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1.
Artículo en Inglés | IMSEAR | ID: sea-139994

RESUMEN

Background: Mucoperiosteal flap surgery stimulates varying amounts of alveolar bone loss due to accelerated osteoclastic activity [Regional Accelerated Phenomenon (RAP)]. Alendronate sodium inhibits osteoclastic activity and is thought to result in a net increase in osteoblastic activity. We undertook a preliminary study evaluating the effect of adjunctive use of topically delivered bisphosphonate alendronate (ALN) along with regenerative bone graft material in the treatment of periodontal infrabony defects. Materials and Methods: Fifteen patients with two-walled or three-walled infrabony defects were selected. In each patient, the infrabony defect of one side of arch was designated as group A (control site) and received hydroxyapatite (HA) bone graft material, while the infrabony defect on the contralateral side of same arch was designated as group B (test site) and received HA + 200 μg drug solution of ALN. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the study groups revealed a statistically nonsignificant reduction in probing depth (P=0.128 NS ) and mean gain in attachment level (P=0.218 NS ). However, there was a statistically significant gain in linear bone fill (P=0.040*) in group B as compared to group A. Conclusions: The results suggest that use of ALN along with graft material led to enhanced linear bone fill at the surgical site. This research provides a clue that bone-targeting properties of bisphosphonates can be harnessed along with regenerative materials to potentiate osseous regeneration.


Asunto(s)
Adulto , Alendronato/uso terapéutico , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/patología , Proceso Alveolar/diagnóstico por imagen , Conservadores de la Densidad Ósea/uso terapéutico , Sustitutos de Huesos/uso terapéutico , Periodontitis Crónica/patología , Periodontitis Crónica/cirugía , Durapatita/uso terapéutico , Femenino , Estudios de Seguimiento , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Masculino , Persona de Mediana Edad , Osteoclastos/efectos de los fármacos , Pérdida de la Inserción Periodontal/patología , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/patología , Bolsa Periodontal/cirugía , Método Simple Ciego , Resultado del Tratamiento
2.
Artículo en Inglés | IMSEAR | ID: sea-139962

RESUMEN

Background: Platelet-rich plasma (PRP) contains high levels of polypeptide growth factors that may enhance periodontal regeneration when combined with graft materials. Aim: The purpose of this study was to compare the efficacy of autologous PRP in combination with β-tricalcium phosphate (β-TCP) versus β-TCP alone in the treatment of human infrabony defects. Materials and Methods: Using a split-mouth design, 20 patients showing clinical evidence of almost identical bilateral infrabony defects were randomly selected. The right infrabony defects of the patient were designated as Group A and treated by the placement of β-TCP alone. The left infrabony defects of the same patient were designated as Group B and treated by the placement of PRP mixed with β-TCP. Clinical assessment of probing pocket depth and attachment level and radiographic evaluation of the defect depth were done preoperatively and at 12, 24 and 36 weeks postoperatively. The relative efficacy of two treatment modalities was evaluated using paired Student's t-test and the comparative evaluation between the two groups was done using independent Student's t-test. Results: Both the groups exhibited a highly significant reduction in probing pocket depth, gain in clinical attachment level and linear bone fill at the end of 36 weeks postoperatively. Comparative evaluation between the two study groups revealed a significant reduction in probing pocket depth (P = 0.036*), mean gain in clinical attachment level (P = 0.042*) and linear bone fill (P = 0.014*) in Group B as compared to Group A. Conclusions: Combination of PRP and β-TCP led to a significantly more favorable clinical and radiographic improvement in infrabony periodontal defects.


Asunto(s)
Implantes Absorbibles , Adulto , Pérdida de Hueso Alveolar/complicaciones , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Materiales Biocompatibles/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Sustitutos de Huesos/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Combinación de Medicamentos , Femenino , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/diagnóstico por imagen , Enfermedades Periodontales/cirugía , Plasma Rico en Plaquetas , Resultado del Tratamiento , Adulto Joven
3.
Artículo en Inglés | IMSEAR | ID: sea-139957

RESUMEN

Background: Absorbable synthetic biopolymers have been used as bone filler in Periodontology, proving effective stimulants to bone regeneration. Aim: Copolymerized polylactic and polyglycolic acid is used as a bone filler and polyglactin 910 as a guided tissue regeneration (GTR) membrane to achieve regeneration in periodontal infrabony defects. Materials and Methods: Forty patients with two- or three-walled infrabony defects were selected and randomly divided into two groups. Group A included patients treated with polylactic-polyglycolic acids 50:50 (Fisiograft® ,Ghimsa SPA,Via Fucini, Italy) alone and Group B included patients treated with polylactic-polyglycolic acids (PLA-PGA)50:50 in conjunction with polyglactin acid 910 (Vicryl Mesh® Johnson&Johnson , U.S.A ). Evaluation of clinical parameters probing depth and attachment level and radiographs was done preoperatively and 12 and 24 weeks postoperatively. Results: Both the groups showed statistically significant mean reduction in probing depth and gain in clinical attachment level and linear bone fill. Conclusions: Within the limit of this study, both the treatment modalities are beneficial for the treatment of infrabony defects.


