EVALUATON OF RESULTES BY THE APPLICATION OF BONE IMPLANTATES IN THERAPY OF DEEP DEFECTS OF A PARODONCIUM

DUSICA CIRIC

doi:10.5937/sjecr15-6137

DUSICA CIRIC Faculty of medical science University of Kragujevac

DOI: https://doi.org/10.5937/sjecr15-6137

Abstract

Reconstruction of infrabony defects created during chronic inflammatory process in parodontopathy represents the main clinical problem in paradontology.

The objective of this research was to compare applications of two bone substituents and evaluate the efficiency of regeneration of deep infrabony defects of paradentium after the application of the new “Biohapel” material, biphasic calcium phosphate/ poly DL-lactide-co-glycolide.

The research included 12 patients of both gender, with the average age 49,7 suffering from clinically manifested parodontopathy. The main criterion in choosing patients for the research was presence of six similar infrabony parodontal defects, at least 4mm deep, in the area of equivalent lower side teeth, on both sides of the jaw. After applying basic causal parodontopathy treatment, defects were divided into two groups: an experimental group (n=72) where defects were reconstructed using “Biohapel” bone substituent (on one side of the lower jaw) and control group (n=72) where infrabony defects were reconstructed using β tricalcium phosphate (βTCP) (Cerasorb®), a preparation very commonly applied in regenerative parodontopathy treatment (on the other side of the lower jaw). Parameters of treatment efficiency were determined before the surgery and 6 months after by measuring the depth of parodontal pocket and the level of junctional epithelium.

It was observed that statistically significant differences existed between the experimental and control group (p<0,05) regarding the examined parameters of parodontal regeneration.

Application of “Biohapel” in surgical treatment of infrabony defects of paradentium provides better bone regeneration of paradentium in comparison with application of β tricalcium phosphate which is an acknowledged standard in regenerative treatment.

References

Lindhe J, Kaррing T, Lang NP. Clinical peрiodontology and implant dentistry, 4th ed. Copenhagen: Blackwell/Munksgaaрd; 2003.

Cochran D. Inflammation and bone loss in periodontal disease. J Periodontol 2008;79:1569-76.

Tonetti P,Cortellini MS, Lang NP. Clinical outcomes following treatment of human infrabony defects with GTR/bone replacment material or access flap alone. A multicentar randomized study. J. Clin Periodontol. 2004;31:770-6.

Dinopoulos H, Dimitрiou R, Giannoudis PV. Bone gрaft substitutes: what aрe the options? The Suрgeon 2012; 10: 230-239.

Sukumaр S, Dрizhal I. Bone gрafts in peрiodontal theрapy. Acta Medica 2008; 51: 203-207.

Dimitrou R, Jones E, McGonagle, Giannoudis PV. Bone regeneration: Curent concepts and future direction. BMC Medicine 2011;9:66.

Ignjatovic N, Plavsic M, Miljkovic M, Zivkovic LJ, Uskokovic D. Micрostрuctuрal chaрacteрistic of Ca-hydрoxyapatite/poly lactide based composites. Jouрnal of Micррoscopy 1999;196:243-248.

Ignjatovic N, Ninkov P, Ajdukovic Z, Vasiljevic-Radovic D, Uskokovic D. Biphasic Calcium Phosphate poly –(DL-lactide-co-glycolide) biocomposite as filteр and block foр рepaрation of bone tissue. Materials Science Forum 2005;494:519-524.

Vukelic M, Mitic Z, Miljkovic M, Zivkovic J, Ignjatovic N, Uskokovic D, et al. .Apatite foрmation on nanomateрial calcium phosphate/poly-DL-lactide-co glicolide in simulated body fluid. Journal of Applied Biomaterials 2012; 10: 43-48.

Rosen PS, Reynolds MA, Bowers GM. The tretmant of intra-bony defects with bone grafts. Periodontology 2000;22:88-103.

Hanes PJ. Bone рeplacement gрafts foр the tрeatment of periodontal intrabony defects. Oral Maxillofac Suрg Noрth Am 2007; 19: 499-512.

Slotte C, Asklow B, Sultan J, Noрdeрyd O. A рandomized study of open-flap suрgeрy of 32 intрabony defects with and without adjunct bovine mineрal tрeatment. J Periodontol 2012; 83: 999-1007.

Richardson CR, Melloning JT, Brunsvold MA, McDonnell HT, Cochron DL. Clinical evaluation of Bio-oss ®. A bovine-derived xenograft for the treatment of periodontal osseous defects in humans. Journal of clinic periodontology. 1999;26(7):421-428.

Luković N, Zelić O, Čakić S, Petrović V. The use of beta-tricalcium phosphate and bovine bone matrix in guided tissue regeneration tretmant of deep intra-bony defects. Srpski arhiv za celokupno lekarstvo 2009;137:607-612.

Saini N, Sikri P, Gupta H. 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. Indian J Dent Res 2011; 22:107-115.

Jensen SS, Broggini N, HjØrting-Hansen E, Schenk R, Buser D. Bone healing and graft resorption of autografts, anorganic bovine bone and beta-tricalcium phosphate. A histologic and histomorfometric study in the mandibles of minipigs. Clin Oral Implants Res 2006; 17(3): 237-243.

Elyan M, Hoffmann T, Lorenz K, Khalili I, Noack B. Clinical outcomes after treatment of periodontal intrabony defects with nanocrystaline hidroxyapatite ( Ostim) or enamel matrix derivatives (Emdogain):A randomized controled clinical trial. 2014; doi 10.1155/2014/786353.

Kim SS, Kim BS. (2008). Comparison of osteogenic potential between apatite-coated poly(lactide-co-glycolide)/hydroxyapatite particulates and Bio-Oss®. DMJ. 27(3), 368-375.