GUIDED TISSUE REGENERATION AROUND DENTAL IMPLANTS IN IMMEDIATE EXTRACTION SOCKETS:COMPARISON OF RESORBABLE ANDNONRESORBABLE MEMBRANES

This study was per formed to compare the efficacy of guided tissue regeneration (GTR) around dentalimplants immediately placed into extraction sockets by resorbable of nonresorbable membranes. Mandibular. P2, P3, and P4 of four aduIt beagle dogs were extracted bilaterally, and buccal standard defects were cre-ated and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into thefresh extraction sockets. Four implants were untreated controls, four implants received polytetrafluoro-ethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes (ParaGuide), andfive implants received polyglactin 910 mesh (Vicryl). After l4 weeks, clinical measurements were takenand the dogs were sacrificed and all specimens retrieved for histologic and histomorphometric evaluation.The average gain in bone height was 2. 1mm for untreated control sites, 3. 3mm for Gore-Tex sites,3. 8mm for collagen sites, and 1. 3mm for polyglactin 910 sites. The greatest gain in bone height and volume was seen for two sites that received Gore-Tex membranes and remained covered for the entire evalua-tion interval. The results of this study indicate that Gore-Tex and collagen membrane preduced gdri re-sults for GTR around Implants immediately placed into extraction sockets. Since collagen membrane doesnot cause obvious infection and does not need the surgical reentry for membrane removal, it can be a validalternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin910 mesh seems not suitable to be used as GTR membrane in immediate implantation for its hIgh infectionrate.

Evaluation of periodontal healing in class II furcation defects following guided tissue regeneration with two different types of poly lactic acid membranes

Background Guided tissue regeneration procedures provide predictable reconstruction of periodontal tissues in the treatment of furcation involvements in animals and huamns. This study was to compare long-term effectiveness of two different types of polylactic acid (PLA) membranes on periodontal regeneration in surgically created class II furcation defects in dogs.Methods Full thickness mucoperiosteal flap was raised on the buccal aspects of the experimental teeth and class II furcation defects having 5 mm vertical dimensions were created on mandibular premolar III and IV on each quadrant. The exposed root surfaces were thoroughly planed and PLA membranes were placed over the experimental defects on both sites. One site received liquid polymer membrane (LPM), and resorbable periodontal mesh (RPM) membranes were applied to the other site. The animals were sacrificed at 7 months after surgery and the specimens were processed for histological evaluation.Results The average length of new attachment formed on the treated roots in both groups ranged from 3. 02 mm to 4. 5 mm. Complete bone filling was observed at the furcation sites. No statistically significant differences were found between two membranes in any of the parameters (P>0. 05).Conclusion This study demonstrates favorable regenerative outcomes by the use of two different types of PLA membranes that could be used as alternatives for guided tissue regeneration (GTR).

Evaluating the Benefits of Platelet Rich-Fibrin in Periodontal Regeneration: A Literature Review

Introduction: Platelet Rich-Fibrin (PRF) is a biological matrix derived from a patient’s own blood, rich in growth factors and platelets. Its use in various periodontal and non-periodontal procedures is gaining recognition due to its potential in promoting tissue regeneration. The purpose of this review was to evaluate the benefits of using PRF in intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Methods: The study searched PubMed for manuscripts published between 2017 and 2022 to better understand the clinical and radiological effects of PRF. The manuscripts were divided into the following sections: intra-bony defect regeneration, guided-bone regeneration, and sinus floor elevation. Results: In intra-bony defects, PRF improved clinical and radiological parameters when compared with OFD alone, with a significant difference in wound healing at 7 days. In GBR, a CBCT evaluation shows no statistical difference between the PRF-autogenous bone complex group and the bovine bone-collagen membrane complex regarding volume change of the augmented bone with a 16% rate of bone loss following a 6-month healing period. Also, a slight increase in bone thickness has been seen when liquid PRF is used. In sinus floor elevation, results revealed no differences in graft volume between PRF group and control group at any of the evaluated time points. Although higher implant stability immediately postoperatively, higher new bone formation, the lesser amount of residual graft and earlier implant placement. Conclusion: Platelet Rich-Fibrin is widely accepted for use in periodontal surgery and dentistry due to its minimally invasive nature and low risk of adverse effects, with positive results in tissue regeneration. There is evidence that PRF leads to improved and faster healing, as well as cost-effective regenerative procedures compared to other treatments.