Asunto(s)
Implantes Absorbibles , Pérdida de Hueso Alveolar/complicaciones , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Materiales Biocompatibles/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Sustitutos de Huesos/uso terapéutico , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Ácido Láctico/uso terapéutico , Membranas Artificiales , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/diagnóstico por imagen , Enfermedades Periodontales/cirugía , Poliglactina 910/uso terapéutico , Ácido Poliglicólico/uso terapéutico , Resultado del Tratamiento
4.
Artículo en Inglés | IMSEAR | ID: sea-139926

RESUMEN

Background: Experimentation confirmed the conclusion that bone allografts, like other tissue and organ allografts, are immunogenic. These immune responses cause resorption of allograft, thus lowering the bone formation capacity of the graft. An attempt has been made in this study to prevent immune reactions and achieve enhanced regeneration of allograft-demineralized freeze-dried bone matrix by incorporating it with an immunosuppressive drug Cyclosporine-A (CsA) in the treatment of human periodontal infrabony defects. Materials and Methods: Fifteen patients showing clinical evidence of almost bilateral infrabony defects requiring bone grafting procedures were selected. In each patient, the infrabony defect of one side of the arch was designated as Group A (control site) and the infrabony defect of the contralateral side of the same arch was designated as Group B (test site). Results: On comparative evaluation of the two groups (by Student t-test), the mean values of reduction in probing depth (P=0.81 NS ) and gain in clinical attachment level (P=1.00 NS ) of Group B were found to be greater than that of Group-A, but the differences were statistically non-significant. The mean linear bone fill (P=0.010 ** ) of Group B was also detected to be higher than that of Group A, and the difference was found to be statistically significant. Conclusion: Increase in linear bone fill in Group B signifies the role of CsA in augmenting the regenerative potential of allograft by eliminating immune reactions.


Asunto(s)
Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Matriz Ósea/trasplante , Regeneración Ósea/fisiología , Periodontitis Crónica/cirugía , Ciclosporina/administración & dosificación , Ciclosporina/uso terapéutico , Femenino , Estudios de Seguimiento , Liofilización , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/cirugía , Bolsa Periodontal/cirugía , Método Simple Ciego , Colgajos Quirúrgicos , Conservación de Tejido , Trasplante Homólogo
5.
Artículo en Inglés | IMSEAR | ID: sea-51661

RESUMEN

BACKGROUND: Microbial colonization of the barrier membranes used for guided tissue regeneration is inevitable and can lead to delayed healing. AIMS: Antimicrobial coating of the membrane with 25% doxycycline paste has been attempted to prevent infection and achieve enhanced regeneration in periodontal infrabony defects. MATERIALS AND METHODS: Twenty-four patients with 2-walled or 3-walled infrabony defects were selected and randomly divided into two equal groups. Infrabony defects of group A were treated with a biodegradable membrane coated with 25% doxycycline while those of group B were treated with membrane alone. Clinical assessment of probing depth and attachment level and radiographic evaluation of the defect depth was done preoperatively and at 12 and 24 weeks postoperatively. STATISTICAL ANALYSIS: The relative efficacy of the two treatment modalities were evaluated using the paired Student's t- test and the comparative evaluation between the two groups was done using the independent Student's t -test. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the two study groups revealed a significant reduction in probing depth ( P = 0.016 FNx01 ) and linear bone fill ( P = 0.02 FNx01 ) in group A as compared to group B. Mean gain in attachment level was greater for group A than for group B but the difference was statistically nonsignificant ( P = 0.065 NS ). CONCLUSIONS: The results suggest that doxycycline is beneficial in reducing membrane-associated infection and can potentiate regeneration through host modulation.


Asunto(s)
Implantes Absorbibles , Pérdida de Hueso Alveolar/diagnóstico por imagen , Antibacterianos/administración & dosificación , Regeneración Ósea , Doxiciclina/administración & dosificación , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Membranas Artificiales , Infección de la Herida Quirúrgica/prevención & control
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