Regeneration of the Periodontal Apparatus in Aggressive Periodontitis Patients (original) (raw)
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Brazilian Dental Journal, 2013
Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. T...
Periodontal regeneration: is it still a goal in clinical periodontology?
Brazilian Oral Research, 2021
In the last decades, Periodontal Regeneration has been one of the most discussed topics in Periodontics, attracting the attention of researchers and clinicians. This can be justified by the evident and continuous progress observed in the field, characterized by a better understanding of the biological mechanisms involved, significant improvement of operative and technical principles, and the emergence of a wide range of biomaterials available for this purpose. Together, these aspects put the theme much in evidence in the search for functional and esthetic therapeutic solutions for periodontal tissue destruction. Despite the evident evolution, periodontal regeneration may be challenging and require the clinician to carefully evaluate each case before making a therapeutic decision. With a critical reassessment of the clinical and preclinical literature, the present study aimed to discuss the topic to answer whether Periodontal Regeneration is still a goal in clinical periodontology. The main aspects involved in the probability of success or failure of regenerative approaches were considered. A greater focus was given to intrabony and furcation defects, clinical conditions with greater therapeutic predictability. Aspects such as more appropriate materials/approaches, long-term benefits and their justification for a higher initial cost were discussed for each condition. In general, deep intrabony defects associated with residual pockets and buccal/lingual class II furcation lesions have predictable and clinically relevant results. Careful selection of the case (based on patient and defect characteristics) and excellent maintenance are essential conditions to ensure initial and long-term success.
Periodontal Regeneration with and Without Endodontic Treatment: A Comparative Study
2015
It is frequently considered that the endodontic tre atment have an effect on the periodontal regenerati on. However, contradictory conclusions have been drawn by variou s nvestigators, thus it remains doubtful. Consider ing this, the present study was carried out to evaluate the periodontal r egeneration with and without endodontic treatment i nvolving 36 sites, comprising control (n=18, received only open flap d ebridement) and case sites (n=18, received combined op n flap debridement and endodontic therapy) in 12 subjects having at least 2 sites of periodontal defects. Gin gival index, probing pocket depth, clinical attachment levels were asses sed clinically, while bony defects were assessed ra diographically. All the parameters were recorded on day 0 (baseline ) a d at the end of 3 and 6 months postsurgically. Significant improvement was observed in all the parameters in t he case sites compared to that of control sites, ex cept gingival health which showed no difference. This m...
We reviewed the literature on the efficacy of enamel matrix derivative (EMD) in comparison with open flap debridement, guided tissue regeneration (GTR), and bone grafting for the treatment of intrabony defects. We searched four major electronic databases for randomized controlled trials (RCTs) with at least one year of follow-up. Several journals were handsearched with no language restrictions. Outcome measures were: tooth loss, changes in probing attachment levels (PAL), pocket depths (PPD), gingival recessions (REC), marginal bone levels on intraoral radiographs, and postoperative infections. Screening of eligible RCTs, assessment of the methodological quality, and data extraction were conducted in duplicate. No difference in tooth loss was observed. A meta-analysis (eight trials) showed that EMD-treated sites displayed statistically significant PAL improvements (mean difference 1.3 mm) and PPD reduction (1 mm) when compared to flap surgery. When EMD was compared to GTR (six trials), GTR showed a statistically significant reduction of PPD (0.6 mm) and increase of REC (0.5 mm). No difference in postoperative infections was observed. No trials compared EMD with bone grafts alone. EMD is able to significantly improve PAL levels and PPD reduction when compared to flap surgery; however, there is no evidence that more teeth could be saved.
Periodontal regeneration in clinical practice
Medicina oral, patología oral y cirugía bucal, 2006
The regeneration or restitution of lost supporting tissue has always been considered the ideal objective of periodontal therapy. However, attempts to convert this intention into solid clinical practice can become tremendously complex, the results of which are very different from the original intention. The aim of this article is to offer an up-to-date, general perspective on periodontal regeneration, orienting the clinician within the global strategy for oral treatment. To this end, we revise the healing process of periodontal injury, the different therapeutic approaches, the interpretation of the results, and finally, limiting factors in periodontal regeneration.
Journey towards periodontal regeneration
2015
Periodontitis is an infectious disease that causes destruction of the attachment apparatus of the tooth. Regeneration has been defined as the reproduction or reconstitution of lost or injured part of the body in a way that the function and architecture of the lost tissue is restored. In terms of periodontal regeneration, the structure and function of the gingiva, alveolar bone, root cementum and periodontal ligament must be restored. There are a broad range of treatment options which bring about regeneration, bone grafts, root biomodification, guided tissue regeneration to name a few. This review paper gives an insight to the various options available for periodontal regeneration and the clinical effectiveness of each of them.