Periodontal Infrabony Defects Research Articles

A comparative evaluation of the effectiveness of guided tissue regeneration by using a collagen membrane with or without decalcified freeze-dried bone allograft in the treatment of infrabony defects: A clinical and radiographic study.

Background:The present, randomized, controlled clinical and radiographic study was undertaken to compare the effectiveness of guided tissue regeneration (GTR) by using a collagen membrane barrier with or without decalcified freeze-dried bone allograft (DFDBA) in the treatment of periodontal infrabony defects characterized by unfavorable architecture.Materials and Methods:Sixteen systemically healthy patients with 20 periodontal infrabony defects were selected for the study. Each patient had at least ≥ 5 mm clinical probing pocket depth (PPD) at the selected site and depth of intrabony component ≥ 3 mm as assessed by clinical and radiographic measurements. Baseline measurements included plaque index, papillary bleeding index, PPD, gingival recession, clinical attachment level and radiographic defect depth (DD). At the time of surgery, the defects were randomly assigned to either the test group (collagen membrane plus DFDBA) or the control group (collagen membrane only).Results:At the 6-month examination, PPPD reduction was significantly greater in the GTR + DFDBA group (4.06 ± 0.38 mm) compared with the GTR group (3.2 ± 0.74 mm). The mean gains of clinical attachment were 3.54 ± 0.36 mm in the test group and 2.50 ± 0.74 mm in the control group. Radiographic DD reduction was similarly greater in the GTR + DFDBA group (2.40 ± 0.51 mm) compared with the GTR group (1.60 ± 0.51 mm).Conclusions:The results of the present study indicate that the use of a GTR membrane with bone graft has significantly improved all clinical parameters tested as compared with the use of bioresorbable membrane alone in the treatment of infrabony defects characterized by unfavorable architecture.

Clinical and Radiographical Evaluation of the Use of Platelet Rich Fibrine Membrane and Autogen Bone Graft in Regenerative Treatment of Periodontal Infrabony Defects. Case Series

Blood sourced biomaterials have recently been used as grafting material in various surgical procedures. Platelet rich fibrine (PRF) is a second generation platelet concentrate, and it is so easily produced biomaterial as it is obtained without biochemical manipulation of blood. In this case series, regenerative treatment of the teeth with infrabony periodontal defects depending on advanced localized periodontal disease with the combination of autogen bone graft and PRF membrane was presented. Pre- and post-operative clinical and radiographical comparisons showed that using of PRF as a membrane was successful for periodontal healing and bone formation in infrabony periodontal defects. Key words: Platelet rich fibrine, infrabony defect, periodontal regeneration

Comparative evaluation of decalcified freeze dried bone allograft with and without local doxycycline in non-contained human periodontal infrabony defects

Background:Doxycycline has been advocated as useful adjuncts in periodontal therapy not only due to their antimicrobial actions, but also to their recently recognized anti-collagenolytic, anti-inflammatory, osteoclast inhibitory and fibroblast stimulating property. The purpose of the present cohort study was to evaluate the regenerative outcomes of bone graft with or without local doxycycline in non-contained infrabony periodontal defects.Materials and Methods:16 one or two wall infrabony defects, in 11 patients suffering from moderate to severe chronic periodontitis, aged 35-60 years, were randomly divided for bone graft, alone (control) and with doxycycline (test) for the study. At baseline, after 3 months and after 6 months of post-operative period, pocket probing depth (PPD), clinical attachment level (CAL), radiological bone fill (RBF) and alveolar height reduction were recorded. Analysis of variance and Newman-Keuls post-hoc test were used or statistical analysis. A two-tailed probability (P) value P < 0.05 was considered to be statistically significant.Results:For the control group PPD reduction 2.00 ± 0.18 mm, CAL gain 1.38 ± 0.17 mm, RBF 0.63 ± 0.27 mm (18.0%) was observed while in the test group PPD reduction 2.00 ± 0.38 mm, CAL gain 1.25 ± 0.31 mm, RBF 0.75 ± 0.31 mm (20.7%) was evaluated. While alveolar height reduction for the control group and test group was 13% and 12.5% respectively.Conclusion:The study confirmed no added benefits of local doxycycline, as compared with bone graft alone, for regeneration of non-contained human periodontal infrabony defects.

