Treatment Of Intrabony Defects Research Articles

Minimally invasive non-surgical periodontal therapy of intrabony defects: A prospective multi-centre cohort study.

To assess the potential benefits of minimally invasive non-surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes. A multi-centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months. Eighty-four patients completed the 12-month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty-six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively. Improvements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally%20invasive%20non%20surgical%20therapy&locStr=UK&country=United%20Kingdom&distance=50&rank=2.

Efficacy of Locally Delivered Simvastatin Combined with Autologous Platelet-rich Fibrin in Treatment of Intrabony Defects: A Randomized Controlled Clinical Trial

Efficacy of Locally Delivered Simvastatin Combined with Autologous Platelet-rich Fibrin in Treatment of Intrabony Defects: A Randomized Controlled Clinical Trial

Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: a case series.

To evaluate the clinical effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic therapy (OT) with clear aligners in stage IV (type 2) periodontitis. Ten patients with a total of 103 intra-bony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by OT with clear aligners. Changes in radiographic bone level (rBL) and probing pocket depths (PPD) were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. Mean rBL gain was significant with 2.13 mm (±1.64 mm) after 1 year (T1) and 3.02 mm (±2.00mm) at final splinting (T2). Mean PPD was significantly reduced from 5.40 mm (±1.80 mm)at baseline to 3.78 mm (±1.73 mm) at T1 and remained stable with 3.73 mm (±1.70 mm)at T2. Pocket closure (PPD< 4mm) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive OT with clear aligners can lead to favorable results.

Entire Papilla Preservation Technique with Recombinant Human Fibroblast Growth Factor-2 and Autogenous Bone Grafting in the Treatment of Isolated Non-Contained Intrabony Defect: Case Report of a 5-Year Follow-Up.

Regenerative periodontal surgery is an effective procedure for the treatment of intrabony defects. Various flap designs preserving the defect-associated interdental papilla have been proposed to improve early wound stability. This case report describes the long-term results of a regenerative treatment in severely compromised mandibular canine using entire papilla preservation technique. Surgical access was provided by a single buccal vertical incision without any papilla incision. Combination of autogenous bone harvested from the same surgical site and recombinant human fibroblast growth factor-2 was applied to non-contained intrabony defect following the granulation tissue removal. Surgical site was closed with single interrupted sutures. The clinical outcomes and 5-year stability of pocket closure with no increase in gingival recession show the potential of entire papilla preservation technique with the use of combined biomaterials.

Long-term results of regenerative treatment of intrabony defects: a cohort study with 5-year follow-up

BackgroundThe aim of this retrospective cohort study was to evaluate the long-term clinical and radiographic outcomes and survival of teeth in periodontal regenerative treatment of intrabony defects using combined enamel matrix protein derivative (EMD) and deproteinized porcine bone mineral (DPBM) compared to EMD alone.MethodsA total of 333 intrabony defects in 176 patients (mean age: 54.7 ± 8.9 years) were followed-up for 58.6 ± 11.2 (range, 25–78) months after periodontal regenerative treatment. Changes in clinical (pocket probing depth and clinical attachment level) and radiographic (defect depth and defect width) parameters were analyzed using serial periapical radiographs. Kaplan–Meier and multivariate Cox proportional-hazards regression analyses for tooth loss were also performed.ResultsCompared to periodontal surgery with EMD alone with a mean follow-up of 5 years, combined EMD and DPBM showed significantly better gain in clinical attachment level (EMD and DPBM: 2.8 ± 2.3 mm vs. EMD alone: 2.2 ± 2.2 mm) and reduction in probing pocket depth (EMD and DPBM: 2.8 ± 1.8 mm vs. EMD alone: 2.3 ± 1.8 mm), defect depth (EMD and DPBM: 2.5 ± 2.4 mm vs. EMD alone: 2.0 ± 2.4 mm) and defect width (EMD and DPBM: 0.6 ± 1.0 mm vs. EMD alone: 0.2 ± 1.3 mm). The overall survival rates of the teeth were 91.48% and 95.20% in the patient- and tooth-based analyses, respectively, showing no statistically significant difference.ConclusionsWithin the limitations of the current study, combined EMD and DPBM offered additional clinical and radiographic benefits over a mean of 5 years compared to EMD alone. However, tooth loss did not differ significantly between the two groups.Clinical relevanceCompared to EMD alone, combined EMD and DPBM for intrabony defects has additional clinical advantages; however, patient- and tooth-related risk factors must be considered when performing periodontal regenerative surgery.

