Evaluation of Efficacy of Surgical Periodontal Therapy with the Use of Bone Graft in the Treatment of Periodontal Intrabony Defects

Abstract

Introduction:One of the most important goals of periodontitis therapy is the elimination of deep periodontal pockets. In regenerative periodontal therapy, different types of bone grafts, membranes, growth factors, etc. are used to improve regeneration of lost periodontal tissue.The aim of this study was to evaluate the effect of surgical therapy supported by the use of bone replacement material in the treatment of deep intrabony pockets, compared to surgical treatment (flap surgery) without the use of bone replacement in advanced periodontitis.Methods and materials:The study included 50 patients of both sexes with advanced periodontitis, divided into two groups. After initial periodontal therapy was performed, plaque index (PI), papillary bleeding index (PBI) were verified, and depth of periodontal pockets was measured in both groups. One group (group 1) of the patients underwent surgical therapy, open flap surgery, while the other group (group 2) underwent the same surgical treatment method (open flap surgery), during which bone defects were filled with bone replacement material.Results:The results showed that both group 1 and group 2 experienced improvements after periodontal surgical therapy. In group 1, there are no statistically significant changes in all three plaque index measurements (PI), while there has been a significant reduction in PI in group 2 following the surgery. For the PBI index, it was determined that there were statistically significant changes in values in group 1, both after surgical procedures and six months later, as well as in group 2. Statistical analysis of the results of the probing depth of pockets has shown that there are significant changes in the measurement of the depth of periodontal pocket one month after the surgery, as well as six months later, meaning that there has been a significant reduction in the depth of the periodontal pocket one month following the surgery as well as six months later, for both groups. However, we did not determine a statistically significant difference in the probing depth of pockets between these two groups.Conclusion:Six months after a surgical therapy, clinical parameters showed a reduction of the probing depth of the periodontal pocket in both examined groups. The use of bone replacement did not yield significantly better results in reducing the depth of probing compared to the standard flap surgery. We believe that future research should focus on testing the effectiveness of new regenerative methods and materials (bone replacements with various properties, membranes, and surgical methods) that will result in better treatment results with predictable outcomes.

<p>Multicenter study of patients&rsquo; preferences and concerns regarding the origin of bone grafts utilized in dentistry</p>

“…There is a variety of surgical treatments that use bone graft material to recover the bone volume that has been lost 1,2. In addition to grafts traditionally harvested from the same patient (autologous graft), advances in technology and biomaterial science have made several types of bone graft available from different sources, such as those obtained from animals (xenograft), human cadavers (allograft) and synthetic materials (alloplastic graft) 3,4…”

Effect of Bio-Gen Mix Granules in Treatment of Periodontal Intrabony Defects.

“…Also, they think that in order to establish a good understanding of the periodontium regeneration, additional long-term clinical studies with histologic evaluation of the results are required. On the other hand Gojkov Vukelic et al (26) disagree with these findings as thier results did not show any significant reduction in PPD and improvement in CAL when comparing between the two sites.…”

Application of 4MATRIX and PRF in the Treatment of Infrabone Defects in Chronic Periodontopathy

“…Therefore the results of the study of Gojkov-Vukelic et all. by using Maxresorb (Bottis dental) which is composed of 60% slowly resorbing hydroxyapatite (HA) and 40% fast resorbing beta-tricalcium phosphate (β-TCP) as regenerative grafts in periodontal pockets showed significant reduction in probing depth for both groups of patients (treated by open flap surgery and treated by open flap surgery in addition with Maxresorb), one and six months after the performed surgical therapy ( 13 ). Also the results of other papers which are talking about the other biomaterials as Bio Oss, .showed significant improvement for clinical parameters at sites treated with BioSS compared to control sites ( 14 ).…”