Uso de L-PRF en defectos infraóseos de pacientes con estadios avanzados de periodontitis / Use of L-PRF in intrabone defects in patients with advanced stages of periodontitis

Objetivo: El propósito de este estudio fue observar el efecto del uso de L-PRF en defectos infraoseos de pacientes con periodontitis en estadios avanzados. Métodos: Se incluyeron 32 defectos infraoseos de 12 pacientes con diagnóstico de Periodontitis estadio III y IV (Workshop 2018). Se realizó raspaje a campo abierto con colocación de membrana de L-PRF. Se incluyeron defectos infraóseos de 1-2-3 paredes y cráter óseo. Se registró la profundidad de sondaje (PS), nivel de inserción clínica (NIC), índice de placa (IP) e índice de sangrado (IS). Se realizaron radiografías periapicale digitales antes de la cirugía y al cuarto mes para observar el llenado óseo. Resultados: De los 32 defectos el 75 % mostró disminución de la profundidad de sondaje (PS) y el 66 % mejoro el nivel de inserción clínica (NIC). Se realizó un análisis de correlación pre y posquirúrgico en PS: MV (p = 0,02), MP/L (p = 0,00), DP/L (p = 0,00) y V (p =0,00). El porcentaje de llenado óseo fue de 62,96 % (DS± 3,88). Conclusiones: La mayoría de los defectos infraóseos mostraron radiográficamente llenado óseo parcial o total con el uso de membranas L-PRF. Además, se mejoraron los parámetros clínicos de profundidad de sondaje y nivel de inserción clínica.

Objective: The purpose of this study was to observe the effect of L-PRF (Leuko- cyte-Platelet Rich Fibrin) usage in intraosseous defects in patients with advanced-stages of periodontitis. Methods: Thirty-two intraosseous defects in 12 patients diagnosed with stage III and IV periodontitis (Workshop 2018) were included in the study. Open flap debridement was performed with the placement of L-PRF membranes. Included defects consisted of 1-2-3 wall defects and osseous craters. Parameters such as probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding index (BI) were recorded. Digital periapical radiographs were taken before surgery and at the fourth month to assess bone fill. Results: Out of the 32 defects, 75% showed a reduction in probing depth (PD), and 66% showed improvement in clinical attachment level (CAL). Pre- and post-surgical correlation analysis was performed for PD: MV (p = 0.02), PI/L (p = 0.00), BI/L (p = 0.00), and CAL (p = 0.00). The percentage of bone fill was 62.96% (±3.88 SD). Conclusion: The majority of intraosseous defects exhibited partial or complete radiographic bone fill with the use of L-PRF membranes. Furthermore, clinical parameters such as probing depth and clinical attachment level improved.

Stem cell-derived exosomes from human exfoliated deciduous teeth promote angiogenesis in hyperglycemic-induced human umbilical vein endothelial cells

Abstract Objective To investigate the angiogenesis in human umbilical vein endothelial cells (HUVEC) under high glucose concentration, treated with exosomes derived from stem cells from human exfoliated deciduous teeth (SHED). Methodology SHED-derived exosomes were isolated by differential centrifugation and were characterized by nanoparticle tracking analysis, transmission electron microscopy, and flow cytometric assays. We conducted in vitro experiments to examine the angiogenesis in HUVEC under high glucose concentration. Cell Counting Kit-8, migration assay, tube formation assay, quantitative real-time PCR, and immunostaining were performed to study the role of SHED-derived exosomes in cell proliferation, migration, and angiogenic activities. Results The characterization confirmed SHED-derived exosomes: size ranged from 60-150 nm with a mode of 134 nm, cup-shaped morphology, and stained positively for CD9, CD63, and CD81. SHED-exosome significantly enhanced the proliferation and migration of high glucose-treated HUVEC. A significant reduction was observed in tube formation and a weak CD31 staining compared to the untreated-hyperglycemic-induced group. Interestingly, exosome treatment improved tube formation qualitatively and demonstrated a significant increase in tube formation in the covered area, total branching points, total tube length, and total loop parameters. Moreover, SHED-exosome upregulates angiogenesis-related factors, including the GATA2 gene and CD31 protein. Conclusions Our data suggest that the use of SHED-derived exosomes potentially increases angiogenesis in HUVEC under hyperglycemic conditions, which includes increased cell proliferation, migration, tubular structures formation, GATA2 gene, and CD31 protein expression. SHED-exosome usage may provide a new treatment strategy for periodontal patients with diabetes mellitus.

