Infrabony Defects Research Articles

Influence of the Angle of Periodontal Intrabony Defects on Blood Clots: A Confocal Microscopy Study

Intrabony defects can be the result of parodontitis. In this study we aimed to examine how clot stability is affected by different infrabony defect angles and superficial treatments in regenerative surgery. Methods: Thirty single-root extracted teeth were cut to obtain a section from each tooth. This section was placed in an artificial model containing an infrabony defect with three walls in order to achieve 10 models at angles of 25°, 37°, and 50°. Five root samples for every angle were not subjected any treatment (NT) and five were subjected to root conditioning with a neutral pH solution of ethylenediaminetetraacetic acid (EDTA) at 24%, applied for 2 min. Venous blood was put into the artificial models containing the root sections, and these were placed in an incubator at a constant temperature of 37 °C for 2 h. Samples were analyzed by laser confocal microscopy. Results: All samples exhibited signs of retraction. The EDTA group exhibited a plateau trend for infrabony defects, while in the NT group, there was a statistically significant difference between clot retraction and the increase in defect amplitude. Conclusion: The greater the angle of the infraosseous defect, the higher the rate of clot retraction. This showed that EDTA could reduce the influence of the angle of the infraosseous defect.

Case report: non-surgical regeneration with adjunctive enamel matrix derivative

A 48-year-old female patient referred to the Birmingham Dental Hospital for generalized periodontitis presented with a residual 8-mm pocket and infrabony defect around her LL2 after Step 1 and 2 of therapy. Following discussion of treatment options, a minimally invasive non-surgical technique was completed alongside the addition of a biologic, a therapeutic agent applied to enhance regenerative or reparative effects during wound healing and in this case, enamel matrix derivative. At 6 months, pocket closure was evident, as well as radiographic evidence of bony infill. The patient remains in ongoing supportive periodontal therapy at 3-monthly intervals. CPD/Clinical Relevance: Addition of biologics traditionally used during surgical therapy may provide improvements when used alongside minimally invasive non-surgical treatment.

Papillary Coronal Anchorage Technique for Periodontal Reconstruction of Infrabony Defect and Interdental Papilla: A Case Report.

Esthetic issues and phonetic disturbances frequently occur after periodontal regeneration of the anterior teeth, even if treatment is supposed to be successful. Conventional regenerative techniques are predominantly targeted at infrabony defects and often inadequately address the loss of the interdental papilla. This study introduces the papillary coronal anchorage technique, a novel modified tunnel surgical procedure, to facilitate the reconstruction of the interdental papilla. This method allows for coronal movement of the entire interdental papilla without incisions at the papilla to facilitate primary wound healing. Using a combination of bone grafts and recombinant human fibroblast growth factor 2 and anchoring the tunnel-like flap coronally using sutures, we successfully achieved a reconstruction of the infrabony defects as well as the interdental papilla. The papillary coronal anchorage technique is effective as it enables the simultaneous reconstruction of both the infrabony defect and the interdental papilla.

The Papilla Base CTG: A Novel Approach for Interdental Soft Tissue Reconstruction.

Impairment or loss of interdental papilla is a common issue in patients with periodontal disease, leading to phonetic, functional, and aesthetic concerns. Numerous techniques have been explored to reconstruct and regenerate interdental papillae, but consistent success remains challenging. This article presents a novel surgical approach that applies the principles of the Connective Tissue Graft (CTG) wall technique to enhance papilla volume when interdental clinical attachment loss is present in the aesthetic zone. The case of a 35-year-old woman with an RT3 recession defect associated with loss of interdental hard and soft tissues is discussed. The patient underwent a procedure involving palatal incisions, application of amelogenins, and a trapezoidal shape CTG fixed at the base of the papilla under a coronally advanced flap. This approach aimed to stabilize the blood clot and prevent soft tissue collapse into the defect area, enhancing the position and volume of the interdental papilla. Results at 6- and 12-months follow-up indicated significant improvement in papilla appearance and complete root coverage. This case suggests that the modified CTG wall technique can effectively treat buccal and interdental gingival recessions associated with horizontal or infrabony defects. Further clinical trials are necessary to confirm these findings and establish the most effective approach for interdental papilla reconstruction.

