Treatment of intrabony periodontal defects in controlled diabetic patients with an enamel matrix derivative: a split-mouth randomized clinical trial

Cimões, Renata; Santiago, Leógenes Maia; Júnior, Arnaldo de França Caldas; Vajgel, Bruna de Carvalho Farias; Perussolo, Jeniffer; Donos, Nikolaos

doi:10.1007/s00784-021-04215-w

Cited by 4 publications

(6 citation statements)

References 83 publications

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“…Two studies employed the minimally invasive surgical technique [63, 66], seven used the modified minimally invasive surgical technique [13, 46, 51, 52, 59, 69, 70], and others used the simplified or modified papilla preservation flap. In terms of defect morphology, 14 involved 1‐ to 2‐wall intrabony defects [35, 36, 40, 42, 45, 47, 54, 56, 60, 62–64, 71, 81], one involved 2‐wall intrabony defects [53], four had 3‐wall intrabony defects [13, 67, 77, 84], five involved 2‐ to 3‐wall intrabony defects [14, 44, 50, 57, 73], 21 involved 1‐, 2‐, or 3‐wall intrabony defects [15, 20, 37, 43, 46, 48, 49, 51, 55, 58, 59, 61, 68, 69, 72, 74, 78–80, 82, 83, 85], and 12 did not provide sufficient details regarding the typology of defects [38, 39, 41, 52, 65, 66, 70, 75, 76, 86, 87].…”

Section: Resultsmentioning

confidence: 99%

“…The regenerative modalities were as follows: (i) open‐flap debridement; (ii) platelet‐rich plasma; (iii) platelet‐rich fibrin; (iv) enamel matrix derivative; (v) guided tissue regeneration; (vi) bone graft; (vii) platelet‐rich plasma + bone graft; (viii) platelet‐rich fibrin + bone graft; (ix) enamel matrix derivative + bone graft; (x) guided tissue regeneration + bone graft; (xi) enamel matrix derivative + guided tissue regeneration; and (xii) platelet‐rich fibrin + enamel matrix derivative. Thirty‐three studies used enamel matrix derivatives [14, 20, 35, 39, 41‐43, 45–49, 51, 52, 54–56, 60, 62, 63, 66, 67, 73, 74, 77–82, 85–87]. Six chose platelet‐rich fibrin [13, 35, 36, 43, 44, 50], and three selected platelet‐rich plasma [38, 50, 61].…”

Section: Resultsmentioning

confidence: 99%

“…As these were periodontal treatments, the surgeons could not be blinded. One study did not blind the examiner [71], and 15 did not provide sufficient information [45–47, 50, 57, 58, 67, 68, 72, 73, 75, 76, 78, 84, 86]. Incomplete outcome data were observed in five studies [43, 45, 67, 79, 80].…”

Section: Quality Assessmentmentioning

confidence: 99%

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Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

Cui,

Mai,

Liu

et al. 2024

European J Oral Sciences

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This study aimed to compare clinical benefits of autologous platelet concentrate with other periodontal regenerative approaches in intrabony defects. An electronic and hand search of studies up to December 2022 was conducted. Randomized controlled trials with at least 6 months of follow‐up were identified to compare autologous platelet concentrates with enamel matrix derivative, bone graft, guided tissue regeneration, and open‐flap debridement. All approaches involved papilla preservation flap surgery. The outcomes included probing depth reduction, clinical attachment level gain, linear bone fill, and safety. A network meta‐analysis and meta‐regression were performed. Fifty‐seven studies were included in five network meta‐analyses. Autologous platelets concentrate and its adjunct treatments achieved significantly greater clinical and radiographic parameters than did open‐flap debridement, and had comparable or better performance than other regenerative treatments. Platelet‐rich fibrin showed superiority over platelet‐rich plasma in probing depth reduction at 6‐month follow‐up. Minimal pain and improved wound healing were observed in the treatments with autologous platelet concentrate. Meta‐regression showed that deeper baseline intrabony defects resulted in larger probing depth reductions, while smoking impaired the effectiveness of regenerative surgeries. Minimal invasive flap designs led to less effect of regenerative materials. Autologous platelet concentrate is a promising biomaterial in periodontal regeneration due to its convenience, safety, and biocompatibility characteristics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

Cui,

Mai,

Liu

et al. 2024

European J Oral Sciences

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“…[176,178,191] Clinical trials have confirmed the efficacy of Emdogain in improving the outcomes of periodontal regeneration. [85,86,156,194,195] In a split-mouth randomized study, Bhutda and Deo demonstrated the benefits of Emdogain combined with the conditioning agent Prefgel (neutral formulation of 24% ethylenediaminetetraacetic acid) and open flap debridement (OFD) when compared to Prefgel and OFD for the treatment of 2-wall and 3-wall intrabony defects. [194] The clinical outcomes at five years and the radiographic outcomes at one year were significantly better when Emdogain was applied (probing pocket depth reduction: 3.84 ± 1.05 mm versus 1.92 ± 0.35 mm; clinical attachment level gain: 3.18 ± 0.87 mm versus 1.60 ± 0.54 mm; percentage radiographic bone fill: 66.66 ± 7.8% versus 31.71 ± 4.1%).…”

Section: Emdmentioning

confidence: 99%

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

De Lauretis,

Øvrebø,

Romandini

et al. 2024

Advanced Science

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Periodontitis is a dysbiosis‐driven inflammatory disease affecting the tooth‐supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step‐wise therapeutic approach is employed for periodontitis. After an initial behavioral and non‐surgical phase, intra‐bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra‐bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.

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“…Both sides showed clinical improvement after 6 months of follow up with EMD side showing enhanced reduction in PD and gain in the PDL attachment. However, the study did not include non diabetic controls [ 82 ].…”

Section: Current Periodontal Therapies In Diabeticsmentioning

confidence: 99%

The Effect of Diabetes Mellitus on IGF Axis and Stem Cell Mediated Regeneration of the Periodontium

et al. 2021

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Periodontitis and diabetes mellitus (DM) are two of the most common and challenging health problems worldwide and they affect each other mutually and adversely. Current periodontal therapies have unpredictable outcome in diabetic patients. Periodontal tissue engineering is a challenging but promising approach that aims at restoring periodontal tissues using one or all of the following: stem cells, signalling molecules and scaffolds. Mesenchymal stem cells (MSCs) and insulin-like growth factor (IGF) represent ideal examples of stem cells and signalling molecules. This review outlines the most recent updates in characterizing MSCs isolated from diabetics to fully understand why diabetics are more prone to periodontitis that theoretically reflect the impaired regenerative capabilities of their native stem cells. This characterisation is of utmost importance to enhance autologous stem cells based tissue regeneration in diabetic patients using both MSCs and members of IGF axis.

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Treatment of intrabony periodontal defects in controlled diabetic patients with an enamel matrix derivative: a split-mouth randomized clinical trial

Cited by 4 publications

References 83 publications

Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

Clinical benefits of autologous platelet concentrate in periodontal intrabony defects: A network meta‐analysis of randomized controlled trials

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials

The Effect of Diabetes Mellitus on IGF Axis and Stem Cell Mediated Regeneration of the Periodontium

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