Combined periodontal regeneration of molar severely compromised by furcation, intrabony defects and attachment loss to the apex: a case report / Regeneración periodontal combinada de molar gravemente comprometido por furcación, defectos intraóseos y pérdida de inserción en el ápice: reporte de un caso

Introduction: Clinicians tend to encounter unfavorable situations in the treatment of teeth with severe attachment loss. Periodontal regeneration has been a successful therapeutic approach in treatments that require a long-term prognosis improvement. This case shows the benefits of combined regenerative periodontal therapy in a patient with a molar severely compromised by furcation, intrabony defects and attachment loss to the apex. Case Report: The clinical case included an endo-periodontal, class III furcation and intrabony defects in a generalized periodontitis, Stage III Grade C patient. After non-surgical periodontal treatment and re-evaluation, a full-thickness flap and surgical debridement were performed. Dental root surface was treated with EDTA and enamel matrix derivatives and the defects were filled with allograft and platelet-rich fibrin, additionally a collagen membrane was applied over the graft. After a 12-month follow-up there was a resolution of the intrabony defects and periodontal regeneration. Clinical and radiographic evaluation also showed the partial resolution of the class III furcation defect. Conclusion: Combined periodontal regeneration can be a therapeutic approach to improve the prognosis and prevent the extraction of molars severely compromised by furcation, intrabony defects and attachment loss to the apex.

Introducción: Los clínicos tienden a encontrar situaciones desfavorables en el tratamiento de dientes por pérdida de inserción severa. La regeneración periodontal ha sido un enfoque terapéutico exitoso en tratamientos que requieren una mejora del pronóstico a largo plazo. Este caso demuestra los beneficios de la terapia periodontal regenerativa combinada en un paciente con un molar gravemente comprometido por furcación, defectos intraóseos y por pérdida de inserción hasta el ápice. Reporte de caso: El caso clínico incluyó un defecto endoperiodontal, furcación clase III y defectos intraóseos en una Periodontitis estadio III generalizada grado C. Tras el tratamiento periodontal no quirúrgico y la reevaluación, se realizó un colgajo de espesor total y un desbridamiento quirúrgico. La superficie de la raíz dental se trató con EDTA y derivados de la matriz de esmalte y los defectos se rellenaron con aloinjerto y fibrina rica en plaquetas, adicionalmente se aplicó una membrana de colágeno sobre el injerto. Después de un seguimiento de 12 meses hubo resolución de los defectos intraóseos y regeneración periodontal. La evaluación clínica y radiográfica también mostró la resolución parcial del defecto de furcación de clase III. Conclusión: La regeneración periodontal combinada puede ser un abordaje terapéutico para mejorar el pronóstico y prevenir la extracción de molares severamente comprometidos por furcación, por defectos y hasta el ápice.

Effects of periodontal tissue regeneration combined with orthodontics on periodontitis / 中国基层医药

Objective:To investigate the effects of periodontal tissue regeneration combined with orthodontics on periodontitis.Methods:Eighty-six patients with periodontitis who received treatment in the Yongkang First People's Hospital, China between January 2017 and December 2018 were included in this study. They were randomly assigned to receive either periodontal tissue regeneration (control group, n = 43) or periodontal tissue regeneration combined with orthodontics (observation group, n = 43). Periodontal function, clinical efficacy, complications and patient satisfaction were compared between the control and study groups. Results:Before treatment, there were no significant differences in plaque index, gingival bleeding index, probing depth, bleeding on probing and attachment loss between the control and study groups (all P > 0.05). After treatment, plaque index, gingival bleeding index, probing depth, bleeding on probing and attachment loss in the observation group were (0.85 ± 0.27) points, (0.64 ± 0.25) points, (2.25 ± 0.24) mm, (34.30 ± 0.48)% and (3.70 ± 0.55) mm, respectively, and they were (1.36 ± 0.30) points, (1.24 ± 0.53) points, (3.49 ± 0.38) mm, (57.88 ± 0.75) %, and (4.61 ± 0.92) mm, respectively. There were significant differences in these indexes between the observation and control groups ( t = 8.286, 6.714, 18.092, 173.648, 5.567, all P < 0.05). Total effective rate in the observation group was significantly higher than that in the control group [95.35% (41/43) vs. 79.07% (34/41), χ2 = 5.108, P < 0.05). Total effective rate in the observation group was significantly lower than that in the control group [2.33% (1/43) vs. 16.28% (7/43), χ2 = 4.962, P < 0.05]. Patient satisfaction in the observation group was significantly higher than that in the control group [(91.17 ± 3.52) points vs. (84.43 ± 2.50) points, t = 10.237, P < 0.05]. Conclusion:Periodontal tissue regeneration combined with orthodontics on periodontitis for treatment of periodontitis is highly safe and effective. It can promote the recovery of oral function and increase patient satisfaction.