Comparison of the efficacy of Er,Cr:YSGG laser on oral biofilm removal from implant surfaces with various application times for the treatment of peri-implantitis defects: ex vivo study

PurposeThe major struggle in peri-implantitis therapy is the availability of successful decontamination of the infected implant surface. The main hypothesis of this study was the Er,Cr: YSGG laser decontamination efficacy investigation on the infected implant surfaces with various peri-implantitis defects. The primary objective of this study was to decide the efficacy of Er,Cr:YSGG laser as a decontamination tool at various peri-implantitis simulating defects. The secondary objective was to compare the efficacy of the Er,Cr: YSGG laser on oral biofilm removal between two protocols the first protocol (4 cycles at 2.5 min) and the second protocol (5 cycles at 5 min) at various peri-implantitis simulating defects.Materials and methodsA total of 3 subjects whose plaque biofilms formed in-vivo on twenty-four tested implants were divided into four tested groups. Two native implants were tested as controls.The in vitro defect model was computer‐aided designed and printed into a 3D-printed model with various anulations in peri-implant infrabony defects, which were 15,30,60,and 90 degrees.ResultsBoth Er, Cr: YSGG decontamination protocols at 50 mJ (1.5 W/30 Hz), 50% air, and 40% water were effective at reducing the total implant surface area/ biofilm ratio (%), but the second protocol had a markedly greater reduction in the duration of application (5 cycles at 5 min) than did the first protocol (4 cycles at 2.5 min).ConclusionThe Er, Cr: YSGG laser is an effective decontamination device in various peri-implantitis defects. The second protocol(5 cycles at 5 min) with greater application time and circles is more effective than the first one. The defect angulation influence the decontamination capability in peri-implantitis therapy.Clinical relevance (Scientific rationale for study)Clinicians anticipate that the exploration of suitable therapeutic modalities for peri-implantitis therapy is limited by the obvious heterogeneity of the available evidence in the literature and need for a pre-clinical theoretical basis setup. The major challenges associated with peri-implantitis therapy include the successful decontamination of the infected implant surface, the absence of any damage to the treated implant surface with adequate surface roughness, and the biocompatibility of the implant surface, which allows osteoblastic cells to grow on the treated surface and is the key for successful re-osseointegration. Therefore, these are the expected empirical triads that need to be respected for successful peri-implantitis therapy. Failure of one of the triads represents a peri-implantitis therapeutic failure. The Er, Cr: YSGG laser is regarded as one of the expected devices for achieving the required triad.Trial registration"Efficacy of Er,Cr YSGG Laser in Treatment of Peri-implantitis". ClinicalTrials.gov ID NCT05137821. First Posted date: 30 -11–2021.

Partial (incomplete) removal of granulation tissue using modified minimally invasive surgical technique in treatment of infrabony defects (randomized control clinical trial)

AimThis study aims to compare the clinical and radiographic outcomes after complete versus incomplete removal of granulation tissue (GT) during modified minimally invasive surgical technique (M-MIST) for management of periodontitis patients with deep pockets associated with infra-bony defects.MethodologyTen patients with a total of 14 deep non-resolving pockets (≥ 5 mm) associated with a vertical infra-bony defect were recruited for this study. They were randomized into 2 groups; a test group with incomplete removal of GT and a control group with complete removal of GT. Clinical parameters of clinical attachment level (CAL), residual probing depth (rPD) and buccal recession (Rec.) were recorded every 3 months. Radiographic periapicals were taken at baseline, 6 and 9 months. The significance level was set to 0.05.ResultsNone of the results showed statistical significance between the 2 groups (p > 0.05). The test group showed less CAL gain (2 ± 0.87 mm, p = 0.062), more reduction in rPD (3.1 ± 0.96 mm, p = 0.017) and more recession (0.857 ± 0.26 mm, p = 0.017) than control group CAL gain (2.4 ± 0.58 mm, p = 0.009), rPD reduction (2.9 ± 0.3 mm, p = 0.001) and recession (0.5 ± 0.34 mm, p = 0.203) respectively. Control group had linear reduction in depth defect (DD) (0.68 ± 0.287, p = 0.064) compared to an increase in DD in test group (-0.59 ± 0.5, p = 0.914).ConclusionsNo statistical significance were observed in healing parameters between complete removal of GT in M-MIST and incomplete (partial) removal of GT of deep pockets with infra-bony defects both clinically and radiographically. Further studies with larger samples are needed to confirm the results.

