Polymer-Based Bone Substitutes in Periodontal Infrabony Defects: A Systematic Evaluation of Clinical Studies

Background and Objectives: The aim was to systematically review the available literature regarding the use of polymers as a bone substitute for the treatment of periodontal infrabony defect. Materials and methods: Three databases (PubMed, Scopus and Web of Science) were searched to find all relevant studies published in English from inception until September 2021 using a combination of keywords. The inclusion criteria consisted of human clinical studies which reported the use of a polymer-based bone substitute in the treatment of infrabony defects. Results: 164 studies were provided from the databases. Of these, five articles were eligible and reported favorable outcome in terms of probing depth, clinical attachment gain and defect fill at the follow-up (3 months and 6 months). Conclusions: Polymer based-bone substitutes may represent a useful alternative in treating infrabony defects. Due to the limited number of studies, more research is needed to sustain the advantages of these products.

Guided Tissue Regeneration Therapy With Bone Augmentation in a Lingual, Infrabony Osseous Defect of a Mandibular Canine

This case report describes the use of canine demineralized freeze-dried membrane allograft and cancellous bone graft material to treat an infrabony osseous defect along the lingual aspect of a left mandibular canine in a 10-year-old miniature dachshund. Postoperative examination 6 and 12 months postoperatively showed osseous integration at the infrabony defect and improvement in periodontal probing measurements.

Clinical and Radiographic Assessment of Periodontal Infrabony Defect Depth and Width and Their Correlation

Brief Background There is preliminary evidence of periodontal defect depth, number of walls and the width of infrabony defects exerting influence on the regenerative potential of particular therapeutic modality. Aim: To assess defect width and defect depth and their influence on pretreatment defect angle in patients affected with periodontal disease. Materials and Methods 60 untreated severe chronic or aggressive periodontitis patients were selected for the study. Digital intraoral periapical radiograph of defects in all patients were taken using RVG. First auxiliary line was drawn to represent tooth axis (AUX1). Perpendicular to this, a second auxiliary line (AUX2) was drawn that ran through most coronal margin of defect (M3). The depth of defect was measured as the distance between the base of bony defect and AUX2. The width of defect was the distance from coronal margin of bony defect to the root surface perpendicular to AUX1. Results In a total of 67 defects, the radiographic defect depth, defect width and defect angle for maxillary arch was 3.19 ± 1.19 mm , 2.82 ± 0.63 mm and 37.34 ± 9.47 ° respectively while these values for mandibular sites were 3.69 ± 0.92 mm, 2.87 ± 0.76 mm and 35.62 ± 7.08 ° respectively. Multilevel regression analysis revealed narrow defect angles to be related to deep infrabony defects, whereas the width of the interdental space to wide defects. Summary and Conclusion Defect dimensions are determined by the radius of action of microbial biofilm and the baseline defect angle of an infrabony defect would be a function of defect depth. Key Words: Periodontitis, periodontal therapy, vertical defects, radiography

Perawatan Bonegraft dengan Penambahan Platelet-Rich Plasma dan Kolagen pada Kerusakan Infraboni

Perawatan kerusakan jaringan periodontal mempunyai tujuan utama mendapatkan jaringan regeneratif dan proses yang berlangsung membentuk struktur jaringan yang fungsional melalui proses pertumbuhan serta diferensiasi sel sel baru. Bonegraft adalah perawatan untuk kasus kerusakan tulang. Platelet-rich plasma yang merupakan platelet autologus konsentrasi tinggi tersuspensi dalam plasma setelah disentrifugasi. Dalam PRP banyak terdapat komponen yang berperan dalam proses penyembuhan regeneratif, growth faktor, agen kemotaktik dan agen vasoaktif. Kombinasi dengan penambahan kolagen merupakan altematif yang aman dan efektif, selain menstimulasi pelepasan growth faktor pada daerah target, juga memperkuat signal agar degranulasi platelet dapat ditingkatkan. Pada kasus ini, wanita berusia 24 tahun mengeluhkan keadaan giginya goyah sejak 3 bulan yang lalu karena traumatik, tidak ada rasa nyeri. Setelah dilakukan rontgen periapikal digital terlihat terjadinya kerusakan tulang infraboni. Penanganan untuk kasus ini dirancang dengan bedah flap, bonegraft Demineralized Freeze-Dried Bovine Bone Allograft (DFDBA), aplikasi platelet-rich plasma, serta penambahan kolagen. Kombinasi bonegraft dengan aplikasi PRP dan penambahan kolagen untuk menunjang perawatan periodontal memberikan hasil yang memuaskan secara penampakan klinis dan penampakan radiografis. ABSTRACT: Bonegraft Treatment with Addition of Platelet - Rich Plasma and Collagen in Infrabony Defect. The treatment of periodontal tissue damage has the main goal to get regenerative tissues and processes that take place to form a functional network structure through the process of cell growth and differentiation of new cells. Bonegraft is a treatment for cases of bone damage. Platelet-rich plasma is autologous platelets suspended in plasma high concentrations after centrifugation. In PRP, there are many components that play a role as a regenerative agent of healing process, growth factors, chemotactic agents and vasoactive agents. Its combination with the addition of collagen is a safe and effective alternative; in addition to stimulating the release of growth factors in the target area, it also strengthens the signal to improve platelet degranulation. In this case, a 24-year-old woman complained of unsteady state of her teeth since the last 3 months due to trauma; there was no pain. A digital periapical X-ray exposed infrabony defect. The treatment for this case was designed to use a surgical flap, bonegraft Demineralized Freeze-Dried Bovine Bone Allograft (DFDBA), application of platelet-rich plasma, as well as the addition of collagen. Bonegraft combination with PRP application and the addition of collagen to support periodontal treatment have given satisfactory results in the clinical and radiographic appearance.

Are We Overlooking Our ‘Gold Mine’? Use of Symphysial Autograft for Treatment of Periodontal Osseous Defect

ABSTRACT This case report presents a technique for utilizing autogenous corticocancellous graft from the mandibular symphysial area to fill a three-walled infrabony defect in a patient diagnosed with generalized aggressive periodontitis. After debridement, a 9 mm defect was present distal to the mandibular first molar. Autogenous bone graft harvested from the mandibular symphysial region was placed in the defect. There was a significant fill at the site 9 months postoperative and a reduction in probing depth was recorded at 4 mm. How to cite this article Bhardwaj A, Grover HS, Luthra S. Are We Overlooking Our ‘Gold Mine’? Use of Symphysial Autograft for Treatment of Periodontal Osseous Defect. Int J Exper Dent Sci, 2012;1(1):40-44.