Platelet rich fibrin is not a barrier membrane!Or is it?

Platelet-rich fibrin(PRF)is widely used in dentistry and other fields of medicine,and its use has become popular in dental implantology.In several published studies,PRF has been used as a barrier membrane.A barrier membrane is a sheet of a certain material that acts as a biological and mechanical barrier against the invasion of cells that are not involved in bone formation,such as epithelial cells.Among the basic requirements of a'barrier membrane,occlusivity,stiffness,and space maintenance are the criteria that PRF primarily lacks;therefore,it does not fall under the category of barrier membranes.However,there is evidence that PRF membranes are useful in significantly improving wound healing.Does the PRF membrane act as a barrier?Should we think of adding or subtracting some points from the ideal requirements of a barrier membrane,or should we coin a new term or concept for PRF that will incorporate some features of a barrier membrane and be a combination of tissue engineering and biotechnology?This review is aimed at answering the basic question of whether the PRF membrane should be considered a barrier membrane or whether it is something more beyond the boundaries of a barrier membrane.

Regulation of tissue repair and regeneration by electric fields

Endogenous electric fields （EFs） have been detected at wounds and damaged tissues. The potential roles of EFs in tissue repair and regeneration have been an intriguing topic for centuries. Recent researches have provided significant insights into how naturally occurring EFs may participate in the control of tissue repair and regeneration. Applied EFs equivalent to the size of fields measured in vivo direct cell migration, cell proliferation and nerve sprouting at wounds. More remarkably, physiological EFs are a guidance cue that directs cell migration which overrides other well accepted directional signals including initial injury stimulation, wound void, contact inhibition release, population pressure and chemotaxis. EFs activate many intracellular signaling pathways in a directional manner. Modulation of endogenous wound EFs affects epithelial cell migration, cell proliferation, and nerve growth at cornea wounds in vivo. Electric stimulation is being tested clinically for the treatments of bone fracture, wound healing and spinal cord injury. EFs thus may represent a novel type of signaling paradigm in tissue repair and regeneration. Combination of the electric stimulation and other well understood biochemical regulatory mechanisms may offer powerful and effective therapies for tissue repair and regeneration. This review introduces experimental evidence for the existence of endogenous EFs and discusses their roles in tissue repair and regeneration.

Periodontal-orthodontic interdisciplinary management of a“periodontally hopeless”maxillary central incisor with severe mobility:A case report and review of literature

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.

Improving chitosan-based composite membrane by introducing a novel hybrid functional nano-hydroxyapatite with carboxymethyl cellulose and phytic acid

A functional hybrid nano-hydroxyapatite(carboxymethyl cellulose-phytic acid-n-HA,CMC-PA-n-HA)was prepared by adding CMC and PA.The results of Fourier transformation infrared spectra,X-ray diffraction,thermal gravimetric analysis and dispersion experiments indicated that the addition of CMC and PA affected the morphology,crystallinity and crystal size of hybrid n-HA,and CMC endowed hybrid n-HA with excellent dispersion.Scanning electron microscope results showed that CMC-PA-n-HA nanoparticle could be uniformly dispersed in chitosan(CS)matrix to obtain composite membrane by casting technology,so that the highest tensile strength of CMC-PA-n-HA/CS composite membrane was 69.64%and 144.45%higher than that of CS membrane and n-HA/CS composite membrane,respectively.Contact angle test showed that CMC-PA-n-HA effectively improved hydrophilicity of the CS membrane.The simulated body fluid immersion results indicated that the CMC-PA-n-HA/CS composite membrane not only exhibited good degradability but also promoted bone-like apatite deposition.The cell proliferation experiments proved that the introduction of PA made the composite membrane have better cell adhesion and proliferation ability.Antibacterial tests demonstrated that PA could effectively improve the antibacterial properties of the composite membrane,which is expected to be applied as guide bone tissue regeneration membrane.

