Aim: Periodontitis is caused by chronic gingival inflammation and affects a large population in the world. Although guided tissue regeneration (GTR) therapy has been proven to be an effective treatment, the deficiency...Aim: Periodontitis is caused by chronic gingival inflammation and affects a large population in the world. Although guided tissue regeneration (GTR) therapy has been proven to be an effective treatment, the deficiency in the symmetrical design of all the GTR membrane in the market leaves large space for improvement. Therefore, we designed a novel asymmetrical bi-layer PLA/gelatin composite membrane for treating periodontitis. Methods: The PLA side was fabricated by electrospinning with metronidazole (MNA) pre-mixed with the PLA solution. The gelatin side containing bioglass (BG) 45S5 was fabricated with freeze-drying process and cross-linked with PLA membrane. The bio-compatibility of the membrane was evaluated in vitro using NIH3T3 cells. The releasing of MNA was measured by spectrophotometer. The bioactivity of the membrane was evaluated by hydroxyapatite (HA) deposit and determined by FTIR spectrometer. The ionic concentration of Ca2+ and was measured by ICPOES. The expression of the osteogenesis makers was determined by qRT-PCR. Results: The bi-layer PLA/gelatin composite membrane is biocompatible and bioactive. The releasing of MNA can rapidly reach the anti-bacterial effective concentration. Interestingly, the incorporation of MNA modulated the degradation rate of PLA scaffold to meet the requirement of tissue regeneration. Meanwhile, the embedding of the BG powder in the gelatin porous layer provided a favorable Ca2+ and ion environment for the regeneration of the alveolar bone tissue. Conclusions: Taken together, this bi-layer GTR membrane is closer to the physiological structure of the periodontal. The addition of MNA and BG makes it more powerful in treating periodontitis. Moreover, this research provides an example of biomimetic design in fabricating biomaterial for clinical applications.展开更多
BACKGROUND Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists.Biofilm-induced periodontal inflammation and occlu...BACKGROUND Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists.Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility.This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma.CASE SUMMARY A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations.To reduce tooth mobility and establish stable occlusion,we combined orthodontic treatment with periodontal therapy to preserve the tooth.Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery.The loosened upper right central incisor was successfully retained,and the periodontal tissue remained stable during follow-up.CONCLUSION Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled.展开更多
文摘Aim: Periodontitis is caused by chronic gingival inflammation and affects a large population in the world. Although guided tissue regeneration (GTR) therapy has been proven to be an effective treatment, the deficiency in the symmetrical design of all the GTR membrane in the market leaves large space for improvement. Therefore, we designed a novel asymmetrical bi-layer PLA/gelatin composite membrane for treating periodontitis. Methods: The PLA side was fabricated by electrospinning with metronidazole (MNA) pre-mixed with the PLA solution. The gelatin side containing bioglass (BG) 45S5 was fabricated with freeze-drying process and cross-linked with PLA membrane. The bio-compatibility of the membrane was evaluated in vitro using NIH3T3 cells. The releasing of MNA was measured by spectrophotometer. The bioactivity of the membrane was evaluated by hydroxyapatite (HA) deposit and determined by FTIR spectrometer. The ionic concentration of Ca2+ and was measured by ICPOES. The expression of the osteogenesis makers was determined by qRT-PCR. Results: The bi-layer PLA/gelatin composite membrane is biocompatible and bioactive. The releasing of MNA can rapidly reach the anti-bacterial effective concentration. Interestingly, the incorporation of MNA modulated the degradation rate of PLA scaffold to meet the requirement of tissue regeneration. Meanwhile, the embedding of the BG powder in the gelatin porous layer provided a favorable Ca2+ and ion environment for the regeneration of the alveolar bone tissue. Conclusions: Taken together, this bi-layer GTR membrane is closer to the physiological structure of the periodontal. The addition of MNA and BG makes it more powerful in treating periodontitis. Moreover, this research provides an example of biomimetic design in fabricating biomaterial for clinical applications.
文摘BACKGROUND Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists.Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility.This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma.CASE SUMMARY A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations.To reduce tooth mobility and establish stable occlusion,we combined orthodontic treatment with periodontal therapy to preserve the tooth.Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery.The loosened upper right central incisor was successfully retained,and the periodontal tissue remained stable during follow-up.CONCLUSION Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled.
