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1.
Article in English | MEDLINE | ID: mdl-23593621

ABSTRACT

One-year data after autologous grafting of infrabony periodontal defects with human cultured periosteum sheets in combination with platelet-rich plasma and hydroxyapatite granules have shown favorable clinical and radiographic results. A 5-year follow-up evaluation of 22 selected patients indicated that treated infrabony defects remained stable. Radiographically, there was an increase in osseous radiopacity and bone trabeculation suggesting further bone maturation. This novel tissue-engineered periodontal treatment approach has resulted in significant clinical improvement, and defects remained stable after 5 years.


Subject(s)
Alveolar Bone Loss/surgery , Autografts/transplantation , Periosteum/transplantation , Tissue Engineering/methods , Alveolar Bone Loss/classification , Alveolar Bone Loss/diagnostic imaging , Bone Regeneration/physiology , Bone Substitutes/therapeutic use , Cell Culture Techniques , Chronic Periodontitis/classification , Chronic Periodontitis/surgery , Dental Prophylaxis/methods , Dental Scaling/methods , Durapatite/therapeutic use , Female , Follow-Up Studies , Humans , Male , Middle Aged , Oral Hygiene/education , Patient Compliance , Periodontal Attachment Loss/classification , Periodontal Attachment Loss/surgery , Periodontal Index , Periodontal Pocket/classification , Periodontal Pocket/surgery , Platelet-Rich Plasma/physiology , Radiography
2.
J Int Acad Periodontol ; 11(3): 206-13, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19753798

ABSTRACT

In a previous publication from our research group we reported that a combination of platelet-rich plasma (PRP) and hydroxyapatite (HA) granules resulted in a significantly favorable clinical result in treating osseous defects. The aim of this study is to evaluate the clinical response of human cultured periosteum (HCP) sheets in combination with autologous PRP and HA granules used as a tissue-engineered grafting material for the treatment of infrabony defects in three female patients. Periosteum cell specimens were harvested from the mandible of each patient and cultured for six weeks until HCP sheets were formed. The periodontal surgery fully exposed the osseous defects and debridement and root planing were carried out. The coagulated PRP and HA mixture were placed into the osseous defects, and then they were covered with autologous HCP sheets. Six months post-surgery there were gains in clinical attachment and radiographic evidence of infrabony osseous fill. It may be concluded that HCP sheets combined with PRP and HA granules showed significant promise for treating human periodontal infrabony defects. A factor contributing to these favorable clinical results would be the presence of osteogenic cells in the HCP sheets, which provided greater regeneration potential.


Subject(s)
Alveolar Bone Loss/surgery , Bone Substitutes/therapeutic use , Durapatite/therapeutic use , Periosteum/transplantation , Platelet-Rich Plasma , Tissue Engineering , Aged , Bone Regeneration/physiology , Chronic Periodontitis/surgery , Debridement , Female , Follow-Up Studies , Guided Tissue Regeneration, Periodontal/methods , Humans , Mandible/surgery , Maxilla/surgery , Middle Aged , Periodontal Attachment Loss/surgery , Periodontal Pocket/surgery , Root Planing , Subgingival Curettage , Tissue Culture Techniques , Treatment Outcome
3.
J Periodontol ; 79(5): 811-8, 2008 May.
Article in English | MEDLINE | ID: mdl-18454659

ABSTRACT

BACKGROUND: The aim of the present controlled clinical study was to compare the clinical response of human cultured periosteum (HCP) sheets in combination with platelet-rich plasma (PRP) and porous hydroxyapatite (HA) granules to a mixture of PRP and HA in the treatment of human infrabony periodontal defects. METHODS: Thirty interproximal infrabony osseous defects in 30 healthy, non-smoking subjects diagnosed with chronic periodontitis were included in this study. The subjects were randomly assigned to the test group (HCP sheets combined with PRP and HA) or the control group (PRP with HA). Clinical and radiographic measurements were made at baseline and the 12-month post-surgical evaluation. RESULTS: Compared to baseline, the 12-month results indicated that both treatment modalities resulted in statistically significant changes (P <0.01) in the gingival index, bleeding on probing, probing depth, clinical attachment level, and radiographic infrabony defect depth. Compared to the control group, the test group exhibited a statistically significantly more favorable change in clinical attachment gain (3.9 +/- 1.6 mm versus 2.7 +/- 1.3 mm; P <0.05), vertical relative attachment gain (83.5% +/- 31.7% versus 55.0% +/- 21.9%; P <0.05), and radiographic infrabony defect fill (4.9 +/- 1.2 mm versus 3.2 +/- 1.1 mm; P <0.01). CONCLUSIONS: Compared to PRP with HA, treatment with a combination of HCP sheets, PRP, and HA led to a significantly more favorable clinical improvement in infrabony periodontal defects. A factor likely contributing to these favorable clinical results is the presence of osteogenic cells in the HCP sheets, which provided greater regeneration potential.


Subject(s)
Alveolar Bone Loss/surgery , Bone Regeneration/drug effects , Bone Substitutes/therapeutic use , Durapatite/therapeutic use , Periosteum , Platelet-Rich Plasma , Absorbable Implants , Aged , Alveolar Bone Loss/complications , Female , Follow-Up Studies , Humans , Male , Middle Aged , Periodontal Index , Periodontitis/complications , Periodontitis/surgery , Tissue Engineering/methods , Treatment Outcome
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