Comparison of Different Periodontal Healing of Critical Size Noncontained and Contained Intrabony Defects in Beagles

Background： Regenerative techniques help promote the formation of new attachment and bone filling in periodontal detects. However, the dimensions of intraosseous defects are a key determinant of periodontal regeneration outcomes. In this study, we evaluated the efficacy of use of anorganic bovine bone （ABB） graft in combination with collagen membrane （CM）, to facilitate healing ofnoncontained （1-wall） and contained （3-wall） critical size periodontal defects. Methods： The study began on March 2013, and was completed on May 2014. One-wall （7 mm × 4 mm） and 3-wall （5 mm × 4 mm） intrabony periodontal defects were surgically created bilaterally in the mandibular third premolars and first molars in eight beagles. The defects were treated with ABB in combination with CM （ABB ＋ CM group） or open flap debridement （OFD group）. The animals were euthanized at 8-week postsurgery for histological analysis. Two independent Student＇s t-tests （1-wall [ABB ＋ CM] vs. 1-wall [OFD] and 3-wall [ABB ＋ CM] vs. 3-wall [OFD]） were used to assess between-group differences. Results： The mean new bone height in both 1- and 3-wall intrabony defects in the ABB ＋ CM group was significantly greater than that in the OFD group （1-wall： 4.99± 0.70 mm vs. 3.01 ± 0.37 mm, P 〈 0.05; 3-wall： 3.11±0.59 mm vs. 2.08± 0.24 mm, P 〈 0.05）. The mean new cementum in 1-wall intrabony defects in the ABB ＋ CM group was significantly greater than that in their counterparts in the OFD group （5.08 ±0.68 mm vs. 1.16 ± 0.38 mm; P 〈 0.05）. Likewise, only the 1-wall intrabony defect model showed a significant difference with respect to junctional epithelium between ABB ＋ CM and OFD groups （0.67 ±0.23 mm vs. 1.12 ± 0.28 mm, P 〈 0.05）. Conclusions： One-wall intrabony defects treated with ABB and CM did not show less periodontal regeneration than that in 3-wall intrabony defect. The noncontained l-wall intrabony defect might be a more discriminative defect model for further research into periodontal regeneration.

Effects of secretive bone morphogenetic protein 2 induced by gene transfection on the biological changes of NIH3T3 cells

Background Bone morphogenetic proteins （BMPs）, which belong to the transforming growth factor beta superfamily, are powerful regulators of cartilage and bone formation. This study investigated the biological changes of NIH3T3 ceils incubated with secretive BMP2 that was induced by gene transfection through transwell.Methods Eukaryonic expression vector （pcDNA3. 1-B2 ） was transfered into NIH333 cells with Sofast^TM, a positive compound transfection agent. The positive cell clones were selected with G418. The cytoplasmic and extracellular expressions of BMP2 were determined by immunohistochemical stain and enzyme-linked immunosorbent assay. NIH333 ceils were co-cultured with hBMP2 gene transfecting ceils through transwell, and the ultrastructure, alkaline phosphatase activity and the expression of osteocalcin （the marker of osteogenetic differentiation） changes were observed.Results There were cytoplasmic and extracellular expressions of BMP2 in transfecting NIH3T3 ceils. The ultrastructural changes, the high activity of alkaline phosphatase and the positive stain of osteocalcin suggested the osteogenetic differentiation tendency of NIH3T3 cells co-cultured with transfecting NIH3T3 cells.Conclusion Secretive BMP2 that is induced by gene transfection could promote the osteogenetic differentiation of fibroblast ceils.