Digital evaluation of supracrestal gingival thickness induced by periodontal regenerative and corticotomy surgery in patients with skeletal class Ⅲ malocclusion / 中华口腔医学杂志

Objective@#To establish a quantitative three-dimensional method based on intraoral scan to evaluate the changes of soft tissue, and to evaluate the changes of supracrestal gingival thickness (SGT) in skeletal class Ⅲ patients induced by periodontal regenerative and corticotomy surgery (PRCS).@*Methods@#Twenty-two systematically and periodontally healthy skeletal class Ⅲ patients (4 males and 18 females, aged between 19 and 35 years), who were in need of combined orthodontic-orthognathic treatment and referred to the Department of Periodontology from the Department of Orthodontics and the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from January, 2018 to March, 2019, were collected in the study. The teeth involved were 112 anterior teeth (46 maxillary anterior teeth and 66 mandibular anterior teeth). PRCS in anterior tooth area was conducted before orthodontic decompensation. Probing depth (PD), bleeding index (BI) and keratinized gingiva width (KGW) were recorded before surgery and 6 months post-surgery. The intraoral digital impressions of maxillary and mandibular anterior teeth were obtained by 3-shape intraoral scanner before surgery and 6 months after surgery. The Standard Tessellation Language (STL) files were processed using Geomagic qualify 12.2 software to establish the soft tissue morphological measurement model, and to quantitatively analyze the changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin on the median sagittal measurement plane.@*Results@#Probing depth and bleeding index had no significant difference before and 6 months after operation (P>0.05). KGW in 6-month post-operation group [(5.18±2.32) mm] was significantly higher than that in pre-operation group [(4.22±1.43) mm] (P<0.05). Supracrestal gingival thickness situated 1 to 2 mm apical to the free gingival margin also significantly increased 6 months after surgery (P<0.05). The changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin in the upper anterior area were (0.68±0.56) and (1.00±0.69) mm, respectively. The changes in the lower anterior area were (0.38±0.42) and (0.58±0.45) mm, respectively. The gingival changes of the upper anterior teeth were also significantly higher than those of the lower anterior teeth (P<0.01).@*Conclusions@#The described quantitative measurement based on intraoral scan could be an effective method for quantitative evaluation of the changes of soft tissue. PRCS could safely increase the supracrestal gingival thickness as well as KGW in skeletal class Ⅲ patients who were in need of combined orthodontic-orthognathic treatment.

Bioceramic cement in the filling of bone defects in rats

Abstract Purpose To evaluate PBS®MCIMMO cement in the filling of bone defects. Methods Thirty-six adult male Wistar rats were divided into three groups of twelve individuals each (group 1, group 2 and group 3). In all groups, a bone failure in the femur was induced, 2.0 mm wide and 7.0 mm deep. In group 1, the PBS®MCIMMO cement was applied to the bone defect produced and a titanium implant (CONNECTION®) 1.5 mm thick and 6 mm long was installed. In group 2, only the PBS® CIMMO cement was installed. In group 3, only bone failure was performed. Kruskal Wallis tests were performed to compare the mean area among the three groups. Results In all comparisons, significance was observed for group 2 (p = 0.0014-0.0026). Conclusion The PBS®CIMMO cement induced bone neoformation, and integration between the newly formed bone, cement, and implant was observed.

Effects of the photobiomodulation using different energy densities on the periodontal tissues under orthodontic force in rats with type 2 diabetes mellitus

Abstract To evaluate the impact of the GaAlAs diode laser with energy densities of 160 J/cm2, 320 J/cm2, and 640 J/cm2 on the periodontal tissues under continuous orthodontic force application and on the rate of orthodontic tooth movement in rats with type-2 diabetes mellitus. The intensity of primary alveolar bone formation was also investigated through the immune-positive osteocytes for OPN antibody. Forty adult male Wistar rats were divided into eight groups of 5 rats: normoglycemic (N), 160 J-laser-normoglycemic (160 J-LN), 320 J-laser-normoglycemic (320 J-LN), 640 J-laser-normoglycemic (640 J-LN), diabetic (D), 160 J-laser-diabetic (160 J-LD), 320 J-laser-diabetic (320 J-LD), and 640 J-laser-diabetic (640 J-LD) rats. Diabetes mellitus was induced by a single intravenous injection of 40 mg/kg monohydrated-alloxan. An orthodontic force magnitude of 20cN was applied. The laser parameters were continuous emission of 780-nm wavelength, output power of 20mW, and fiber probe with a spot size of 0.04 cm in diameter. Radiographic, histomorphological, and immunohistochemical analysis were performed after a period of 21 days. The photobiomodulation using the energy density of 640 J/cm2 strongly stimulated the alveolar bone formation and contributed the reorganization of the soft periodontal tissues, followed by the 320 J/cm2. Extensive alveolar bone loss, intense infiltration of inflammatory cells, and degradation of the PDJ tissue were mainly found in the D and 160 J-LD groups. The rate of orthodontic tooth movement was represented by the interdental distance between the cementoenamel junctions of the right mandibular first and second molars . This distance was larger in the diabetic groups (D: 39.98±1.97, 160 J-LD: 34.84±6.01, 320 J-LD: 29.82±1.73, and 640 J-LD: 35.47±4.56) than in the normoglycemic groups (N: 21.13±1.19; 160 J-LN: 22.69±0.72, 320 J-LN: 22.28±0.78, and 640 J-LN: 24.56±2.11). The number of osteopontin-positive osteocytes was significantly greater in the 640 J-LD (14.72 ± 0.82; p < 0.01) and 640 J-LN (13.62 ± 1.33; p < 0.05) groups than with D (9.82 ± 1.17) and 160 J-LD (9.77 ± 1.10) groups. Therefore, the energy density of 640 J/cm2 provided the best maintenance and integrity of the periodontal tissue microarchitecture under continuous orthodontic force when compared with the other dosages, mainly in the uncontrolled diabetic rats. The interdental distance was greater in the D and 160 J-LD groups due to presence of severe periodontitis caused by diabetes plus the mechanical stress generated by continuous orthodontic forces, implying, thus, an insufficient biostimulatory effect for the dosage of 160 J/cm2.