Appraising and comparing the role of autogenous periosteal graft as a barrier membrane in the treatment of intrabony defects in chronic periodontitis cases: A systematic review and meta-analysis.

Periodontal regeneration refers to procedures aimed at restitution of lost supporting tissue around the periodontally compromised tooth. Regenerative procedures very often include the use of barrier materials to encourage the growth of key surrounding tissues. The current study aimed to evaluate the effectiveness of autogenous periosteal graft as a barrier membrane for the treatment of intrabony defects in chronic periodontitis patients. A total of four data bases MEDLINE (by PubMed), Cochrane database, EBSCO, and Google Scholar were explored to identify the studies in English up to December 2022. An additional hand search of relevant journals was also done. A team of three independent reviewers screened the retrieved articles using the inclusion criteria. Randomized control trials (RCTs) evaluating the effectiveness of autogenous periosteal grafts in the treatment of intrabony defects in chronic periodontitis cases were included in the study. A total of six relevant articles were recognized for data procurement. A total of 117 patients with 68 sites with an age range between 18 years and 55 years were selected. Outcome variables examined were pocket depth (PD), clinical attachment level (CAL), radiographic bone defect fill (BDF), gingival recession (GR), plaque index (PI), gingival index (GI) and bleeding on probing (BOP). Data were analyzed using Revman 5.3 software. The mean differences and 95% confidence interval were used to illustrate the estimate of effect size. There is an equal effect in both groups for the PI, GI, and BOP reduction. For PD reduction, the result was in the favor of periosteal graft with open flap debridement (OFD) group. For CAL gain, radiographic BDF and GR, results also favored the periosteal graft, but no statistically significant difference was found amongst the groups. Within the limitation of the study, it seems that the autogenous periosteal graft can be used successfully along with OFD to treat intrabony defects in chronic periodontitis patients.

Uso de proteínas derivadas de la matriz del esmalte combinado con injerto óseo para el tratamiento de defectos intraóseos: Resumen estructurado de revisiones sistemáticas (revisión FRISBEE)

Introduction: The use of enamel matrix-derived proteins (EMD) has increased in recent years due to their tissue-inducing properties that support periodontal regeneration. This study is an overview of systematic reviews with FRISBEE methodology on the use of EMD alone or combined with autologous bone graft materials (BGM) in the treatment of intrabony defects. Materials and Methods: A systematic search in the Epistemonikos database was performed. RevMan 5.3 and GRADEpro were used for data analysis and presentation Results: Four systematic reviews and two clinical trials were identified. All studies analysed change in probing depth, clinical attachment level, gingival margin level and bone defect depth (all changes in favour of EMD+BGM groups: mean difference (MD): 0.37 mm more, MD: 0.7 mm more, MD: 0.3 mm less, MD: 0.75 more, respectively). Conclusions: Adding autologous bone graft to EMD to treat intrabony defects showed better results, but not a relevant clinical difference compared to the use of EMD alone. Keywords: Dental enamel proteins; Bone transplantation; Autologous transplantation; Alveolar bone loss; Periodontal diseases; Bone regeneration.

Combination of Platelet-rich Fibrin (PRF) in Advanced Periodontitis Stage Treatment

Introduction: The treatment of advanced periodontitis has been a challenge for clinicians. Platelet-rich fibrin (PRF) is a second-generation platelet concentrate that contains various growth factorss and cytokines that promote tissue regeneration. The use of PRF in combination with other regenerative materials and techniques has been shown to be effective in the treatment of intrabony defects. This case series aims to evaluate the efficacy of PRF combinations in the regenerative treatment of patients with advanced periodontitis. Case report: Two patients diagnosed with advanced periodontitis (stage III/IV grade C) were selected for this study. After the completion of periodontal initial therapy, there were still pockets with a probing depth ≥ 5 mm (5–10 mm). Therefore, surgical interventions were planned. The first case used the combination of PRF with bone graft and guided tissue regeneration (GTR), while open flap debridement (OFD) with the addition of PRF and bone graft to create sticky bone was done in the second case. Three to five months of follow-up showed favorable outcomes, as evidenced by reductions in probing depth (PD), gains in clinical attachment level, and filling of bone defects, as well as improvements in patient comfort and rapid wound healing. Conclusion: The combination of PRF with grafting material and/or GTR has been shown to be a beneficial therapeutic approach for periodontal regenerative therapy. Platelet-rich fibrin in periodontal surgery may accelerate the tissue healing process.

