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Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation

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Abstract

The objective of this work is to compare the clinical and radiographic outcomes of demineralized freeze-dried bone allograft (DFDBA)/platelet-rich plasma (PRP) combination with PRP alone for the treatment of infrabony defects 18 months after surgery and to examine the influence of radiographic defect angle on the clinical and radiographic outcomes. Twenty-eight infrabony defects were treated with DFDBA/PRP combination or PRP alone. Clinical parameters and radiographic measurements were compared at baseline and 18 months. Interquartile range was performed to classify the defect angles. Mann–Whitney, Wilcoxon test, and Pearson correlation were used to analyze the data. The DFDBA/PRP combination exhibited more favorable gains in both clinical and radiographic parameters than PRP alone group (p < 0.05). A correlation existed between defect angle, defect depth, and clinical/radiographic outcomes for the defects treated with DFDBA/PRP. The narrow defects presented more favorable clinical attachment level values (CAL) gain, probing pocket depth (PPD) reduction and defect resolution than wide defects in the combination group (p < 0.05). The influence of baseline defect angle was not significant in the PRP-alone group (p > 0.05). The results indicate that DFDBA/PRP combination is more effective than PRP alone for the treatment of infrabony defects, and the amount of CAL gain, PPD reduction, and bone fill increases when the infrabony defect is narrow and deep before DFDBA/PRP combination treatment.

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References

  1. Aghaloo TL, Moy PK, Freymiller EG (2002) Investigation of platelet-rich plasma in rabbit cranial defects: a pilot study. J Oral Maxillofac Surg 60:1176–1181

    Article  PubMed  Google Scholar 

  2. Benn DK (1992) A computer-assisted method for making linear radiographic measurements using stored regions of interest. J Clin Periodontol 19:326–332

    Article  Google Scholar 

  3. Bowers GM, Chadroff B, Carnevale R, Mellonig J, Corio R, Emerson J, Stevens M, Romberg E (1989) Histologic evaluation of new attachment apparatus formation in humans. Part II. J Periodontol 60:675–682

    PubMed  Google Scholar 

  4. Bowers GM, Felton F, Middleton C, Glynn D, Sharp S, Mellonig J, Corio R, Emerson J, Park S, Suziki J et al (1991) Histological comparison of regeneration in human intrabony defects when osteogenin is combined with demineralized freeze-dried bone allograft and with purified bovine collagen. J Periodontol 62:690–702

    PubMed  Google Scholar 

  5. Camargo PM, Lekovic V, Weinlaender M, Vasilic N, Madzarevic M, Kenney EB (2002) Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects. J Periodontal Res 37:300–306

    Article  PubMed  Google Scholar 

  6. Carlson NE, Roach RB (2002) Platelet-rich plasma: clinical applications in dentistry. J Am Dent Assoc 133:1383–1386

    PubMed  Google Scholar 

  7. Cortellini P, Pini-Prato G, Tonetti MS (1995) Interproxymal free gingival grafts after membran removal in GTR treatment of intrabony defects. A controlled clinical trial indicating improved outcomes. J Periodontol 66:488–493

    PubMed  Google Scholar 

  8. Cortellini P, Pini-Prato G, Tonetti MS (1995) Periodontal regeneration of human intrabony defects with titanium re-inforced membranes. A controlled clinical trial. J Periodontol 66:797–803

    PubMed  Google Scholar 

  9. Cortellini P, Carnevale G, Sanz M, Tonetti MS (1998) Treatment of deep and shallow intrabony defects. A multicenter randomized controlled clinical trial. J Clin Periodontol 25:981–987

    Article  PubMed  Google Scholar 

  10. Cortellini P, Tonetti MS (1999) Radiographic defect angle influences the outcomes of GTR therapy in intrabony defects. J Dent Res 78:381 (special issue)

    Google Scholar 

  11. Eickholz P, Benn DK, Staehle HJ (1996) Radiographic evaluation of bone regeneration following periodontal surgery with or without expanded polytetrafluoroethylene barriers. J Clin Periodontol 67:379–385

    Google Scholar 

  12. Eickholz P, Hausmann E (1998) Evidence for healing of interproximal intrabony defects after conventional and regenerative therapy: digital radiography and clinical measurements. J Periodontal Res 33:156–165

    Article  PubMed  Google Scholar 

  13. Fennis JP, Stoelinga PJ, Jansen JA (2004) Mandibular reconstruction: a histological and histomorphometric study on the use of autogenous scaffolds, particulate corticocancellous bone grafts and platelet-rich plasma in goats. Int J Oral Maxillofac Surg 33:48–55

    Article  PubMed  Google Scholar 

  14. Fürst G, Gruber R, Tangl S, Sanroman F, Watzek G (2004) Effects of fibrin sealant protein concentrate with and without platelet released growth factors on bony healing of cortical mandibular defects. Clin Oral Implants Res 15:301–307

    Article  Google Scholar 

  15. Fürst G, Gruber R, Tangl S, Zechner W, Haas R, Mailath G, Sanroman F, Watzek G (2003) Sinus grafting with autogenous platelet-rich plasma and bovine hydroxyapatite. A histomorphometric study in minipigs. Clin Oral Implants Res 14:500–508