Clinical effectiveness of autologous platelet rich fibrin in the management of infrabony periodontal defects

BackgroundThis interventional controlled clinical trial with split mouth design compares the clinical effectiveness of autologous platelet rich fibrin with open flap debridement in the management of infrabony periodontal defects. MethodsFifteen patients with paired contralateral infrabony defects were treated with open flap debridement and autologous platelet rich fibrin (experimental group) or open flap debridement alone (control group). The changes in probing pocket depth, clinical attachment level, and radiographic defect depth were evaluated. Patient perception regarding pain and discomfort following the procedures and early soft tissue healing responses were assessed by visual analog scales, scored 7 days after the surgical procedures. Final reevaluation was done 1 year after surgery. ResultsBaseline clinical and radiographic measurements were comparable between the groups. Reevaluation at 1 year revealed that both treatment modalities resulted in a significant decrease in probing pocket depth, gain in clinical attachment and radiographic bone fill of the defects compared to baseline. Postoperative differences observed between the two groups were 2.27±0.29mm (P<0.001) for probing pocket depth, 3.33±0.35mm (P<0.001) for clinical attachment level and 1.29±0.32mm (P<0.001) for radiographic infrabony defect depth reduction, all in favor of the experimental group. Patient preference was greater and early healing response better for the experimental group as assessed by the visual analog scores. ConclusionWithin the limitations of this study it can be concluded that use of platelet rich fibrin is more effective than open flap debridement alone in the management of infrabony periodontal defects.

Use of an Autogenous Cortical Graft in Combination with Guided Tissue Regeneration for Treatment of an Infrabony Defect

Infrabony periodontal defects are common findings encountered during complete oral examinations. Treatment options for infrabony lesions are aimed at meeting client demands as well as patient needs. Deciding on how to treat these lesions depends on the nature and degree of disease present as well as having the materials available to improve the chances of achieving the greatest clinical success. Bone grafting of an infrabony defect of the left mandibular first molar tooth of a dog using an autogenous cortical graft harvested with a reusable bone grafter in combination with guided tissue regeneration is described.

Early and late studies of EMD use in periodontal intrabony defects

The clinical efficacy of EMDs for the treatment of periodontal infrabony defects has been reported. However, recent publications have questioned the validity of results from early findings. Hence, the purpose of this study was to compare the results obtained from early and late studies when EMD was used as an adjunct in treating human intrabony defects during flap surgery. The aim of this meta-analysis was to evaluate the validity of results published from early studies compared with those published from later studies. PubMed and MEDLINE searches were performed. The evaluation period was 1997-2010 and it was divided into two groups of equal periods of time: early studies (1997-2003) and late studies (2004-2010). The clinical parameters assessed were clinical attachment level (CAL), probing pocket depth and bone gain (BG; measured as a percentage or in mm). No statistically significant difference was found between the results obtained from early studies (1997-2003) and late studies (2004-2010) with regards to CAL gain, probing pocket depth reduction and BG. Nonetheless, both study periods showed a benefit for using EMD to treat periodontal infrabony defects when compared with the groups without EMD during open flap surgery. The results obtained from this study failed to show any potential differences between the results published from early studies and late studies with regards to the clinical effectiveness of EMD in treating periodontal infrabony defects.

Effects of bioactive glass, hydroxyapatite and bioactive glass - Hydroxyapatite composite graft particles in the treatment of infrabony defects

Background:Several synthetic alloplastic materials have been used in the past as an implant in infrabony defects with a goal to reconstruct the lost part of attachment apparatus via new osseous tissue formation. The present study was undertaken to evaluate and compare clinico-radiographically, the effect of bioactive glass (BG), hydroxyapatite (HA), and BG-HA composite bone graft particles in the treatment of human infra-bony periodontal defects.Materials and Methods:Indigenous synthetic HA, BG, and BG-HA composite bone graft materials were developed in the laboratory. Twenty eight infrabony periodontal defects were equally distributed (i.e., seven defects) into four groups. The defects were treated separately with three types of graft materials and non-grafted manner (open flap debridement alone, control) to evaluate both the soft and hard tissue responses after six months of surgery. Evaluation was done by studying different parameters such as plaque index, gingival index, relative attachment level, probing pocket depth, and radiographic bone fill in Intra Oral Peri-Apical radiograph.Results:The healing of defects was uneventful and free of any biological complications. The gain in relative attachment level, reduction of probing pocket depth, and bone fill was statistically significant in all four groups. BG and BG-HA synthetic bone graft implanted sites showed significant bone fill (P<0.05) than hydroxyapatite and unimplanted control sites.Conclusion:The performance of BG and its composite was better compared to HA and open flap debridement alone for the reconstruction of infrabony defects. The BG-HA composite particles may effectively be used as an alternative bone graft material for infrabony defects.