ROLE OF HYALURONIC ACID IN PERIODONTAL BONE REGENERATION

Hyaluronic acid is a natural component of extra cellular matrix in both soft and hard periodontal tissues .Hyaluronic acid is located in both mineralised tissues (i.e cementum and alveolar bone) and non mineralised tissues (i.e gingiva and periodontal ligament) .Hyaluronic acid due to its anti-inflammatory ,anti -edematous ,anti- bacterial ,stimulation of angiogenic effects and osteoconductive effects has the potential to regulate periodontal tissue regeneration .Along with these properties , its role in modulation of wound healing makes it an adjunct to surgical and non surgical periodontal therapy.The use of Hyaluronic acid to treat periodontal bone defects has been shown to accelerate bone regeneration owing to its osteoconductive potential ,proliferation and differentiation of mesenchymal cells ,and regulating activities of osteoblast ,fibroblast ,cementoblast along with enhancement of osteogenetic effect of bone morphogenetic protein -2 in periodontal regeneration .This review examines the current literature favouring the use of hyaluronic acid in the regeneration of periodontal infrabony defects.

Comparison of immediate vs. delayed guided tissue regeneration in Infrabony defect of second molars after adjacent third molar extraction: a retrospective study

BackgroundThe distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making.MethodsD-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn’s test or the Bonferroni test for pairwise comparisons.ResultsA total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group.ConclusionGTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery.

Native vs. ribosome-crosslinked collagen membranes for periodontal regeneration: A randomized clinical trial.

To evaluate whether the ribosome-crosslinked collagen membrane (RCCM) is non-inferior to the natural collagen membrane (NCM) used in regeneration surgery in terms of clinical attachment level (CAL) gain at 6 months. Eighty patients diagnosed as generalized periodontitis presenting with isolated infrabony defect (≥4 mm deep) were enrolled and randomized to receive regenerative surgery, either with NCM or RCCM, both combined with deproteinized bovine bone mineral (DBBM). CAL, pocket probing depth (PPD), and gingival recession (GR) were recorded at baseline, 3, and 6 months postoperatively. Periapical radiographs were taken at baseline, immediately, and 6 months after surgery. Early wound healing index (EHI) and patients' responses were recorded at 2 weeks postoperatively. At 6 months post-surgery, the mean CAL gain was 3.1 ± 1.5 mm in the NCM group and 2.9 ± 1.5 mm in the RCCM group, while the mean PPD was 4.3 ± 1.1 mm in the NCM group and 4.2 ± 1.0 mm in the RCCM group. Both groups demonstrated a statistically significant improvement from the baseline (p < .01). RCCM was non-inferior to NCM concerning the primary outcome (CAL gain at 6 months). The GR at 6 months postoperatively was 1.3 ± 1.2 and 1.2 ± 1.1 mm, which showed no difference compared with baseline. At 6 months follow-up, the radiographic linear bone fill (RLBF) was 6.5 ± 2.8 and 5.5 ± 2.6 mm (p > .05), while the bone fill percentage (BF%) was 102.3 ± 53.5% and 92.3 ± 40.1% (p > .05), in the NCM and RCCM groups, respectively. There was no significant difference in EHI and postoperative responses between two groups. RCCM + DBBM resulted in no-inferior clinical and radiographic outcomes to NCM + DBBM for the treatment of isolated infrabony defect in 6 months.

A Comparative Evaluation of Advanced Platelet-Rich Fibrin Combined With Demineralized Freeze-Dried Bone Allograft and Demineralized Freeze-Dried Bone Allograft Alone in the Treatment of Periodontal Infrabony Defects: A Clinical and Radiographic Study.