EFFICACY OF NATURAL BIOPOLYMER CHITOSAN MEMBRANE FOR GUIDED TISSUE REGENERATION / Шинэ санаа Шинэ нээлт

@#BACKGROUND. Periodontal regeneration is the reconstruction of periodontal tissues and restoration of functions, which is achieved through techniques, such as soft tissue grafts, guided tissue regeneration, bone replacement grafts, root bio-modification, and a combination of these techniques. Chitosan is a natural biopolymer with several beneficial properties, including excellent biocompatibility, low toxicity and corresponding degradation rates and hemostatic activities. This systematic review assessed the efficacy of biopolymer membrane (chitosan) for guided tissue regeneration (GTR) in animal and human studies. MATERIAL AND METHODS. The Cochrane Oral Health Group specialist trials, PubMed, MEDLINE, and EMBASE databases were searched for articles published before January 2017. Animal and human studies that used chitosan for GTR, which had a follow-up period of ≥6 weeks and 6 months, respectively, were retrieved. The following outcomes were analyzed: new bone (NB) and new cementum (NC) formation for animal studies and probing pocket depth and clinical attachment level changes for human studies. RESULTS. After a full-text review,six animal studies and three human studies were found to be eligible for this study. All included animal and human studies demonstrated that the use of chitosan for GTR exerts a positive effect on periodontal defects. Subgrouping meta-analysis outcomes of three dog studies revealed that GTR with pure chitosan membranes has a positive effect on NB (14.36%) and NC (10.21%) formation. CONCLUSION. Within the limitations of the present study, there is little evidence to demonstrate the efficacy of chitosan for GTR either in animal or human studies. Chitosan should rather be used as an adjunct component for membrane production.

Histomorphometric evaluation of ridge preservation after molar tooth extraction / 北京大学学报(医学版)

Objective:To evaluate bone formation in human extraction sockets with absorbed surrounding walls augmented with Bio-Oss(R) and Bio-Gide(R) after a 6-month healing period by histologic and histomorphometric analyses.Methods:Six fresh molar tooth extraction sockets in 6 patients who required periodontally compromised moral tooth extraction were included in this study.The six fresh extraction sockets were grafted with Bio-Oss(R) particle covered with Bio-Gide(R).The 2.8 mm × 6.0 mm cylindric bone specimens were taken from the graft sites with aid of stent 6 months after the surgery.Histologic and histomorphometric analyses were performed.Results:The histological results showed Bio-0ss(R) particles were easily distinguished from the newly formed bone,small amounts of new bone were formed among the Bio-Oss(R) particles,large amounts of connective tissue were found.Intimate contact between the newly formed bone and the small part of Bio-Oss(R) particles was present.All the biopsy cylinders measurement demonstrated a high inter-individual variability in the percentage of the bone,connective tissues and BioOss(R) particles.The new bone occupied 11.54％ (0-28.40％) of the total area;the connective tissues were 53.42％ (34.08％-74.59％) and the Bio-Oss(R) particles were 35.04％ (13.92％-50.87％).The percentage of the particles,which were in contact with bone tissues,amounted to 20.13％ (0-48.50％).Conclusion:Sites grafted with Bio-Oss(R) particles covered with Bio-Gide(R) were comprised of connective tissues and small amounts of newly formed bone surrounding the graft particles.

