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AIM: To compare the outcomes of therapy using recombinant human fibroblast growth factor (rhFGF)-2 combined with autologous bone grafting (ABG) therapy with those of rhFGF-2 alone and ABG alone in the treatment of periodontal intraosseous defects. METHODS: Periodontal intraosseous defects were randomized to receive rhFGF-2 therapy + ABG, rhFGF-2 therapy alone, or ABG alone. Periodontal examination and periapical radiography were performed preoperatively and at 3, 6, and 12 months postoperatively. RESULTS: At the 12 months follow-up, all three groups showed significant improvement in the clinical attachment level (CAL): 5.6 ± 1.6, 5.8 ± 1.7, and 5.2 ± 1.6 mm in the rhFGF-2 + ABG, rhFGF-2 alone, and ABG alone groups, respectively, with no significant inter-group differences (p < .05). rhFGF-2 therapy (alone or in combination) resulted in greater bone defect filling (BDF) (2.3 ± 1.2 mm and 2.6 ± 1.9 mm, respectively) than ABG therapy alone (1.2 ± 1.2 mm). Gingival recession was lesser in the ABG alone (1.2 ± 1.1 mm) and rhFGF-2 + ABG groups (1.4 ± 0.8 mm) than in the rhFGF-2 alone group (2.2 ± 1.2 mm). CONCLUSION: The results of this study showed that at 12 months postoperatively, all treatments resulted in statistically significant clinical improvements compared to the baseline. From these results, it can be concluded that rhFGF-2 promotes hard tissue regeneration in intraosseous defects.

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Aim The purpose of this research was to assess the clinical and radiographic outcomes of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of intraosseous abnormalities after periodontal flap surgery. Material and methods Patients aged 35-55 years who had undergone periodontal treatment at Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, and had a total of 14 intraosseous abnormalities were included in the research. Those in the control group had open flap debridement with alloplast, whereas those in the experimental group underwent the same procedure with the addition of rhBMP-2. Clinical indicators, such as plaque index (PI), gingival index, probing pocket depth (PPD), clinical attachment level, and radiographic defect fill, were collected at baseline at three months, six months, and nine months. Results The findings demonstrated that following periodontal treatment, both sets of patients had considerable improvements in their PI, gingival index, and PPD. The degree of relative connection improved significantly in both groups. When comparing the two groups radiographically, we saw that the test group had significantly better defect fill than the control group. Conclusion According to this research, there was a statistically significant decrease in PI, gingival index, PPD, clinical attachment level, and radiographic bone fill in patients who received rhBMP-2. Open flap debridement with rhBMP-2 and alloplastic bone grafts showed better reduction than open flap debridement with alloplastic bone grafts group in the radiographic defect fill.

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The aim of this literature review was to present minimally invasive surgical techniques (MISTs) for the regeneration of intrabony defects and the impact of these surgical procedures on clinical outcomes. Less invasive surgical procedures lead to a more uneventful postoperative healing and reduce patient morbidity. The introduction of these techniques together with the use of magnification tools enables gentle tissue manipulation with performing minimal incisions and flap elevations in the field of surgical treatment of intrabony defects. Minimally invasive surgical techniques induce minor surgical trauma and improve the wound stability with favorable results in terms of clinical outcomes and the patient's comfort. The defect anatomy, patient-centered factors and the various biomaterials applied are considered. Recent evidence concludes that the adjunctive use of regenerative materials seems to have a less determinant effect on the clinical performance of minimally invasive surgical techniques. In addition, more studies are required to investigate the clinical efficacy of these surgical techniques in the treatment of intrabony defects in comparison with the conventional papilla preservation flap techniques.

Asunto(s)

Pérdida de Hueso Alveolar , Regeneración Tisular Guiada Periodontal , Pérdida de Hueso Alveolar/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Colgajos Quirúrgicos/cirugía , Resultado del Tratamiento

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AIMS: Several materials have been introduced as bone grafts, i.e., autografts, allograft, xenografts, and alloplastic grafts, and studies have shown them to produce greater clinical bone defect fill than open flap debridement alone. The aim of this clinical and radiological 6-month study was to compare and evaluate the clinical outcome of deep intraosseous defects following reconstructive surgery with the use of mineralized cancellous bone allograft (Puros®) or autogenous bone. MATERIALS AND METHODS: Ten patients with 12 sites exhibiting signs of moderate generalized chronic periodontitis were enrolled in the study. The investigations were confined to two and three-walled intra bony defects with a preoperative probing depth of ≥5 mm. Six of these defects were treated with Puros® (group A) the remaining six were treated with autogenous bone graft (group B). Allocation to the two groups was randomized. The clinical parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and bone fill, were recorded at different time intervals at the baseline, 1 month, 3 months, and 6 months. Intraoral radiographs were taken using standardized paralleling cone technique at baseline, 1, 3, and 6 months. Statistical analysis was done by using the one-way analysis of variance (ANOVA) followed by Tukey highly significant difference. RESULTS: Both groups resulted in decrease in probing depth (group A, 3.0 mm; group B, 2.83 mm) and gain in clinical attachment level (group A, 3.33 mm; group B, 3.0 mm) over a period of 6 months, which was statistically insignificant. CONCLUSION: Within the limitations of the present study, it can be concluded that both mineralized cancellous bone allograft (Puros®) or autogenous bone result in significant clinical improvements.

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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.