A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique in the treatment of intrabony defects: a retrospective cohort study

BackgroundGingival recession and post-operation discomfort are still a problem for patients receiving the periodontal regeneration surgery for intra-bony defects. To further reduce the trauma and the post-operation gingival recession, a novel periodontal endoscopy-aided non-incisional regeneration technique (NIT) was proposed in the treatment of intra-bony defects.MethodsRetrospective analysis of 21 subjects treated with NIT and 21 subjects with periodontal endoscopy-aided scaling and root planing (PSRP) at baseline and 1-year evaluation was conducted. After removing the subgingival calculus and granulation tissue, bone grafting materials were placed into intrabony defects with the assistance of a gingival retractor in the NIT group. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as the distance between bone crest (BC) level and base of the defect (BD) (intrabony defect depth, IBD) were evaluated at baseline and 1 year after treatment.ResultsAt 1-year follow-up, the value of CAL, PD and IBD were statistically significant different compared with baseline in both two groups (p<0.001). CAL gain (p = 0.012) and PD reduction (p = 0.004) was greater in the NIT than PSRP. However, no difference in the IBD reduction was found between the NIT group and PSRP. Better CAL gain and PD reduction was achieved in the 1-year term in the NIT when compared with PSRP.ConclusionNIT have resulted in significant gains in both clinical and radiographic parameters. NIT might be utilized as an alternative of the surgical treatment for periodontal intrabony defects.Trial registrationThis clinical trial registration was registered retrospectively (August 3, 2023) and the number is ChiCTR2300074317.

Evaluation of platelet-rich fibrin in the treatment of decorticated intrabony defects: a randomized clinical trial.

The objective of the present study was to evaluate the clinical and radiographic outcomes of intrabony defects treated with decortication (intramarrow penetration) alone versus decortication combined with platelet-rich fibrin in periodontitis patients followed up for 6 months postsurgery. A total of 46 intrabony defects from periodontitis patients with a mean age of 36.30 ± 6.10 years were randomly assigned into two treatment groups. The control group (n = 23) intrabony sites were accessed with simplified papilla preservation flap (SPPF) followed with debridement, decortication, and closure. The test group (n = 23) sites were accessed with SPPF, followed with debridement, decortication, platelet-rich fibrin placement, and closure. The clinical parameters Plaque Index, Gingival Index, probing pocket depth, relative attachment level, gingival marginal level, along with radiographic defect depth and defect width were recorded at baseline, 3 months, and 6 months postsurgery. Gain in clinical attachment level was the primary outcome, and probing pocket depth reduction and radiographic bone fill were secondary outcomes of the study. The Plaque Index and Gingival Index scores showed nonsignificant difference on intra- and intergroup comparison at baseline, 3 months, and 6 months. The probing pocket depth was 8.17 ± 1.56 mm, 6.65 ± 1.30 mm, and 5.26 ± 1.18 mm for the control group, and 8.17 ± 2.01 mm, 6.26 ± 1.42 mm, and 4.78 ± 1.28 mm for the test group, at baseline, 3 months, and 6 months, respectively. The relative attachment level was 8.83 ± 1.40 mm, 6.78 ± 1.31 mm, and 5.39 ± 1.16 mm for the control group, and 8.39 ± 1.62 mm, 6.96 ± 1.36 mm, and 5.48 ± 1.20 mm for the test group at baseline, 3 months, and 6 months, respectively. Statistically significant reductions were observed for probing pocket depth for the control (2.91 mm, P < .001) and test groups (3.39 mm, P < .001), as well as for relative attachment level for the control (3.44 mm, P < .001) and test groups (2.91 mm, P < .001). However, intergroup differences were nonsignificant for probing pocket depth and relative attachment level. The radiographic defect depth was reduced by 0.31 mm for the control and 1.57 mm for the test group. The radiographic defect width was reduced by 0.18 mm for the control and 0.83 mm for the test group. Intergroup statistically significant differences were observed at the 6-month follow-up (P < .001) for radiographic defect depth and width. Within the limitations of the present study, the results demonstrate statistically significant intragroup improvements in clinical outcomes with decortication alone and decortication combined with platelet-rich fibrin in the treatment of intrabony defects in periodontitis patients. The addition of platelet-rich fibrin did not improve the clinical results beyond decortication alone, and unacceptable postsurgery residual pockets were observed in both the protocols. Considering the small sample size, the addition of platelet-rich fibrin resulted in significant bone fill over and above that of decortication alone.