Effect of concentrated growth factors on the treatment of degree Ⅱ furcation involvements of mandibular molars / 北京大学学报(医学版)

Objective:Concentrated growth factors (CGF),a new generation of platelet concentrate products,appears to have more abundant growth factors because of its special centrifugation process.However,there are few studies supporting this.This study was designed to evaluate the effect of CGFs in the treatment of Ⅱ ° furcations of mandibular molars.Methods:In the present study,thirty-one Ⅱ ° furcation involvements in twenty mandiblular molars were included and randomly divided into two groups.The furcation involvements in the experimental group were treated with bone graft therapy combined with CGFs,and the furcation involvements in the control group were treated with bone graft therapy alone.The clinical examination and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery for the two groups.The changes of clinical and CBCT data at baseline and 1 year postsurgery were compared between the experimental group and the control group.Results:At baseline,there were no significant differences between the two groups in the probing depth (PD),vertical clinical attachment loss (CAL-V) and horizontal clinical attachment loss (CAL-H):PD (7.36 ± 2.32) mm (the experimental group) vs.(7.53 ±2.06) mm (the control group);CAL-V (8.69 ± 1.65) mm (the experimental group) vs.(8.81 ±1.53) mm (the control group);CAL-H (5.24 ±2.01) mm (the experimental group) vs.(5.35 ±2.14) mm (the control group).At the end of 1 year post-surgery,the clinical parameters of both groups were significantly improved (P ＜ 0.001).For the experimental group,the average vertical attachment gain was (2.78 ± 1.66) mm,and the vertical attachment loss was improved significantly compared with the baseline (P ＜ 0.001);the average horizontal attachment gain was (2.10 ± 1.89) mm,and the horizontal attachment loss were improved significantly compared with the baseline (P ＜ 0.001).Furthermore,the improvement degree of the experimental group was significantly higher than that of the control group (P ＜ 0.001).At baseline,there were no statistical differences in the vertical bone loss (BL-V) or horizontal bone loss (BL-H) between the two groups (P ＞ 0.05):BL-V (5.08 ± 2.17) mm (the experimental group) vs.(5.84 ± 2.65) mm (the control group);BL-H (5.85 ±2.13) mm (the experimental group) vs.(6.01 ±2.27) mm (the control group).At 1 year post-surgery,both groups showed significant radiographic bone gain at vertical and horizontal directions compared with baseline (P ＜ 0.001).For the experimental group,the average vertical radiographic bone gain was (2.20 ± 1.98) mm,the horizontal radiographic bone gain was (2.51 ±2.18) mm,the vertical and horizontal radiographic bone loss were both significantly reduced compared with the baseline (P ＜ 0.001).For the control group,the average vertical radiographic bone gain was (1.89 ± 2.15) mm,the horizontal radiographic bone gain was (1.30 ± 2.47) mm,the vertical and horizontal radiographic bone losses were both significantly reduced compared with the baseline (P ＜ 0.001).And the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with the control group (P ＜ 0.001).Conclusion:Within the limitation of the present study,CGFs showed positive role in the treatment of Ⅱ° furcation involvements of mandibular molars.

Bioinductive biomaterials for periodontal regeneration / 中华口腔医学杂志

Periodontal regeneration is a great challenge faced by clinical treatment, and traditional therapies are not effective in regenerating periodontal tissues. Bioinductive biomaterials are materials that are able to induce the regeneration of damaged tissues, and they can induce the migration of stem cells or precursor cells to the defect site to proliferate, differentiate for tissue regeneration. For example, the osteoinductive biomaterials are able to induce regeneration of alveolar bone. In this review, the writer combined the recent advances of both clinical and scientific field, and summarize the application of bioinductive biomaterials includingautogenous bone, human derived growth factors, enamel matrix proteins and platelet-rich fibrin.

Recubrimiento de recesiones múltiples: Uso de matriz dérmica acelular vs. matriz de colágeno / Multiple gingival recession coverage: Use of acellular dermal matrix vs. collagen matrix

La literatura periodontal contiene numerosas descripciones de procedimientos quirúrgicos diseñados para el recubrimiento radicular en dientes con recesión gingival, basados en injertos autógenos provenientes del paladar o de la tuberosidad. Actualmente, existen otras alternativas que disminuyen la morbilidad postoperatoria con buenos resultados funcionales y estéticos mediante el uso de matriz dérmica acelular (MDA) y matriz de colágeno porcino (MC), las cuales han venido siendo probadas en multiples ensayos clinicos. En la presente serie de casos se describen dos técnicas de recubrimiento radicular para recesiones múltiples utilizando MDA y MC. Se reportan dos pacientes: un primer caso con problemas estéticos en el sector anterosuperior debido a recesiones gingivales y restauraciones en mal estado que recibió MDA (AlloDerm (MR)). El segundo paciente presentaba sensibilidad en el sector anteroinferior además de escasa cantidad de encía queratinizada , la cual recibió MC (Mucograft®). Se obtuvieron resultados favorables en ambos casos demostrando buenos resultados clínicos en el recubrimiento de recesiones gingivales múltiples; considerándolos como una buena alternativa frente a los injertos gingivales autógenos.