Comparison of radiovisiography and digital volume tomography to direct surgical measurements in the detection of infrabony defects.

Objectives: To compare the linear measurements of Radiovisiography (RVG) and Digital volume tomography (DVT) to direct surgical measurements in the detection of periodontal infrabony defects. Study Design: RVG and DVT images were taken prior to periodontal surgery for 28 infrabony periodontal defects. After defect debridement, direct bony defect measurements were made from the cemento enamel junction (CEJ) to the base of the defect (CEJ-BD) and to the alveolar crest (CEJ-AC) with a periodontal probe. These same measurements were made on the RVG and DVT images and then compared to the direct surgical values. Results: DVT correlated strongly with surgical measurements, whereas RVG correlated less favorably (P=0.0109, P=0.0193 respectively).No significant difference for CEJ-AC (P=0.0599) was seen between DVT and surgical measurements; however, there was a significant difference for the distance CEJ-BD (P=0.0105). Conclusion: DVT technique is significantly more accurate than RVG in the detection of infrabony periodontal defects. Key words:Tomography, volume computed, dental radiovisiography, periodontal diseases.

The use of a natural osteoconductive porous bone mineral (Bio-Oss™) in infrabony periodontal defects

Aim:The aim of the present study was to evaluate the efficacy of a bovine derived xenograft Bio-Oss™ and to compare with open flap debridement in human infrabony periodontal defects.Materials and Methods:Twelve healthy patients (5 males, 7 females; aged 30-50 years), with no systemic disease with moderate to severe periodontitis were treated. Surgically defects were included only if presence of two or more vertical osseous defects as verified by radiographs with associated probing pocket depth of ≥5.0 mm following non-surgical therapy. Final selection included 24 defects. The defects were randomly assigned treatment with bovine derived xenograft Bio-Oss™ as experimental sites or open flap debridement as control sites. Soft tissue and hard tissue measurements were recorded on the day of surgery and six months post-operatively.Results:The results showed significant difference statistically between experimental and control sites in all measurements. Soft tissue measurements for the experimental sites included probing pocket depth reduction of 4.33±0.651 mm and attachment gain of 2.92±0.9003 mm, while the control sites showed a probing pocket depth reduction of 2.92±0.669 mm and a attachment gain of 0.583±0.515 mm. Osseous measurements showed bone fill of 1.936±1.046 mm (54.065±12.642%) for experimental sites and 0.02±0.01 mm (0.534±0.384%) for the control sites. Defect resolution was 50.75% for the experimental sites and 5.45% for the control sites.Conclusion:Bio-Oss™ is a bone graft material of considerable promise. However, further long term clinical studies with histological evaluation are warranted.

Effects of platelet‐rich fibrin on human periodontal ligament fibroblasts and application for periodontal infrabony defects

Platelet-rich fibrin (PRF) by Choukroun's technique is derived from an autogenous preparation of concentrated platelets. Little is known about the effects of PRF on periodontal ligament fibroblasts (PDLFs) and the application of PRF for periodontal regeneration. PDLFs were derived from healthy individuals undergoing extraction for orthodontic reasons. Blood collection was carried out from healthy volunteers. PRF was obtained from a table centrifuge centrifuged at 3000 rpm for 12 minutes. The effects of PRF on PDLFs were determined by measuring the expression of phosphorylated extracellular signal-regulated protein kinase (p-ERK), osteoprotegerin (OPG) and alkaline phosphatase (ALP) activity. Moreover, we retrospectively examined the feasibility and safety of reconstructing the periodontal infrabony defects with PRF in six patients. PRF was found to increase ERK phosphorylation and OPG in PDLFs in a time-dependent manner (p < 0.05). ALP activity was also significantly upregulated by PRF (p < 0.05). Application of PRF in infrabony defects exhibited pocket reduction and clinical attachment gain after six months. Periapical radiography revealed radiographic defect filled in grafted teeth. The enhancement of p-ERK, OPG and ALP expression by PRF may provide benefits for periodontal regeneration. Clinical and radiologic analysis showed that the use of PRF is an effective modality for periodontal infrabony defects.