Aim Allografts, autografts, alloplast and xenografts are frequently used for periodontal regeneration. The aim of this study was to determine the efficacy of advanced platelet-rich fibrin (A-PRF) in combination with demineralized freeze-dried bone allograft (DFDBA) andDFDBA alone in periodontal infrabony defects. Methodology This was a split-mouth design study where 20 infrabony defects in 10 patients were included. Patients were randomly divided into two groups, where DFDBA allograft and A-PRF were used in the test group, while the DFDBA allograft alone was used in the control group. Furthermore, the results were evaluated at baseline, three, and nine months, respectively, in terms of clinical and radiographic parameters. Data were analysed with an unpaired t-test at the significance level of P < 0.05 (statistically significant). Results Both treatments showed reduced clinical and radiographic parameters from baseline to nine months. There was a non-significant difference in the plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), and radiographic defect fill (RDF). In comparison to the control group (3.40 ± 0.516), the probing pocket depth (PPD) in the test group at nine months (3.22 ± 0.422) was statistically significant showing reduction in the PPD (P = 0.042). Conclusion Within its limitations, the study showed that A-PRF plus DFDBA and DFDBA alone treatment modalities reduced clinical and radiographic parameters from baseline, at 9 months; however, the inclusion of A-PRF did not substantially improve the treatment outcome when comparing both the groups, except for the probing pocket depth after nine months.

Influence of physicochemical characteristics of calcium phosphate-based biomaterials in cranio-maxillofacial bone regeneration. A systematic literature review and meta-analysis of preclinical models

ObjectivesCalcium phosphate-based biomaterials (CaP) are the most widely used biomaterials to enhance bone regeneration in the treatment of alveolar bone deficiencies, cranio-maxillofacial and periodontal infrabony defects, with positive preclinical and clinical results reported. This systematic review aimed to assess the influence of the physicochemical properties of CaP biomaterials on the performance of bone regeneration in preclinical animal models. MethodsThe PubMed, EMBASE and Web of Science databases were searched to retrieve the preclinical studies investigating physicochemical characteristics of CaP biomaterials. The studies were screened for inclusion based on intervention (physicochemical characterization and in vivo evaluation) and reported measurable outcomes. ResultsA total of 1532 articles were retrieved and 58 studies were ultimately included in the systematic review. A wide range of physicochemical characteristics of CaP biomaterials was found to be assessed in the included studies. Despite a high degree of heterogeneity, the meta-analysis was performed on 39 studies and evidenced significant effects of biomaterial characteristics on their bone regeneration outcomes. The study specifically showed that macropore size, Ca/P ratio, and compressive strength exerted significant influence on the formation of newly regenerated bone. Moreover, factors such as particle size, Ca/P ratio, and surface area were found to impact bone-to-material contact during the regeneration process. In terms of biodegradability, the amount of residual graft was determined by macropore size, particle size, and compressive strength. ConclusionThe systematic review showed that the physicochemical characteristics of CaP biomaterials are highly determining for scaffold's performance, emphasizing its usefulness in designing the next generation of bone scaffolds to target higher rates of regeneration.

Step 3 for the treatment of periodontal diseases: non-regenerative periodontal surgery

This article outlines the key aspects of considering non-regenerative periodontal surgery in step 3 of the UK version of the EFP S3-level clinical practice guidelines for the treatment of periodontitis. The third step of periodontal treatment is aimed at treating those sites that have not responded adequately, targeting non-responding or residual deep pockets. The purpose of non-regenerative surgery is to achieve access to root surfaces associated with residual pockets for further subgingival instrumentation, aiming to eliminate those lesions that add complexity to the management of periodontitis (such as infrabony defects, root concavities and furcations). At these localized sites, the main objective of periodontal surgery is to improve direct vision and access for professional instrumentation, to reduce or correct anatomical factors, partially regenerate lost periodontal tissue where possible, and ultimately create an environment that is easy and comfortable for the patient and the dental professional to maintain. CPD/Clinical Relevance: Knowledge of the non-regenerative surgical treatment of Stage III and IV periodontitis patients is valuable for dental clinicians.

Treatment of an Infrabony Defect of a Maxillary Canine Tooth Using Enamel Matrix Derivatives with Allogeneic Bone Augmentation in a Dog.

A 5-year-old Miniature Dachshund was presented having an infrabony pocket on the palatal aspect of the right maxillary canine tooth. The bony defect had worsened despite previous closed root planing and administration of a perioceutic agent. A second surgery using an allogeneic cancellous bone augmentation with an enamel matrix derivative was performed in the infrabony defect following open root planing. Eight months after the periodontal surgery, the osseous defect showed healing by improved periodontal probing measurements and increased radiopacity using dental radiography and computed tomography.