Periodontal literature contains numerous descriptions of surgical procedures designed for covering teeth root gingival recession, based on autogenous grafts from the palate or tuberosity. Currently, there are other alternatives that reduce postoperative pain with good functional and aesthetic results; such as the use of acellular dermal matrix (ADM) and Porcine collagen matrix (CM); which have been being tested in multiple clinical trials. Describe two techniques of root coverage for multiple recessions: ADM and CM. This case series present a patient with anterior esthetic problems in the sector due to gingival re- cession and old restoration, which received ADM (AlloDerm ®). Another patient with tenderness in the anterior sector due to poor keratinized gingiva, which received graft CM (Mucograft(MR)). We had favorable results in both cases. Both treatments have shown good clinical results in covering multiple gingival recessions; considering them as a good alternative to autogenous free gingival grafts.

Application of membrane guided bone regeneration technique combined with 3 I implant system in anterior dental implant / 中国基层医药

Objective To analyze the clinical effect of membrane guided bone regeneration technique combined with 3 I implant system in anterior dental implant.Methods 50 patients with anterior teeth missing were selected as the experimental group,they received membrane guided bone regeneration technique combined with 3 I implant system of dental implant.50 cases alone with 3 I implant system of dental implant were selected as the control group.The clinical data were retrospectively analyzed.The effects of the two groups were compared.Results Statistical results showed that the satisfaction of appearance and function had significant difference between the two groups(χ2 =6.73,P<0.05).The operation area of plaque index (PLI) (t=3.16,P<0.05),gingival sulcus bleeding index (MBI) (t=6.32,P<0.05),probing depth (PD) (t=2.63,P<0.05) had significant differences between the two groups.The thickness of the buccal tongue of the bone graft,and other indicators of the top of the implant to the top of the alveolar ridge showed significant differences between the two groups (t=17.65,P<0.05,t=8.48,P<0.05). Conclusion Using membrane guided bone regeneration technique and 3 I implant system combined application can improve dental implant in the anterior and the success rate of patients on the appearance and function of satisfaction after dental implant in the anterior,and to broaden the bone defect of anterior tooth planting the indication effect,it is worthy of clinical promotion.

Periodontal ligament stem cell differentiation and proliferation in periodontal tissue regeneration / 中国组织工程研究

BACKGROUND:Periodontal ligament stem cels are one of the ideal seed cels in periodontal tissue regeneration. Sources, biological characteristics and influential factors of periodontal ligament stem cels have been an issue of concern. OBJECTIVE:To review the biological characteristics and functional factors of periodontal ligament stem cels as wel as relevant research status and progress in regenerative medicine, and to discuss the relevant application prospect and existing problems, thereby providing theoretical and experimental basis. METHODS:PubMed and Wanfang databases were searched by the first author for articles related to differentiation and proliferation of periodontal ligament stem cels published from 2002 to 2015. The key words were “periodontal ligament stem cel, periodontal tissue, proliferation, differentiation” in English and Chinese, respectively. Finaly, 47 articles were included in result analysis. RESULTS AND CONCLUSION:Periodontal ligament stem cels have the ability of differentiating into fibroblasts, adipocytes, chondrocytes and cementum. Cel growth factors play an important role in the proliferation and differentiation of periodontal ligament stem cels. Fibroblast growth factor, vascular endothelial growth factor and insulin-like growth factor can promote the proliferation of periodontal ligament stem cels. Application of stem cel biofilm as a carrier material can effectively guide periodontal tissue regeneration. Isolation, culture and influential factors of periodontal ligament stem cels should be further improved. Combined application of stem cels, biofilms and growth factors is expected to achieve the desired periodontal tissue regeneration, which is the focus of future research.

Terapia periodontal regenerativa: antecedentes y perspectivas / Regenerative Periodontal Therapy: History and Prospects

Dentro del campo de ingeniería de tejidos, en el área de la periodoncia, la utilización de matrices para guiar la proliferación de tejidos ha incluido los procedimientos de regeneración tisular guiada, la cual busca la nueva formación de hueso, cemento y desmodonto. Se realizó la presente revisión bibliográfica con el objetivo de ofrecer una perspectiva general y actualizada sobre la utilización de estos procedimientos en la terapia periodontal. Se concluye que la regeneración tisular guiada enriquece el espectro terapéutico en periodoncia; que la literatura científica avala su elección, y en específico el uso de membranas para facilitar los procesos regenerativos de las alteraciones generadas por la enfermedad periodontal y sus secuelas.