Evaluation of the relative efficacy of copolymerized polylactic-polyglycolic acids alone and in conjunction with polyglactin 910 membrane in the treatment of human periodontal infrabony defects: A clinical and radiological study

Absorbable synthetic biopolymers have been used as bone filler in Periodontology, proving effective stimulants to bone regeneration. Copolymerized polylactic and polyglycolic acid is used as a bone filler and polyglactin 910 as a guided tissue regeneration (GTR) membrane to achieve regeneration in periodontal infrabony defects. Forty patients with two- or three-walled infrabony defects were selected and randomly divided into two groups. Group A included patients treated with polylactic-polyglycolic acids 50:50 (Fisiograft ,Ghimsa SPA,Via Fucini, Italy) alone and Group B included patients treated with polylactic-polyglycolic acids (PLA-PGA)50:50 in conjunction with polyglactin acid 910 (Vicryl Mesh Johnson&Johnson , U.S.A ). Evaluation of clinical parameters probing depth and attachment level and radiographs was done preoperatively and 12 and 24 weeks postoperatively. Both the groups showed statistically significant mean reduction in probing depth and gain in clinical attachment level and linear bone fill. Within the limit of this study, both the treatment modalities are beneficial for the treatment of infrabony defects.

Evaluation of the relative efficacy of an alloplast used alone and in conjunction with an osteoclast inhibitor in the treatment of human periodontal infrabony defects: A clinical and radiological study

Mucoperiosteal flap surgery stimulates varying amounts of alveolar bone loss due to accelerated osteoclastic activity [Regional Accelerated Phenomenon (RAP)]. Alendronate sodium inhibits osteoclastic activity and is thought to result in a net increase in osteoblastic activity. We undertook a preliminary study evaluating the effect of adjunctive use of topically delivered bisphosphonate alendronate (ALN) along with regenerative bone graft material in the treatment of periodontal infrabony defects. Fifteen patients with two-walled or three-walled infrabony defects were selected. In each patient, the infrabony defect of one side of arch was designated as group A (control site) and received hydroxyapatite (HA) bone graft material, while the infrabony defect on the contralateral side of same arch was designated as group B (test site) and received HA+200 μg drug solution of ALN. Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the study groups revealed a statistically nonsignificant reduction in probing depth (P=0.128NS) and mean gain in attachment level (P=0.218NS). However, there was a statistically significant gain in linear bone fill (P=0.040*) in group B as compared to group A. The results suggest that use of ALN along with graft material led to enhanced linear bone fill at the surgical site. This research provides a clue that bone-targeting properties of bisphosphonates can be harnessed along with regenerative materials to potentiate osseous regeneration.

Evaluation of the relative efficacy of autologous platelet-rich plasma in combination with β-tricalcium phosphate alloplast versus an alloplast alone in the treatment of human periodontal infrabony defects: A clinical and radiological study

Platelet-rich plasma (PRP) contains high levels of polypeptide growth factors that may enhance periodontal regeneration when combined with graft materials. The purpose of this study was to compare the efficacy of autologous PRP in combination with β-tricalcium phosphate (β-TCP) versus β-TCP alone in the treatment of human infrabony defects. Using a split-mouth design, 20 patients showing clinical evidence of almost identical bilateral infrabony defects were randomly selected. The right infrabony defects of the patient were designated as Group A and treated by the placement of β-TCP alone. The left infrabony defects of the same patient were designated as Group B and treated by the placement of PRP mixed with β-TCP. Clinical assessment of probing pocket depth and attachment level and radiographic evaluation of the defect depth were done preoperatively and at 12, 24 and 36 weeks postoperatively. The relative efficacy of two treatment modalities was evaluated using paired Student's t-test and the comparative evaluation between the two groups was done using independent Student's t-test. Both the groups exhibited a highly significant reduction in probing pocket depth, gain in clinical attachment level and linear bone fill at the end of 36 weeks postoperatively. Comparative evaluation between the two study groups revealed a significant reduction in probing pocket depth (P = 0.036FNx01), mean gain in clinical attachment level (P = 0.042FNx01) and linear bone fill (P = 0.014FNx01) in Group B as compared to Group A. Combination of PRP and β-TCP led to a significantly more favorable clinical and radiographic improvement in infrabony periodontal defects.

