ABSTRACT
ABSTRACT: The aim of this research was to perform a systematic review to identify the most frequent uses of PLA/ PGA in alveolar bone regeneration and their results. A study was designed to answer the question: What are the most frequent uses of PLA/PLGA and their copolymers in alveolar bone regeneration?. A systematic search was done on MEDLINE, EMBASE and LILACS from April 1993 to December 2017. The search string used on MEDLINE was: (((polylactic acid) OR PLA) OR PLA-based copolymers) OR PLA blends) OR PLA scaffolds)) AND ((("Bone Regeneration"[Mesh]) OR bone regeneration) OR guided bone regeneration). The search was complemented by a manual review of the references from the articles included. Most of the studies selected were weak and, regarding the most frequent uses of PLA/PGA, 13 studies used it as a resorbable membrane, two as an absorbable mesh, one as an absorbable screw and three as filling material. Based on our results, the authors consider that PLA/PGA requires a delicate relation between the mechanical resistance and the degradation process. PLA/PGA does not interrupt bone regeneration; however, the influence in cellular events related to bone regeneration and later osseointegration have not been identified.
RESUMEN: El objetivo de esta revisión fue realizar una revisión sistemática de la literatura para identificar los usos más frecuentes de PLA/PGA en regeneración ósea en área maxilofacial y sus resultados. Se diseñó un estudio para responder a la pregunta: ¿Cuáles son los usos más frecuentes de PLA/PLGA y sus copolímeros en regeneración ósea en el sector maxilofacial?. Los estudios seleccionados fueron en su mayoría débiles y sobre los usos más frecuentes de PLA/PGA, 13 estudios lo utilizaron como membrana reabsorbible, 2 estudios como malla absorbible, un estudio como tornillo absorbible y 3 estudios como material de relleno. En base a nuestros resultados, los autores estiman que PLA/PGA requiere una delicada relación entre la resistencia mecánica que ofrece y la degradación que se produce; PLA/ PGA no interrumpe la regeneración ósea, sin embargo, no se ha identificado la potencialidad o influencia que presenta en los eventos celulares de la regeneración y posterior oseointegración.
Subject(s)
Humans , Polyethylene Glycols/chemistry , Dental Implants , Alveolar Bone Loss/surgery , Bone Substitutes , Alveolar Ridge Augmentation/methods , Bone Regeneration , Bone TransplantationABSTRACT
The goal of periodontal treatment is regeneration of the periodontium. Bone graft and absorbable PLA/PGA membrane have been used for this purpose. In this study, 4x4mm 1-wall intrabony defects were surgically created bilaterally in the mandible of five male beagles. The control group went through a conventional flap operation, while the experimental group I was treated with absorbable PLA/PGA membranes only, group II was treated with absorbable membrane and calcium phosphate. The results are the following : 1. The defect height was 4.82+/-0.45mm in the control group, 4.93+/-0.79mm in the experimental I group, and 4.92+/-0.62mm in the experimental II group. There was no statistically significant difference among 3 groups(P<0.05). 2. The amount of junctional epithelium migration was 30.90+/-9.92% of the defect height in the control group, 39.16+/-7.51% in the experimental I group, and 38.68+/-12.22% in the experimental II group. There was no statistically significant difference among 3 groups(P<0.05). 3. The amount of connective tissue adhesion was 36.38+/-9.03% in the control group, 14.73+/-3.93% in experimental I group, and 27.87+/-9.70% experimental II group. Experimental group I was a statistically significantly different from control group(P<0.05). 4. The amount of new cementum regeneration was 32.92+/-10.51%, 50.04+/-7.61%, and 39.62+/-12.14% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). 5. The amount of new alveolar bone regeneration was 27.24+/-7.49%, 40.75+/-8.03%, and 36.47+/-15.11% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). The results suggest that the use of PLA/PGA membrane in 1-wall intrabony defect of beagle dogs may promote periodontal regeneration. Further studies are required to determine their regeneration effects.