and 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 OFD alone.
A Comparable Study of Combinational Regenerative Therapies Comprising Enamel Matrix Derivative plus Deproteinized Bovine Bone Mineral with or without Collagen Membrane in Periodontitis Patients with Intrabony Defects  [PDF]
Takehiko Kubota, Yasuko Nemoto, Kaname Nohno, Arata Nezu, Toshiya Morozumi, Hiromasa Yoshie
Open Journal of Stomatology (OJST) , 2018, DOI: 10.4236/ojst.2018.89026
Abstract: Aim: The aim of the present study was to examine the effectiveness of collagen membrane (CM) in regenerative therapy with deproteinized bovine bone mineral (DBBM) and enamel matrix derivative (EMD) for periodontal intrabony defects. Methods: Eighteen periodontal intrabony defects of nine chronic periodontitis patients were evaluated. Two defects per patient with probing pocket depth (PPD) ≥ 6 mm were assigned to two different types of treatments: EMD + DBBM + CM or EMD + DBBM. Clinical parameters including Gingival Index (GI), PPD, clinical attachment level (CAL), gingival recession (GR), bleeding on probing (BOP), tooth mobility (MOB), and the filled bone volume/rate (FBV/FBR), which was measured by cone beam computed tomography, were compared at baseline and 12 months post-treatment. Differences between groups were determined by the chisquare test, McNemar’s test, and Wilcoxon signed-rank test. Results: Clinically, PPD, CAL, and FBR significantly improved in both groups (p < 0.05). The between-group comparison showed that the EMD + DBBM + CM group resulted in slightly greater PPD reduction, CAL gain, and FBR; however, these differences were not statistically significant. Conclusion: Periodontal regenerative therapies comprising EMD and DBBM with and without CM resulted in positive clinical outcomes. The use of CM may result in better outcomes in MOB decrease; however, long-term prognosis must be further studied.
Reconstruction of the mandible with an autogenous corticocancellous bone graft and fibrin glue: An animal experiment
Mirkovi? Zoran,Lon?arevi? S.,?ur?evi? D.,Bubalo Marija
Acta Veterinaria , 2012, DOI: 10.2298/avb1204467m
Abstract: This paper reports on an experimental animal study evaluating a method of mandibular reconstruction in dogs using autogenous corticocaneclous bone graft and fibrin glue. Eight animals underwent a resection at the mandibular body and primary reconstruction was carried out using osteosynthesis plates and screws. The defect was bridged with an autogenous particulate bone graft from the anterior iliac crest. To accelerate bone healing, fibrin glue (FG) was mixed with particulate bone graft. The hypothesis of this study was based on the presumption that bone healing, in segmental reconstruction of the dog mandible with a particulate cancellous bone graft mixed with FG, would be successful. All dogs had eventful healing. The histological results were less favorable with regard to bone remodeling than the results obtained in similar experiments with a particulate corticocancellous bone graft.
Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study
Chambrone, Daniela;Pasin, Ivan Munhoz;Conde, Marina Clemente;Panutti, Claudio;Carneiro, Silvia;Lima, Luiz Antonio Pugliesi Alves de;
Brazilian Oral Research , 2007, DOI: 10.1590/S1806-83242007000300009
Abstract: the objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2- or 3-wall intrabony defects with open flap debridement (ofd) combined or not with enamel matrix proteins (emp). thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (ppd) > 5 mm. all individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. each participant received the two treatment modalities: test sites were treated with ofd and emp, and control sites received only ofd. after 6 months, a significant reduction was observed in ppd for the emp group (from 6.42 ± 1.08 mm to 2.67 ± 1.15 mm) and for the ofd group (from 6.08 ± 1.00 mm to 2.00 ± 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). a significant gain in relative attachment level (ral) was observed in both groups (emp: from 13.42 ± 1.88 mm to 10.75 ± 2.26 mm, p < 0.001; ofd: from 12.42 ± 1.98 mm to 10.58 ± 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). gingival recession (gr) was higher in the emp group (from 1.08 ± 1.50 mm to 2.33 ± 1.43 mm; p = 0.0009) than in the ofd group (from 0.66 ± 1.15 mm to 1.16 ± 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). in conclusion, the results showed that ofd combined with emp was not able to improve treatment of intrabony defects compared to ofd alone.
Comparative study of two autogenous graft techniques using piezosurgery for sinus lifting
Camargo Filho, Geraldo Prestes de;Corrêa, Luciana;Costa, Claudio;Pannuti, Claudio Mendes;Schmelzeisen, Rainer;Luz, Jo?o Gualberto de Cerqueira;
Acta Cirurgica Brasileira , 2010, DOI: 10.1590/S0102-86502010000600005
Abstract: purpose: maxillary sinus lifting is a technique, in which, a possible complication is sinus membrane perforation. the aim of this study was to compare two techniques using ultrasound surgery to perform autogenous graft for maxillary sinus lifting. methods: ten rabbits were used in the study, one of them did not undergo surgery. the other nine rabbits had their maxillary sinuses filled with autogenous bone grafts collected from the external skull diploe in particulate form on the right side, and shaved on the left side, both with ultrasonic device. data on bone density in left and right maxillary sinus, obtained by computed tomography in transverse and longitudinal sections, recorded 90 days after the grafts, were statistically compared. results: there were no statistically significant differences between the two techniques that used shaved and particulate bone collected by means of ultrasonic device from rabbit skulls. conclusion: assessment of operative procedures led to the conclusion that piezoelectric ultrasound was shown to be a safe tool in the surgical approach to the maxillary sinus of rabbits, allowing sinus membrane integrity to be maintained during surgical procedures.