Within the field of tissue engineering, in the area of periodontics, the use of matrices for guiding tissue proliferation has included the guided tissue regeneration procedures, which aims at new bone, cementum and desmodontium formation. The present literature review was conducted in order to provide a general and updated overview on the use of these procedures in periodontal therapy. It was concluded that guided tissue regeneration improve the periodontal therapeutic spectrum; that scientific literature supports its choice and, specially the use of membranes to facilitate the regenerative processes of the anomalies caused by periodontal disease and its sequelae.

The use of latex biomembrane in mandible vestibuloplasty: a case report / O uso de biomembrana de látex natural em vestibuloplastia de mandíbula: relato de caso clínico

Introduction: the latex biomembrane BiomembranaTM has been used in several medical specialties with promising results in promoting wound healing, including surgical, traumatic, isquemic and pressure-induced, as well as ulceration of varied etiology. However, in dentistry its use is not currently well established. Objective: the aim of this study was to describe a treatment for vestibuloplasty using a latex membrane. Case report: due to the inherent characteristics of the latex biomembrane (BiomembranaTM), a vestibuloplasty of the anterior sextant of the mandible was performed using Arruda?s technique of second intention healing modified by the use of a latex biomembrane, in order to assess its applicability and ability to maintain the depth of the vestibule in this type of surgery. Final considerations: latex membrane is an easy to use material which proved useful for vestibuloplasty, since it provided gain of attached gingiva, which remained stable during the 9-month follow-up period.

Regeneración tisular guiada para recubrimiento radicular con biomateriales dentales: reporte de un caso / Guided tissue regeneration with dental biomaterials for root coverage: a case report

Los biomateriales son sustancias naturales, sintéticas o una combinación de ambas que sustituyen partes u órganos completos del cuerpo humano con una apropiada respuesta por parte del hospedador basado en los principios de biocompatibilidad y biofuncionalidad; la periodoncia como parte de las ciencias médicas se beneficia del uso y aplicación de los mismos para mejorar y simplificar los resultados de la reparación de tejidos, teniendo como meta principal la regeneración de éstos. Por su versatilidad y buenos resultados, los injertos gingivales son los procedimientos más usados dentro de la práctica clínica para recubrir raíces denudadas; sin embargo, requieren de tejidos donantes, por lo que se afectan dos sitios quirúrgicos. Cuando dentro de los diferentes tipos de tratamientos se cuenta con biomateriales que pueden sustituir esos tejidos donantes y lograr resultados similares, se puede simplificar entonces el acto quirúrgico y el post operatorio del paciente. Este artículo muestra como la combinación del Apafill-G, el Membracel y el Tisuacryl®, fueron efectivos en el tratamiento de dos recesiones periodontales bilaterales de los dientes 13 y 23 en un paciente de 35 años, con antecedentes de buena salud, que fue tratado en la Clínica Estomatológica de Varadero mediante la técnica quirúrgica de regeneración tisular guiada, utilizada para lograr recubrimiento radicular. La realización de la misma simplificó el procedimiento, sin la necesidad de extracción de tejidos donadores, se logró una cantidad adecuada de tejido adherido coronal y una cobertura radicular completa , sin que estuvieran presentes las molestias post operatorias comunes que se generan cuando se utilizan injertos gingivales

Biomaterials are natural substances, synthetic or a combination of both to replace parts or whole organs of the human body with an appropriate response by the host based on the principles of biocompatibility and biofunctionality, periodontics as part of medical science benefits from the use and applying them to improve and simplify the results of tissue repair, having as main goal the regeneration of these. Because of its versatility and good results, gingival grafts are the procedures used in clinical practice to cover denuded roots, however, require donor tissue, so it involved two surgical sites. When within the different types of treatments with biomaterials that can replace those tissues donors and achieve similar results, then you can simplify the surgery and the postoperative patient. This article shows how the combination of Apafill-G, and MEMBRACEL Tisuacryl ® were effective in the treatment of periodontal recessions bilateral two teeth 13 and 23 in a 35 year old patient with a history of good health, which was treated Dental Clinic in Varadero by the surgical technique of guided tissue regeneration, used to achieve root coverage. The simplified embodiment of the same procedure, without the need for removal of tissue donors, was obtained an adequate amount of adhering tissue and coronal complete root coverage, without the presence common postoperative discomfort generated when using gingival grafts

Therapeutic effect of the bone-guided tissue regeneration in combination with a composite bovine-derived xenograft on intra-bony defects in elderly patients with periodontal disease / 中华老年医学杂志