Development, Characterisation and Biocompatibility Analysis of a Collagen-Gelatin-Hydroxyapatite Scaffold for Guided Bone Regeneration

Guided Bone Regeneration (GBR) is the choice of treatment for improving the horizontal and vertical bone volume through bone grafting. GBR membranes work on the principle of preventing epithelial migration into the defect space while maintaining the space for cell migration and differentiation at the defect site. Hydroxyapatite has been commonly used as a bone graft for infrabony defects. The study was conducted at the Department of Biomaterials at Saveetha Dental College. GBR membrane was prepared and its material characterization was done using Scanning Electron Microscope (SEM), Energy Dispersive X-ray (EDX) analysis, Fourier Transform Infrared Radiation (FTIR), and Confocal Analysis. The developed GBR membrane revealed SEM properties conducive to cell attachment. EDX and FTIR analysis showed the successful development of the collagen-gelatin-hydroxyapatite membrane. Cell culture and confocal analysis revealed excellent biocompatibility with a homogenous layer of viable cells. The developed composite GBR membrane is a biogenic membrane with relevant biomineralization potential that should be applied for GBR applications.

Polynucleotides and Hyaluronic Acid (PN-HA) Mixture With or Without Deproteinized Bovine Bone Mineral as a Novel Approach for the Treatment of Deep Infra-Bony Defects: A Retrospective Case-Series.

Polynucleotides and Hyaluronic Acid (PN-HA) mixture showed several effects in modulation of healing process. The aim of this study was to assess the safety and clinical performance of PN-HA alone or in association with Deproteinized Bovine Bone Mineral (DBBM) with papillary preservation flaps (PPF) in the treatment of residual pockets. A total of 43 patients with 55 infra-bony defects were recruited; 30% were smokers. The mean baseline Probing Depth (PD) was 7.7 ±1.9 mm with a corresponding mean recession (Rec) of 1.9± 1.3 mm. The depth of infra-bony defect at the surgical measurement was 5.2±2.1 mm. DBBM was applied at 56% of the defects considered as not-containing based on clinical judgment. Healing was uneventful at all sites. After one year, PD reduction was 4.4±1.8 mm with a Rec increase of 1.0 ±0.8 mm. Detected bone fill at x-ray was 3.5 ± 1.9mm. The multilevel analysis showed that absence of smoking habits was associated with improved PD reduction (P =0.026) and bone gain (P= 0.039). PN-HA mixture is a safe product for periodontal surgery and seems to promote clinical benefit in the treatment of residual pockets associated to infra-bony defects.

Assessing the Impact of Stem Cell-based Therapy on Periodontal Health: A Meta-analysis of Clinical Studies.

While clinical trials exploring stem cells for regenerating periodontal tissues have demonstrated positive results, there is a limited availability of systematic literature reviews on this subject. To gain a more comprehensive understanding of stem cell interventions in periodontal regeneration, this meta-analysis is undertaken to assess the beneficial effects of stem cells in human periodontal regeneration. "PubMed," "Cochrane Library," "Web of Science," "Embase," "Wanfang," and "CNKI," were used to extract clinical studies related to the utilization of stem cells in repairing periodontal tissue defects. This search included studies published up until October 5, 2023. The inclusion criteria required the studies to compare the efficacy of stem cell-based therapy with stem cell-free therapy for regenerating periodontal tissues. Meta-analysis was conducted using Review Manager software (version 5.4). This meta-analysis synthesized findings from 15 selected studies investigating the impact of stem cell interventions on periodontal tissue regeneration. The "stem cell" group displayed a substantial reduction in clinical attachment level (CAL) compared to the "control" group within 3 to 12 months post-surgery. However, no significant differences in CAL gain were found between groups. Probing pocket depth (PPD) significantly decreased in the "stem cell" group compared to the "control" group, particularly for follow-up periods exceeding 6 months, and dental stem cell treatment exhibited notable improvements. Conversely, no significant differences were observed in PPD reduction. Gingival recession (GR) significantly decreased in the "stem cell" group compared to the "control" group at 3 to 12 months post-surgery. No significant differences were observed in GR reduction between groups. No significant differences were identified in cementoenamel junction-bone distance reduction, infrabony defect reduction, or bone mineral density increase between the two groups. Furthermore, no significant changes were observed in the gingival index, plaque index, or width of keratinized gingiva. In conclusion, while stem cell-based therapy offers promising prospects for periodontal defect treatment, there are notable limitations in the current body of research. Larger, multicenter, double-blind RCTs with robust methodologies are needed to provide more reliable evidence for stem cell-based intervention in periodontitis.