Regeneration of Intrabony Defects Using a Novel Magnesium Membrane.

Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. The surgical procedure was described using a series of three cases. Materials and Methods: The patients were healthy individuals suffering from a severe form of periodontitis associated with IBD. Based on radiographic examination, the patients had interproximal bone loss of at least 4 mm. Due to its good mechanical properties, it was easy to cut and shape the magnesium membrane into three different shapes to treat the specific morphology of each IBD. In accordance with the principles of guided bone regeneration, a bovine xenograft was used to fill the IBD in all cases. Results: After a healing period of 4 to 6 months, successful bone regeneration was confirmed using radiological analysis. The periodontal probing depth (PPD) after healing showed a reduction of 1.66 ± 0.29 mm. Conclusions: Overall, the use of the different shapes of the magnesium membrane in the treatment of IBD resulted in a satisfactory functional and esthetic outcome.

Comparison of the effectiveness of DFDBA and T-PRF in the regeneration of intra-bony defects- A randomized split-mouth study

ObjectivesThis research intended to compare and evaluate the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) over demineralized freeze-dried bone allograft (DFDBA) in treating intra-bony defects based on the clinical and radiographic criteria. MethodsThis is a prospective randomized controlled, single-blinded split-mouth study where 15 patients with 30 intrabony defects were included. Subjects were randomly divided into T-PRF and DFDBA groups respectively. Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative- clinical attachment- level (R-CAL), Defect depth, Linear amount of bone fill, Percentage of bone fill, Defect angle were assessed at baseline, 3, 6, and 9 months. For intra- and inter-group comparisons, paired and unpaired t-tests were executed. P<0.05 was set as statistically significant. ResultsThere were statistically significant differences (P<0.05) in clinical and radiographic parameters in both T-PRF and DFDBA groups from baseline values to 9 months in intragroup comparisons. However, on intergroup comparison, no statistical significance was seen. ConclusionThe clinical parameters and radiographic outcomes showed marked improvement at 9 months with both T-PRF and DFDBA in the treatment of intrabony defects from baseline values. Clinical relevanceT-PRF has shown favorable results that are comparable to DFDBA for the treatment of intrabony periodontal defects.

Is Autologous Sticky Bone Better Than a Simple Mixture of Autologous PRF and Bioactive Glass in the Regeneration of Human Periodontal Intrabony Defects? An Extensive Clinical and CBCT Study.

Periodontal intrabony defects (IBDs) are commonly encountered in dental practice and are usually treated by open flap debridement (OFD) with or without bone grafts and/or guided tissue regeneration (GTR), platelet-rich fibrin (PRF), or other additives. A difficulty with these approaches is maintaining the space for bone growth at the determined location. In this report, autologous sticky bone (ASB) was used and compared to a simple mixture of PRF and bone graft (PRF-BG) using the identical graft material-bioactive glass morsels-to assess its regenerative potential in IBDs, as sticky bone is known to maintain the space, according to previous research. A total of 21 IBDs were treated by OFD, PRF-BG mixture, or ASB. Regenerative assessment was clinically and radiographically performed by CBCT at 1 year. All the treatment modalities (OFD, PRF-BG, and ASB) showed statistically significant improvements clinically and radiographically at 1 year in terms of probing pocket depth reduction (PPDR), clinical attachment level gain (CALG), CBCT defect fill (CBCT-DF), and CBCT defect resolution (CBCT-DR); P < .05. The ASB group depicted the most favorable results (P < .05) in terms of the parameters at 1 year followed by the PRF-BG group and then the OFD group. Treatment of periodontal IBDs with ASB resulted in significant improvements in clinical and CBCT parameters compared to baseline at 1 year, and intrasurgical graft handling was much better in the ASB group.

A comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Twelve-month results of a multicenter, randomized, controlled study.

The purpose of this publication is to report on the 12-month clinical and radiographic results comparing the surgical use of the Er,Cr:YSGG laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. Fifty-three adult subjects (29 females and 24 males; 19-73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n=27) or MIST (n=26). Fifty subjects completed the study. Recession (REC), probing depth (PD), clinical attachment level (CAL), treatment time, and standardized radiographs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4-6weeks following SRP, and 6 and 12months following surgical therapy. Radiographic results were compared to baseline at 6 and 12months following surgical therapy. The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.7 mm (p=0.05), PD with a non-inferiority margin of 0.7mm (p=0.05), and REC with a non-inferiority margin of 0.4mm (p=0.05). Standardized radiographs suggest similar bone fill of 1.14±1.73mm for MIST and 1.12±1.52mm for ERL. This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST at 12 months in terms of clinical outcomes and similar to MIST in terms of radiographic bone fill for the surgical treatment of intrabony defects.

Clinical outcomes of periodontal regenerative therapy with carbonate apatite granules for treatments of intrabony defects, Class II and Class III furcation involvements: A 9-month prospective pilot clinical study

IntroductionCarbonated apatite (CO3Ap) has unique properties as an alloplastic bone substitute and has been reported the safety and efficacy for bone regeneration. However, no previous studies reported the clinical application of CO3Ap for periodontal regeneration therapy. The aim of this study was to evaluate the safety and efficacy of periodontal regeneration with CO3Ap in treating intrabony defects, Class II and Class III furcation involvement (FI). MethodsA single-arm and single-center prospective pilot clinical study was performed to verify the safety and efficacy of CO3Ap in patients with periodontitis. A total of four patients with seven teeth, including three deep intrabony defects, two Class II FI, and two Class III FI, were treated with CO3Ap. The clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility (Mo), Plaque index (PI), and Gingival index (GI) were evaluated at baseline, 6 months, and 9 months after the surgery. Radiographic analysis was conducted on images of dental X-ray and cone beam computed tomography (CBCT) at baseline and 9 months post-surgery. ResultsThe postoperative healing in all cases was uneventful, with no abnormal bleeding, pain, or swelling. The mean PPD reduction and CAL gain were 5.0 ± 1.0 mm, 4.5 ± 0.7 mm, 1.5 ± 0.7 mm, and 4.7 ± 1.2 mm, 4.5 ± 0.7 mm, 0.0 mm for intrabony defect, Class II and Class III FI, respectively. According to radiographic analysis, linear bone height in intrabony defects and vertical subclassification of FI in Class II FI were improved. ConclusionsThe clinical application of CO3Ap for the treatment of intrabony defects and Class II FI could be effective for periodontal regeneration, although its efficacy in treating Class III FI might be limited. Despite the limitations of this study, the findings in this study suggested that CO3Ap has the potential to be a promising bone graft substitute for periodontal regeneration.

The Effect of Xenograft and Platelet-Rich Plasma in the Surgical Management of Intrabony Defects in Periodontitis Patients: A Systematic Review.

When treating intrabony defects to regenerate periodontal structure, platelet-rich plasma (PRP) alone or in conjunction with various grafting materials, enamel matrix proteins, and barrier membranes have shown promising results. This evidence-based review aimed to systematically appraise the efficacy of xenograft in combination with PRP in the surgical treatment of periodontal intrabony defects in comparison to xenograft alone in terms of clinical and radiographic outcomes in adults with periodontitis. Electronic and manual data were searched exhaustively by 2 reviewers, including PubMed-Medline, Cochrane Central Register of Controlled Trials, Embase and Scopus from the earliest available date till January 31, 2023 without restriction on language. Randomized controlled clinical trials of either parallel or a split-mouth design and studies where xenograft and PRP were in the intervention group or as a comparator was included. After screening the articles, 3 studies were included. The current systematic review reveals that PRP used as an adjunct with a xenograft resulted in a significant reduction in pocket depth and greater clinical attachment level gain in comparison to xenograft alone. The analysis of the present review concludes that PRP in conjunction with xenograft for the treatment of intrabony defects shows promising outcomes. However, owing to the short follow-up time and heterogeneity of included studies, caution should be followed while using this material clinically.

