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Abstract
Aim and objectives:: The aim of the present study was to compare autogenous bone graft (Group
(G
- 1)
and xenograft combined with PRP (Group
(
- 2). The clinical and radiographic healing was evaluated
after a period of six months in periodontal intra bony defects.
Material and methods: A split mouth design was followed, where two sites in the contra lateral
quadrants with probing pocket depth of 5 mm with radiographic evidence of bone loss at baseline
were chosen. Patients were grouped as Group - 1: 7 intra bony defects treated with autogenous
International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.
Copy right 2015,, IAIM, All Rights Reserved.
Page 28
Key words
Regeneration, Autografts, Platelet
latelet rich plasma (PRP), Xenografts.
Xenografts
Introduction
Periodontitis is an inflammatory disease of
supporting tissues of the teeth caused by
specific microorganisms resulting in the
progressive destruction of periodontal ligament,
alveolar bone with pocket formation, recession
or both [1].. Conventional periodontal
treatmentss such as scaling and root planing
plan
are
highly effective in repairing
airing disease related
defects but result in the development of long
junctional epithelium between the root surface
and gingival connective tissue rather than
regrowth of tissue that restores the
t architecture
and function. Open flap debridement may result
in the formation of long junctional epithelium
which is more susceptible to microbial invasion
and is thought to be less stable attachment.
Thus bone grafting is the most common form of
regenerative therapy [2].
Among all these biomaterials autogenous bone
grafts have been adopted as gold standard since
there is possibility to retain cell viability, graft
revascularization and no possibility of disease
transmission and contain live osteoblasts and
osteoprogenitor cells and heal by Osteogenesis
[3].. Autogenous bone grafts can be harvested
either from intraoral or extra oral donor sites.
Multiple intraoral locations have been used
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Exclusion criteria
Known systemic diseases, short and long
term drug therapies.
Drug allergies.
Pregnant and lactating women.
Teeth with traumatic occlusion.
Smokers.
Presurgical therapy
For all the enrolled patients routine blood
investigations were taken. The initial therapy
consisted of oral hygiene instructions,
instructi
scaling
and root planning. Three weeks following phase
I therapy, a periodontal re-evaluation
re
was
performed.
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Page 31
Photo - 8: Pre-operative
operative view (Group - 2).
Page 32
Results
The mean plaque index
ndex score at baseline was
rd
1.140.68, at 3 month was 0.800.52 and at 6th
month was 0.510.42 and the mean oral
hygiene index score at baseline was 1.040.70,
at 3rd month was 0.720.52 and at 6th month
was 0.520.42. At baseline the mean gingival
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osseous defects
ects with autogenous bone graft
(Group - 1) resulted in clinically and statistically
significant higher probing pocket depth
reduction, clinical attachment level gain and
radiographic bone fill compared to xenograft
mixed with PRP (Group - 2). However,
limitations
itations of this study include a small sample
size and limited time frame for post surgical
evaluation. Hence it is necessary to have a large
sample size and long term well controlled
clinical trials to evaluate the true efficacy of
these materials. Also further
urther studies needed to
be carried out to confirm the effects of PRP in
periodontal regeneration.
References
1. Newman MG, Takei H, Carranza FA.
Clinical Periodontology,
Periodontology 10th edition.
Philadelphia: Saunders; 2006, p. 816.
2. Carraro JJ, Sznajder N, Alonso CA.
Intraoral cancellous bone autografts in
the treatment of infra bony pockets. J
Clin Periodontol, 1976; 3: 104-109.
3. Kim CS, Choi SH, Cho KS, Chai JK,
Wikesjo, Kim CK. Periodontal healing in
one-wall intra-bony
bony defects in dogs
following implantation
ntation of autogenous
bone or a coral-derived
derived biomaterial. J
Clin Periodontol, 2005; 32: 583589.
583
4. Robinson E. Osseous coagulum for bone
induction. J Periodontol, 1969; 40: 503510
5. Abolfazli N, Saber FS, Lafzi A, Eskandari
A, et al. A Clinical Comparison of
Cerabone (A Decalcified Freeze-dried
Freeze
Bone Allograft) with Autogenous Bone
Page 35
Table 1: Comparison of mean plaque index scores, oral hygiene index scores, gingival index scores
at baseline, 3 months and 6 months.
months
Parameters
Plaque index
Oral hygiene index
Baseline
1.14 0.68
1.040.70
3 months
0.800.52
0.720.52
6 months
0.510.42
0.520.42
p - value
>0.05*
>0.05*
Gingival index
1.020.53
0.730.48
0.420.32
>0.05*
p- value between baseline, 3 months and 6 months was >0.05 denotes not statistically significant at
5% level.
International Archives of Integrated Medicine, Vol. 2, Issue 3, March, 2015.
Copy right 2015,, IAIM, All Rights Reserved.
Page 36
Group - 1 (MeanSD)
Group - 2 (MeanSD)
p value
Baseline
7.85 0.89
7.57 0.80
< 0.001**
3 months
5.14 0.75
4.861.20
< 0.001**
6 months
3.860.90
4.570.55
< 0.001**
Group - 1 (MeanSD)
Group - 2 (MeanSD)
p - value
Baseline
8.71 0.94
8.28 0.60
< 0.001**
3 months
6.141.49
6.831.32
< 0.001**
6 months
4.571.30
5.421.12
< 0.001**
Group - 1 (MeanSD)
7.57 0.75
6.331.11
4.420.53
Group - 2 (MeanSD)
7.71 0.94
6.710.75
5.570.97
p value
< 0.001**
< 0.001**
< 0.001**
**
p- value between baseline, 3 months and 6 months wass < 0.001 denotes statistically highly
significant at 1% level.
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Graph - 2: Comparison of mean changes in probing pocket depth (PPD) between the groups at
baseline, 3 months and 6 months.
months
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Graph 4: Comparison
on of mean bone fill between the groups in baseline, 3 months and 6 months.
months
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