A comparative study on treatment of two and three walled periodontal bony defects utilizing open flap debridement with and without enamel matrix derivatives
Soleimani Shayesteh Y.,Mohseni Salehi Monfared SH.,Eskandarion S.
Journal of Dental Medicine , 2006,
Abstract: Background and Aim: Intrabony periodontal defects are important problems in periodontology and up to now several ways have been suggested for their treatment .Treatment with enamel matrix derivatives (EMD) has been shown to enhance periodontal regeneration. There is limited information available from clinical trials regarding the performance of EMD in the treatment of periodontal intrabony defects. This study was designed to compare the clinical and radiographic effects of EMD treatment to that of open flap debridment (OFD) for two and three walled intrabony defects. Materials and Methods: 18 patients were included in this clinical trial which have 24 two and/ or three intrabony defects. Defects were randomly divided into two groups (test and control). Defects in test group were treated with flap surgery plus EMD and in control group with open flap debridment. At baseline and at 3 and 6 months follow up, clinical and radiographic measurements were performed. Data were analyzed using Greenhouse-Geisser test with p<0.05 as the limit of significance. Results: At 3 and 6 months, mean probing pocket depth reduction was greater in the test group (EMD) (4.33 mm and 4.70 mm) compared to the OFD group (2.54 mm and 3.09 mm). Mean values for clinical attachment gain in the EMD group after 3 and 6 months were 4.29 mm and 4.98 mm, and in OFD group were 2.83 and 2.82 mm respectively. Radiographic bone gain measured by radiovisiography technique was greater in the EMD group compared to the OFD group (4.66 mm in EMD and 1.11 mm in OFD group after 3 months and 5.78 mm in EMD and 1.39 mm in OFD group after 6 months). Conclusion: Based on the results of this study, treatment with flap surgery and EMD compared to open flap debridment, produced more favorable clinical improvements in two and three walled intrabony defects.
Segmental Reconstruction of the Caudal Vena Cava Using an Autogenous Tubular Graft of the Internal Rectus Abdominus Sheath: A Pilot Study
Julius M. Liptak,Peter T. Chin,Michael S. Stephen,Edward J. Wills,Geraldine B. Hunt
Veterinary Research , 2012,
Abstract: The aim of this study was to evaluate the mesothelial-lined internal sheath of the rectus abdominus muscle (IRAS), with and without glutaraldehyde fixation and postoperative acetylsalicylic acid administration, as an autogenous interpositional graft of the prerenal caudal vena cava in clinically normal dogs. The IRAS was harvested from the right abdominal wall, tubularized with the mesothelial surface forming the luminal surface of the graft and then placed as an interpositional segmental graft in the prerenal caudal vena cava. In three dogs, the graft was fixed in glutaraldehyde and acetylsalicylic acid was administered in the postoperative period. In the remaining three dogs, the graft was not fixed and adjunctive treatment was not administered. Ultrasound and angiography were used to evaluate patency of the caval grafts following surgery and every 7 days for a maximum of 21 days. Dogs were euthanatized prior to 21 days if graft occlusion was evident on imaging studies or 21 days if the graft was patent. Endothelialization of the luminal surface of the graft was assessed by gross examination at necropsy and histologic and immunohistochemical analysis. One untreated and all three glutaraldehyde-fixed autogenous grafts remained patent for 21 days. Two untreated grafts, both non-isodiametric, thrombosed by 7 days. Histologic and immunohistochemical analyses showed mesothelial cells did not survive on the graft surface and endothelialization was only apparent in patent grafts. The IRAS is a readily available source of autogenous tissue, but untreated grafts have a low patency rate and graft fixation in glutaraldehyde and postoperative treatment with acetylsalicylic acid may be required to improve the patency rate of venous grafts in large veins such as the caudal vena cava.
Bioactive Glass Efficacy in the Periodontal Healing of Intrabony Defects in Monkeys
Villa?a, José Henrique;Novaes Jr., Arthur B.;Souza, Sérgio Luís Scombatti de;Taba Jr., Mario;Molina, Gustavo Otoboni;Lamano Carvalho, Teresa Lúcia;
Brazilian Dental Journal , 2005, DOI: 10.1590/S0103-64402005000100012
Abstract: the purpose of this study was the histomorphologic analysis of the efficacy of bioactive glass particles with a narrow size range (biogran) in the periodontal healing of 2-wall intrabony defects in monkeys. the 2-wall defects were made in the mesial area of the left and right second premolars of four monkeys, filled with gutta-percha and, after 15 days, they were debrided and either naturally filled with coagulum (control) or implanted with bioactive glass (test). in the control sites, the junctional epithelium migrated up to the base of the defect. the presence of newly formed cementum was more significant in the test defects. both control and test sites showed newly formed bone at the base of the defect. the test defects presented foci of newly formed bone around and within the glass particles localized in the middle third, distant from the defect walls. histologic analysis showed that the 300- to 355-μm bioactive glass particles aided new periodontal insertion. in conclusion, the tested bioactive glass had better healing potential than debridement only. the graft material showed a promising inhibition of apical migration of the junctional epithelium and greater cementum deposition on the radicular surface of the intrabony defects. the replacement of bioactive glass particles by new bone occurred due not only to an osteoconductive property, but also to an osteostimulatory capacity. future investigations should evaluate this potential comparatively or together with other grafting materials, regenerative techniques and biological modifiers, as well as assess the longitudinal stability of the new attachment.
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