Two-stage method of free gingival graft prior to periodontal regenerative surgery for the treatment of intrabony defects with insufficient keratinised tissue width: a study protocol for an open-label randomised controlled trial

IntroductionGuided tissue regeneration (GTR) combined with bone grafting for periodontal regenerative surgery has ideal clinical results for intrabony defect. However, some sites of intrabony defects often suffer from insufficient keratinised...

Long-term stability of regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: 10-year data of a retrospective study.

To evaluate the long-term effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic therapy (OT) in stage IV periodontitis. 22 patients with a total of 256 intra-bony defects were analyzed after regenerative surgery followed by OT initiated 3 months later. Changes in radiographic bone level (rBL) and probing pocket depths (PPD) were evaluated after 1 year (T1), final splinting (T2) and 10 years (T10). Mean rBL gain was significant with 4.63 mm (±2.43 mm) after 1 year (T1), 4.19 mm (±2.61 mm) at final splinting (T2) and 4.48 mm (±2.62 mm) after 10 years (T10). Mean PPD was significantly reduced from 5.84 mm (±2.05 mm) at baseline to 3.19 mm (±1.23 mm) at T1, to 3.07 mm (±1.23 mm) at T2 and to 2.93 mm (±1.24 mm) at T10. Pocket closure (PPD≤ 4mm) was achieved in 90% of all defects. Tooth loss amounted to 4.5%. Within the limitations of this retrospective study design, these 10-year findings suggest that in motivated and compliant patients with stage IV periodontitis and in need of orthodontic therapy an inter-disciplinary treatment can lead to favorable and stable long-term results. This article is protected by copyright. All rights reserved.

A comparative study of demineralized freeze-dried bone allograft alone and with 1% metformin in the treatment of intrabony defects in patients with chronic periodontitis: A randomized clinical trial.

Periodontal disease is ubiquitous and its treatment requires a detailed treatment plan. Biomaterials are often used along with demineralized freeze-dried bone allograft (DFDBA) for periodontal regeneration. One percent metformin has evolved as a regeneration material. This study was initiated to assess and compare the regenerative potential of DFDBA alone and with 1% metformin in the treatment of intrabony defects in subjects with chronic periodontitis. 20 sites with intrabony defects were diagnosed of which 10 were assigned to Group A (1% Metformin + DFDBA) and 10 to Group B (DFDBA alone). Clinical parameters were measured at baseline, 3, 6, and 9 months postoperatively, whereas radiographic parameters were measured at baseline and 9 months postoperatively, and data were statistically analyzed. Both the groups showed a statistically significant improvement in probing pocket depth and relative attachment level at 9 months. Radiographically, a statistically significant reduction in defect depth was seen in both the groups at 9 months. There was no statistically significant difference between the two groups as far as crestal bone loss is concerned. No statistically significant difference was seen for clinical and radiographic parameters between the test and control groups. The addition of 1% metformin to DFDBA did not have any additional benefits in the treatment of subjects with defects which are intrabony.

Injectable platelet-rich fibrin polymerized with hydroxyapatite bone graft for the treatment of three-wall intrabony defects: A randomized control clinical trial.

The study was aimed to compare and evaluate the clinical and radiographic outcomes of injectable platelet-rich fibrin (i-PRF) polymerized with hydroxyapatite (HA) bone graft and HA bone graft alone for treating three-wall intrabony defects (IBDs). The trial was planned as a randomized, prospective clinico-radiographic study with inclusion of 34 three-wall IBDs in patients with stage III periodontitis. IBDs were assigned randomly to one of the groups, i.e., Group I - experimental (i-PRF + HA) and Group II - control (HA alone). At baseline and 6 and 9-month intervals, both the clinical and radiographic measurements were taken and baseline and 9-month data were tabulated and imported into SPSS 22 software. Student unpaired and paired t- tests were used to find significant differences (p<0.05). Both the groups showed substantial changes in all clinical and radiographic measures on comparison from baseline values. On intergroup comparison, the i-PRF + HA group reported significantly higher original defect resolution and original defect fill as compared to the HA group. i-PRF polymerized with HA graft has shown better results as compared to HA graft alone in three-wall IBDs and therefore can be used as a better possible alternative for the treatment of three-wall IBDs.