Actual quantitative attachment gain secondary to use of autologous platelet concentrates in the treatment of intrabony defects: A meta-analysis.

BACKGROUND: There are no authoritative meta-analyses and no clear quantitative assessments available estimating effects of open flap debridement (OFD) combined with platelet-rich fibrin (PRF) or platelet-rich plasma (PRP) over and above that of OFD. This study evaluated the actual quantitative mean gain for various clinical (clinical attachment level [CAL], probing pocket depth [PPD] and gingival marginal level [GML]) and radiographic (intrabony defect depth [IBD]) parameters of Platelet Concentrates- PCs (PRP/PRF) as sole grafting material along with OFD and OFD alone in the treatment of intrabony defects. MATERIALS AND METHODS: A detailed electronic search was carried out in PUBMED/MEDLINE, COCHRANE, EBSCOHOST, and Google Scholar databases by unifying related search terms with additional hand searches in select specialty journals up to May 2017. The eligibility criteria included human randomized clinical trials, either of a parallel group or a split-mouth design with follow-up period of at least 6 months. Periodontal intrabony defects with radiographic IBD ≥3 mm with corresponding CAL ≥5 mm were included. For the meta-analysis, the inverse variance method was used in fixed- or random-effect models. RESULTS: Actual quantitative mean gains were calculated for OFD with PRF/PRP (CAL = 1.1 mm, IBD = 1.68 mm, PPD = 0.97 mm and GML = 0.48 mm) over and above that of OFD alone. CONCLUSION: Because of very high heterogeneity, the results may not be dependable. Apart from gains in radiographic bone fill, all other periodontal clinical parameters showed negligible gains. Using PRF technologies in periodontal intrabony defects may not be of great clinical significance over and above that of OFD alone, the effect sizes are also not large enough.

Scaffolds with shape memory behavior for the treatment of large bone defects.

The aim of the presented study was preparation, analysis of properties, and in vitro characterization of porous shape-memory scaffolds, designed for large bone defects treatment using minimally invasive surgery approach. Biodegradable terpolymers of l-lactide/glycolide/trimethylene carbonate (LA/GL/TMC) and l-lactide/glycolide/ε-caprolactone (LA/GL/Cap) were selected for formulation of these scaffolds. Basic parameters of shape memory behavior (i.e. recovery ratio, recovery time) and changes in morphology (SEM, average porosity) and properties (surface topography, water contact angle, compressive strength) during shape memory cycle were characterized. The scaffolds preserved good mechanical properties (compressive strength about 0.7 to 0.9 MPa) and high porosity (more than 80%) both in initial shape as well as after return from compressed shape. Then the scaffolds in temporary shape were inserted into the model defect of bone tissue at 37°C. After 12 min the defect was filled completely as a result of shape recovery process induced by body temperature. The scaffold obtained from LA/GL/TMC terpolymer was found the most prospective for the planned application thanks to its appropriate recovery time, high recovery ratio (more than 90%), and cytocompatibility in contact with human osteoblasts and chondrocytes.

Uso de la regeneración ósea guiada (rog) con membranas biodegradables de co-polímeros en cirugía bucal para reparar defectos óseos: estudio clínico de 30 meses de seguimiento postquirúrgico

La regeneración ósea guiada (ROG) es frecuentemente usada para tratar defectos óseos pero muchas veces el tipo de membrana usada se degrada antes de que ocurra la adecuada cicatrización ósea y se introduce tejido blando en la zona a regenerar. El objetivo de éste estudio es evaluar la eficacia de usar el sistema de membranas y tachuelas biodegradables de co-polímeros en pacientes con defectos óseos o que necesiten levantamiento de membrana sinusal con un periódico control clínico y radiográfico. Este estudio fue realizado en 15 pacientes que tenían defectos óseos o necesitaban levantamiento de membrana sinusal, con un rango de edad entre 19 y 49 años con un promedio de 34 años de edad. 8 pacientes fueron femeninos y 7 masculinos. Se usó relleno óseo con las membranas y tachuelas biodegradables de co-polímeros en todos los casos, 7 de los casos fueron levantamiento de membrana sinusal y los otros 8 se trataron de defectos óseos. Se les realizó un seguimiento clínico y radiográfico cada 3 y 6 meses hasta 30 meses después del día de la cirugía entre los años 2005 y 2007, realizándose un análisis longitudinal. Se encontró que a 5 pacientes se les expuso la membrana, uno de ellos se mantuvo con enjuagues de clorhexidina hasta que cicatrizó por segunda intención, en 2 de los pacientes se les recortó y moldeó el borde expuesto y los otros 2 casos se tuvo que retirar la membrana y tachuelas por completo. Los 10 pacientes restantes cicatrizaron adecuadamente y no tuvieron ningún tipo de exposición, siendo el porcentaje de éxito al utilizar éste nuevo sistema de membranas y tachuelas biodegradables de co-polímeros del 66,7%. Se destaca que éste sistema de membranas y tachuelas biodegradables de co-polímeros no necesita ser retirado en una 2da cirugía. Debido al buen control postquirúrgico se pudo manejar de inmediato los casos donde hubo exposición de la membrana y sólo fracasaron 2 de 15. Se observó una adecuada cicatrización ósea tanto clínica ...

Guided bone regeneration (GBR) is frequently used to treat bone defects, however, most of the membranes degrade before bone healing has occurred permitting soft tissue invasion into the desired bone chamber. The aim of this clinical trail is to evaluate the efficacy of using a biodegradable co-polymers membrane and tacks system in patients with bone defects or need of maxillary sinus lift for implant placement with a long term clinical and radiographically follow up. All patients included in this study had the necessity of guided bone regeneration. 15 patients consisted of bone defects or the need of maxillary sinus lifting, with an age range of 19 to 49 years of age with an average of 34 years old. There were 8 females and 7 males. In all cases, we used biodegradable co-polymers membrane and tacks system that gets soft when applied but becomes rigid in-situ after approximately 15 minutes allowing the new bone cicatrization because it becomes a barrier for the bone grafting material, 7 patients underwent surgery for maxillary sinus lift and the other 8 for bone defects. Patients were followed clinical and radiographically during 3 to 6 months intervals up to 30 months between 2005 - 2007. A longitudinal study was performed by checking the patients clinical and radiographically during a continuously period of time up to 30 months postoperatively. 5 patients had partial membrane exposure, one of them was kept in clorhexidine mouth rinses and irrigation until secondary healing was accomplished. 2 patients were treated by cutting and trimming the membrane edges in order to get full mucosa coverage and it was obtained in 2 weeks after this procedure. In 2 cases the flap open totally and we had to remove the membrane. The rest 10 of the 15 patients healed uneventfully. The percentage of success using the biodegradable co-polymers membrane and tacks system was 66,7% . This biodegradable co-polymers membrane and tacks system does not require ...