Treatment of human periodontal infrabony defects with hydroxyapatite+ β tricalcium phosphate bone graft alone and in combination with platelet rich plasma: A randomized clinical trial

The present study was aimed at comparing the clinical effectiveness of two regenerative techniques - platelet rich plasma (PRP) + bone graft (HA + β TCP) versus bone graft (HA + β TCP) + normal saline in the treatment of periodontal intrabony defects. Ten patients diagnosed with chronic periodontitis were enrolled in a randomized split mouth clinical trial. Following phase I therapy the sites were randomly assigned to the test group - PRP + bone graft (HA + β TCP) and control group - saline + bone graft (HA + β TCP). Clinical parameters recorded at baseline and 6 months included plaque index, probing pocket depth, relative attachment levels, and relative gingival margin levels. Hard tissue evaluation was done using digital radiography to evaluate the image intensity and therefore the radioopacity of a desired region of interest in the intrabony defect. Pre- and postoperative comparisons were made between the treatment groups at 6 months. Test group sites showed a significantly higher reduction in pocket depth compared to control group sites. Test group sites showed a significantly higher amount of radioopacity in the regions of interest, indicative of better graft remodeling, compared to control group sites. (HA + β TCP) bone graft appears to be a beneficial material in the treatment of human periodontal intrabony defects. When combined with platelet-rich plasma there is a significantly higher reduction in probing pocket depth, higher gain in attachment levels and higher amount of radio-density seen in the intrabony defects.

Assessment of combination techniques in enhancing the regenerative potential of tricalcium phosphate graft in treatment of infrabony periodontal defects

The purpose of the present study was to evaluate and compare the clinical outcome of infrabony defects following reconstructive surgery with the use of tricalcium phosphate (TCP) alone; TCP and citric acid (CA) root conditioning; and TCP, CA, and oxidized regenerated cellulose (ORC) membrane. Thirty-nine systemically healthy subjects with vertical infrabony defect were initially selected based on intraoral periapical radiographs and clinical examination to record probing pocket depth (PPD) and clinical attachment level (CAL). Only 21 defects revealed two-walled configuration on surgical debridement. These defects were selected and randomly allotted to the study groups. Group 1 defects were treated with TCP, group 2 with TCP+CA, and group 3 with TCP+CA+ORC. PPD, CAL, defect depth (DD), and level of alveolar crest (AC) were evaluated at the time of initial surgery and after 6 months at surgical re-entry. These measurements were utilized to calculate PPD reduction, CAL gain, defect fill (DF), %defect fill (%DF), and crestal resorption (CR). A paired t-test was used for assessing changes in each group. Unpaired t-test was used for intergroup comparisons. All three groups showed statistically significant PPD reduction, CAL gain, DF, and %DF, but insignificant CR at the end of 6 months. On intergroup comparison, no statistically significant differences were noted between the groups for all the parameters. Efficacy of combination techniques using TCP+CA; TCP+CA+ORC in treatment of periodontal infrabony defects is at least equal to that of TCP alone.

Clinical and radiographic outcomes following non-surgical therapy of periodontal infrabony defects: a retrospective study

The aim of this retrospective study was to analyse the clinical and radiographic response of infrabony defects following non-surgical therapy and to detect the factors associated with such a response. Clinical and radiographic data were retrieved from 143 consecutive patients treated with non-surgical periodontal therapy and re-assessed by the same clinician. Linear radiographic measurements of infrabony periodontal defects were performed on baseline and follow-up (12-18 months post-treatment) radiographs. Multilevel analysis was performed to analyse the associations between subject and site factors and healing of infrabony defects. A total of 126 infrabony defects from 68 of these patients were identified at baseline and included in the analysis. Statistically significant reductions in probing pocket depth, clinical attachment loss, radiographic defect depth and a widening of the radiographic infrabony defect angle were detected following treatment. Initial defect depth and use of adjunctive antibiotics were positively associated with a reduction of radiographic defect depth, whereas smoking showed a negative association. Within the limitations of a retrospective analysis with no control group, this study shows favourable clinical and radiographic outcomes in periodontal infrabony defects following non-surgical therapy, with complete bone fill in some cases.

The Combined Use of Nd:YAG Laser and Enamel Matrix Proteins in the Treatment of Periodontal Infrabony Defects

