Comparison of mesenchymal stem cells and autogenous cortical bone graft in the treatment of class II furcation defects in dogs.

The purpose of this study was to compare the effectiveness of mesenchymal stem cells (MSCs) with platelet-rich plasma (PRP) as scaffold and autogenous cortical bone (ACB) graft with and without PRP in the regenerative treatment of class II furcation defects in dogs. The mandibular second, third, and fourth premolars (P2, P3, P4) and maxillary P3 and P4 of both sides in three dogs were selected for experimentation. Class II furcation defects (5 mm in height and 2 mm in depth) were surgically created. Five weeks after the first operation, scaling + root planning (group 1), PRP (group 2), ACB (group 3), combination of ACB/PRP (group 4), and combination of MSCs/PRP (group 5) treatments were performed during open flap debridement. The percentage of cementum and alveolar bone formation was evaluated by histomorphometric analysis after a healing period of 8 weeks. There was new cementum along with periodontal ligament and coronal growth of alveolar bone in all groups. Cementum formation was significantly higher in groups 3, 4, and 5 compared to the control group (P < 0.05) with no significant difference between groups 2, 3, 4, and 5. Alveolar bone formation was similar in all groups (P > 0.05). It can be concluded that periodontal regeneration with complete filling of class II furcation defects with cementum, alveolar bone, and periodontal ligament is obtained 8 weeks after ACB, ACB/PRP, and MSCs/PRP treatments; however, efficacy of none is higher than another.

Effect of autogenous cortical bone grafting in conjunction with guided tissue regeneration in the treatment of intraosseous periodontal defects.

OBJECTIVES: The aim of this clinical trial was to evaluate the additional benefit of using guided tissue regeneration (GTR) with autogenous cortical bone (ACB) grafting versus ACB grafting alone for the regenerative treatment of intraosseous periodontal defects. METHODS: Via a split-mouth design, 12 patients with chronic periodontitis (five men, seven women; mean age, 45.3±4.6 years) who had probing pocket depths (PPDs) of ≥6 mm following initial periodontal therapy were randomly assigned to two treatments in contralateral areas of the dentition: a combination of ACB grafting and GTR (with a absorbable membrane of polylactic acid) or ACB grafting alone. The compared parameters were preoperative and 6-month postoperative PPDs, clinical attachment levels (CALs), and radiographic alveolar bone heights. RESULTS: Both treatment modalities resulted in significant changes in the postoperative measurements from the preoperative values (P<.01). The reduction in the PPDs, gain in the CALs, and gain in the radiographic alveolar bone heights were 4.58±1.08, 4.25±1.06, and 5.50±2.24 mm in the patients treated with ACB grafting and GTR and 4.92±1.00, 4.50±0.80, and 5.92±1.83 mm in those treated with ACB grafting alone, respectively. The differences between the treatments were not statistically significant (P>.05). CONCLUSIONS: Within the study limitations, both ACB grafting with GTR and ACB grafting alone lead to significant improvements in clinical and radiographic parameters at 6 months postoperatively. The combined approach does not provide any additional benefit for treating intraosseous periodontal defects.

Vascular endothelial growth factor expression levels of gingiva in gingivitis and periodontitis patients with/without diabetes mellitus.

OBJECTIVE AND DESIGN: The aim of this study was to determine vascular endothelial growth factor (VEGF) mRNA expression levels in gingival tissues of gingivitis and periodontitis patients with diabetes mellitus and those without. The hypothesis tested is that expression of VEGF, considered the effective cytokine in the relationship between diabetes and periodontal disease, is differentially affected in gingivitis and periodontitis patients with or without diabetes mellitus compared to healthy controls. METHODS: Forty-five subjects were evaluated in five groups; individuals with gingivitis (group 1; n = 10), individuals with periodontitis (group 2; n = 10), individuals with gingivitis + type II diabetes (group 3; n = 10), individuals with periodontitis + type II diabetes (group 4; n = 10), and individuals without periodontal and systemic disease (group 5; n = 5). VEGF mRNA levels in gingival tissues were measured by quantitative real-time PCR using Lightcycler. RESULTS: Expression of VEGF mRNA was detected in all groups. There was no significant difference in expression levels of VEGF mRNA between groups (P > 0.05). CONCLUSIONS: VEGF expression is probably related to both maintenance of periodontal health and periodontal tissue destruction. It can be concluded that systemic condition in type II diabetes mellitus under good metabolic control does not seem to have additional effects on gingival tissue VEGF mRNA levels in gingivitis and periodontitis patients.