Abstract
Periodontitis is an infectious and inflammatory disease associated with significant loss of alveolar crest and soft tissue attached to the teeth. Chitosan and hydroxyapatite are biomaterials used for bone tissue repair because of their biodegradability and biocompatibility in nature. The present study evaluated the effects of chitosan (CH) in combination with hydroxyapatite (HAP) to promote alveolar bone growth. A chitosan implant mixed with hydroxyapatite was implanted into the affected area of 9 patients suffering chronic periodontitis. Patients were evaluated through X-ray images and a millimetric slide over a one year period. The application of CH/HAP produced an average alveolar bone growth of 5.77 mm (±1.87 mm). At the onset of the study, the dental pocket exhibited a depth level (DPDL) of 8.66 mm and decreased to 3.55 mm one year after the implant. Tooth mobility grade was 2.44 mm at the onset and 0.8 mm at the end of the study with a significant difference of p < 0.001. Moreover, the bone density in the affected areas was similar to the density of the bone adjacent to it. This result was confirmed with the software implant viewer from Anne Solutions Company. In conclusion, the CH/HAP implant promoted alveolar bone growth in periodontitis patients.
Highlights
Chronic periodontitis is caused by aerobic and anaerobic microorganisms
Chronic periodontitis produces bone loss as well as damage to the soft tissue attached to it, which is accompanied by an inflammatory tissue reaction and extracellular matrix breakdown
The biomaterial exhibited the presence of osteoblasts, fibroblasts and connective tissue without inflammatory infiltrate
Summary
Chronic periodontitis is caused by aerobic and anaerobic microorganisms. Clinical manifestations depend on the hosts response to the bacterial invasion. The most common periodontitis treatment is Emdogain, a protein derived from developing pork enamel. This protein promotes alveolar bone growth and the periodontal mucous membrane restitution [1]. The combined treatment of Emdogain with the bovine lyophilized bone protein has a better outcome compared to individual treatments [2]. This combined treatment is expensive for most people living in low-income countries. It consists in the insertion of a membrane separation between the soft tissue and the bone defect in order to allow bone regeneration and avoid mucous invagination [3]
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