ObjectiveTo compare therapeutic effects of the bone-guided tissue regeneration in combination with a composite bovine-derived xenograft versus flap surgery only on intra-bony defects in elderly patients with periodontal disease. MethodsThirty elderly patients with periodontal disease were randomly divided into two groups. One group was treated by the bone-guided tissue regeneration in combination with a composite bovine-derived xenograft (experimental group). The other group was treated by flap surgery only (control group). Probing depth (PD)and clinical attachment level (AL) were determined before surgery and six months after treatment in two groups. The change of bone amount was also determined before surgery and six months after treatment through computer-assisted densitometric image analysis(CADIA). ResultsThe changes of PD and CADIA were (3.8+1.7)mm, (20. 3+11.1)g/mm2 in experimental group and were (2.5+1.1)mm, (9.4+8. 6)g/mm2 in control group. The differences between two groups were significant (P.＜0. 05). The change of AL was (3.5+ 1.6)mm in experimental group, compared with control group(2. 3 1.7)mm, which showed more obvious regeneration of alveolar bone (P＜ 0. 01). ConclusionsGuided tissue regeneration in combination with a composite bovine-derived xenograft appears to be more effective than flap surgery only for intra-bony defects in elderly patients with periodontal disease.

Efeitos da intrusão ortodôntica na reparação de lesões de furca grau III em cães, e da presença de TNFα e/ou IL-β 1 na mecanoresposta de células ósseas in vitro / Effects of orthodontic intrusion on the healing of class III furcation lesions in dogs, and of the presence of TNFα and/or IL-1β on the mechanoresponse of bone cells in vitro

O objetivo dessa tese foi avaliar os efeitos da intrusão ortodôntica no processo de reparação de lesão de furca grau III em cães, e da presença de fator de necrose tumoral alfa (TNFα) e/ou interleucina-1 beta (IL-1ß) na mecanoresposta de células com característica de osteócitos e osteoblastos in vitro. No estudo in vivo, lesões de furca grau III foram criadas em pré-molares inferiores de sete cães. Após 75 dias, as lesões foram aleatoriamente tratadas com cirurgia a retalho (OFD) associada ou não à regeneração tecidual guiada (GTR) e enxerto ósseo autógeno (BA). Após um mês, iniciou-se a intrusão ortodôntica (I) em parte dos dentes tratados pelas duas diferentes abordagens (grupos teste), por meio de ancoragem em miniimplantes. Os cães foram sacrificados após três meses de movimentação e um mês de contenção. Todas as lesões de furca grau III foram reduzidas para grau II ou I nos grupos teste. O mesmo foi observado em 50% das lesões nos grupos controle (sem movimentação). O nível de inserção clínico foi reduzido nos grupos teste, no final da contenção (p<0.01). O grupo OFD+I apresentou maior preenchimento ósseo que os demais grupos (p<0.05), demonstrando superioridade desta associação, no tratamento de lesões de furca grau III, em cães. Esses resultados levantaram a hipótese de que o processo de degradação da membrana e/ou enxerto ósseo interagiria negativamente sobre o processo de reparo quando associado a forças ortodônticas, pois a presença de mediadores inflamatórios estaria intensificada. É conhecido que a alteração tecidual proveniente da movimentação ortodôntica é resultado da ação de mediadores químicos sobre as células dos tecidos periodontais. Portanto, buscamos avaliar in vitro a ação de duas citocinas pró-inflamatórias, TNFα e IL-1ß, sobre células ósseas em presença e ausência de carga mecânica.

The aim was to assess the effects of orthodontic intrusion on the healing of class III furcation lesions in dogs, and of the presence of tumor necrosis factor alpha (TNFα) and/or interleukin-1 beta (IL-1ß) on the mechanoresponse of osteocyte and osteoblast-like cells in vitro. In the in vivo study, class III furcation lesions were created in lower pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with open flap debridment (OFD) associated or not to guided tissue regeneration (GTR) and bone autograft (BA). After one month, teeth were randomly assigned to orthodontic intrusion using mini-implants anchorage or no movement. Dogs were sacrificed after three months of movement and one month contention. All class III furcations were closed or reduced to class II or I lesions in the intrusion groups while 50% of the class III lesions in non-moved teeth remained unchanged. Clinical attachment level was reduced in the intrusion groups by the end of contention (p<0.01). OFD + I presented smaller soft tissues area and larger bone tissue area than other groups (p<0.05). Orthodontic intrusion with mini-implants anchorage improved healing of class III furcation defects after OFD in dogs. Based on these results we hypothesized that degradation of membrane and/or bone autograft can negatively interfere on repair when associated to orthodontic movement because inflammatory mediators are intensified. It‘s known that cytokines are present during orthodontic movement which are acting on periodontal cells. Therefore we evaluated in vitro the effects of two pro-inflammatory cytokines, TNFα and IL-1ß, on bone cells in presence or absence of mechanical loading.