The objective of regenerative periodontal therapy is the reconstitution of lost periodontal structures, such as cementum, periodontal ligament, and alveolar bone. Enamel matrix proteins (EMP) are used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The aim of this split-mouth study evaluates and compares the healing of intrabony defects after treatment with an EMP with or without neodymium-doped:yttrium-aluminum-garnet (Nd:YAG) laser application for root surface conditioning. Forty-two intrabony defects in 21 patients with chronic periodontitis were randomly assigned to an access flap surgery with application of Nd:YAG laser (1 W, 10 Hz, 100 mJ, 1064 nm) and EMP (test group), and on the contralateral defect to an access flap surgery with application of EDTA and EMP alone (control group). Clinical periodontal parameters were assessed at baseline and after 6 and 12 months. Both treatments yielded significant improvements in terms of decrease in probing depth (PD) and gain in clinical attachment level (CAL) compared to baseline values. At 12 months after therapy, in the test group, the mean PD value was reduced from 7.3 ± 0.6 to 3.3 ± 0.4 mm and the mean CAL value changed from 9.5 ± 0.7 to 6.9 ± 0.7 mm (P <0.001). The sites treated with EMP (control) showed a reduction in mean PD value from 7.3 ± 0.7 to 3 ± 0.4 mm and a change in mean CAL value from 9.3 ± 0.8 to 6.4 ± 0.5 mm (P <0.001). The control group showed a greater reduction in PD and gain in CAL compared to the test group (P <0.05). Within the limits of the present study, it may be concluded that both therapies led to improvements of the clinical parameters, and Nd:YAG laser root conditioning as used in this study compared to EDTA root conditioning did not improve the outcome of EMP use.

Evaluation of the Relative Efficacy of an Allograft used alone and that in Combination with Simvastatin in the Treatment of Human Periodontal Infrabony Defects – A Clinical and Radiological Study

Abstract Objectives Simvastatin has been found to cause increased bone formation in vitro and in animal studies. However, its effect on periodontal reconstruction in humans is yet to be determined. With this study an attempt was made to evaluate the effects of a combination of simvastatin drug with Demineralised Freeze-Dried Bone Allograft (DFDBA) and also to compare the efficacy of this combination with that of DFDBA alone in the treatment of human periodontal defects. Methods Fifteen patients with almost identical bilateral 2-walled or 3-walled infrabony defects were selected. Defects on the right side (Group A) were treated with the placement of DFDBA alone while those on the left side (Group B) were treated using a combination of DFDBA and a 10 −8 M solution of the drug simvastatin. Two clinical parameters, namely probing pocket depth and clinical attachment level and one radiographic parameter, namely infrabony defect depth were measured preoperatively and 12 and 24 weeks postoperatively. Results DFDBA alone as well as the combination of DFDBA and simvastatin resulted in a highly significant mean reduction in probing depth, gain in clinical attachment level, and linear defect fill. The values of mean changes in parameters were significantly greater with the drug-graft combination in comparison with the graft alone. Conclusions Combination of DFDBA with a solution of simvastatin leads to significantly greater reduction in probing depth, gain in clinical attachment level, and linear defect fill than when the graft is used alone in the treatment of human periodontal infrabony defects.

Comparison of the regenerative potential of an allograft used alone and that in conjunction with an immunosuppressive drug in the treatment of human periodontal infrabony defects: A clinical and radiological study

Experimentation confirmed the conclusion that bone allografts, like other tissue and organ allografts, are immunogenic. These immune responses cause resorption of allograft, thus lowering the bone formation capacity of the graft. An attempt has been made in this study to prevent immune reactions and achieve enhanced regeneration of allograft-demineralized freeze-dried bone matrix by incorporating it with an immunosuppressive drug Cyclosporine-A (CsA) in the treatment of human periodontal infrabony defects. Fifteen patients showing clinical evidence of almost bilateral infrabony defects requiring bone grafting procedures were selected. In each patient, the infrabony defect of one side of the arch was designated as Group A (control site) and the infrabony defect of the contralateral side of the same arch was designated as Group B (test site). On comparative evaluation of the two groups (by Student t-test), the mean values of reduction in probing depth (P=0.81 NS ) and gain in clinical attachment level (P=1.00 NS ) of Group B were found to be greater than that of Group-A, but the differences were statistically non-significant. The mean linear bone fill (P=0.010 FNx08 ) of Group B was also detected to be higher than that of Group A, and the difference was found to be statistically significant. Increase in linear bone fill in Group B signifies the role of CsA in augmenting the regenerative potential of allograft by eliminating immune reactions.

Evaluation of the Relative Efficacy of an Allograft used alone and that in Combination with Simvastatin in the Treatment of Human Periodontal Infrabony Defects – A Clinical and Radiological Study “Arabic abstracts”

Evaluation of the Relative Efficacy of an Allograft used alone and that in Combination with Simvastatin in the Treatment of Human Periodontal Infrabony Defects – A Clinical and Radiological Study “Arabic abstracts”