Comparing the Clinical and Radiographic Outcomes of Two Different Surgical Approaches for Treating Infrabony Defects in Chronic Periodontitis Patients

ABSTRACT Background: Chronic periodontitis is a prevalent oral health issue, affecting a substantial portion of the population. Infrabony defects, characterized by bone loss around teeth, are a hallmark of this condition and require surgical intervention to prevent further damage and tooth loss. Two commonly used surgical approaches are open flap debridement (OFD) and guided tissue regeneration (GTR). Materials and Methods: This prospective cohort study included 60 patients with chronic periodontitis and infrabony defects. Patients were randomly assigned to either the OFD or GTR group. Clinical parameters, including probing depth (PD) and clinical attachment level (CAL), were recorded at baseline and at 6-month and 12-month follow-up appointments. Radiographic assessments were conducted using periapical radiographs. The primary outcome measures were changes in PD and CAL, while secondary outcomes included radiographic evidence of bone regeneration. Results: At the 6-month follow-up, the OFD group demonstrated an average reduction in PD of 2.4 mm (SD = 0.8) and an increase in CAL of 1.6 mm (SD = 0.5). In contrast, the GTR group showed a reduction in PD of 2.1 mm (SD = 0.7) and an increase in CAL of 1.9 mm (SD = 0.6). These differences were not statistically significant (P &gt; 0.05). Radiographic analysis indicated a mean bone fill of 1.2 mm (SD = 0.4) in the OFD group and 1.4 mm (SD = 0.3) in the GTR group at 12 months, with no significant difference observed between the two groups (P &gt; 0.05). Conclusion: In this study, both OFD and GTR approaches demonstrated comparable clinical and radiographic outcomes in the treatment of infrabony defects in chronic periodontitis patients.

Comparing the Clinical and Radiographic Outcomes of Two Different Surgical Approaches for Treating Infrabony Defects in Chronic Periodontitis Patients

ABSTRACT Background: Chronic periodontitis is a prevalent oral health issue, affecting a substantial portion of the population. Infrabony defects, characterized by bone loss around teeth, are a hallmark of this condition and require surgical intervention to prevent further damage and tooth loss. Two commonly used surgical approaches are open flap debridement (OFD) and guided tissue regeneration (GTR). Materials and Methods: This prospective cohort study included 60 patients with chronic periodontitis and infrabony defects. Patients were randomly assigned to either the OFD or GTR group. Clinical parameters, including probing depth (PD) and clinical attachment level (CAL), were recorded at baseline and at 6-month and 12-month follow-up appointments. Radiographic assessments were conducted using periapical radiographs. The primary outcome measures were changes in PD and CAL, while secondary outcomes included radiographic evidence of bone regeneration. Results: At the 6-month follow-up, the OFD group demonstrated an average reduction in PD of 2.4 mm (SD = 0.8) and an increase in CAL of 1.6 mm (SD = 0.5). In contrast, the GTR group showed a reduction in PD of 2.1 mm (SD = 0.7) and an increase in CAL of 1.9 mm (SD = 0.6). These differences were not statistically significant (P &gt; 0.05). Radiographic analysis indicated a mean bone fill of 1.2 mm (SD = 0.4) in the OFD group and 1.4 mm (SD = 0.3) in the GTR group at 12 months, with no significant difference observed between the two groups (P &gt; 0.05). Conclusion: In this study, both OFD and GTR approaches demonstrated comparable clinical and radiographic outcomes in the treatment of infrabony defects in chronic periodontitis patients.

Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis

Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2–11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = −1.10 mm, 95% confidence interval −1.97 to −0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.

Comparative Study between 1% Metformin and 1% Alendronate Gel in the Treatment of Infrabony Defects: A Randomized Controlled Trial

Comparative Study between 1% Metformin and 1% Alendronate Gel in the Treatment of Infrabony Defects: A Randomized Controlled Trial