    Article  PubMed  Google Scholar 

  16. Galgut PN, Waite IM, Bookshaw JD, Kingston CP (1992) A 4-year controlled clinical study into the use of a ceramic hydroxylapatite implant material for the treatment of periodontal bone defects. J Clin Periodontol 19:570–577

    Article  PubMed  Google Scholar 

  17. Garrett S, Bogle G (1994) Periodontal regeneration with bone grafts. Curr Opin Periodontol 168–177

  18. Genco RJ (1987) Highlights of the conference and perspectives for the future. J Periodontal Res 22:164–171

    Article  PubMed  Google Scholar 

  19. Gunsolley J, Elswick RK, Davenport JM (1998) Equivalence and superiority testing in regeneration clinical trials. J Periodontol 69:521–527

    PubMed  Google Scholar 

  20. Jakse N, Tangl S, Gilli R, Berghold A, Lorenzoni M, Eskici A, Haas R, Pertl C (2003) Influence of PRP on autogenous sinus grafts: an experimental study on sheep. Clin Oral Implants Res 14:578–583

    Article  PubMed  Google Scholar 

  21. Kim SG, Kim WK, Park JC, Kim HJ (2002) A comparative study of osseointegration of Avana implants in a demineralized freeze-dried bone alone or with platelet-rich plasma. J Oral Maxillofac Surg 60:1018–1025

    Article  PubMed  Google Scholar 

  22. Klein F, Kim TS, Hassfeld S, Staehle HJ, Reitmeir P, Holle R, Eickholz P (2001) Radiographic defect depth and width for prognosis and description of periodontal healing of intrabony defects. J Periodontol 72:1639–1646

    Article  PubMed  Google Scholar 

  23. Kornman KS, Robertson PB (2000) Fundamental principles affecting the outcomes of therapy for osseous lesions. Periodontol 2000 22:22–43

    Article  PubMed  Google Scholar 

  24. Lekovic V, Camargo PM, Weinlaender M, Nedic M, Aleksic Z, Kenney EB (2000) A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans. J Periodontol 71:1110–1116

    Article  PubMed  Google Scholar 

  25. Lekovic V, Camargo PM, Weinlaender M, Vasilic N, Djordjevic M, Kenney EB (2001) The use of bovine porous bone mineral in combination with enamel matrix proteins or with an autologous fibrinogen/fibronectin system in the treatment of intrabony periodontal defects in humans. J Periodontol 72:1157–1163

    Article  PubMed  Google Scholar 

  26. Lekovic V, Camargo PM, Weinlaender M, Vasilic N, Kenney EB (2002) Comparison of platelet-rich plasma bovine porous bone mineral and guided tissue regeneration versus platelet-rich plasma and bovine porous bone mineral in the treatment of intrabony defects: a reentry study. J Periodontol 73:198–205

    Article  PubMed  Google Scholar 

  27. Marx ER, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR (1998) Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:638–646

    Article  PubMed  Google Scholar 

  28. Mellonig JT (1984) Decalcified freeze-dried bone allografts as an implant material in human periodontal defects. Int J Periodontics Restorative Dent 4:40–55

    PubMed  Google Scholar 

  29. Mellonig JT (1992) Autogenous and allogeneic bone grafts in periodontal therapy. Crit Rev Oral Biol Med 3:333–352

    PubMed  Google Scholar 

  30. Mellonig JT, Bowers GM, Bailey RC (1981b) Comparison of bone graft materials. Part II. A histological evaluation. J Periodontol 52:297–302

    PubMed  Google Scholar 

  31. Mellonig JT, Bowers GM, Cotton WR (1981a) Comparison of bone graft materials. Part I. New bone formation with autografts and allografts determined by strontium-85. J Periodontol 52:291–296

    PubMed  Google Scholar 

  32. Obarrio JJ, Arauz-Dutari JI, Chamberlain TM, Croston A (2000) The use of autologous growth factors in periodontal surgical therapy: platelet gel biotechnology—case reports. Int J Periodontics Restorative Dent 20:487–497

    Google Scholar 

  33. Pontoriero R, Wennström J, Lindhe J (1999) The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study. J Clin Periodontol 26:833–840

    Article  PubMed  Google Scholar 

  34. Quintero G, Mellonig JT, Gambill V, Pelleu G (1982) A six month clinical evaluation of decalcified freeze-dried bone allografts in periodontal osseous defects. J Periodontol 53:726–730

    PubMed  Google Scholar 

  35. Roldan JC, Jepsen S, Miller J, Freitag S, Rueger DC, Açil Y, Terheyden H (2004) Bone formation in the presence of platelet-rich plasma vs. bone morphogenetic protein-7. Bone 34:80–90

    Article  PubMed  Google Scholar 

  36. Scheyer ET, Velasquez-Plata D, Brunsvold MA, Lasho DJ, Mellonig JT (2002) A clinical comparison of a bovine-derived xenograft used alone and in combination with enamel matrix derivative for the treatment of periodontal osseous defects in humans. J Periodontol 73:423–432

    Article  PubMed  Google Scholar 

  37. Schwartz Z, Mellonig JT, Carnes DL Jr, de la Fontaine J, Cochran DL, Dean DD, Boyan BD (1996) Ability of commercial demineralized freeze-dried bone allograft to induce new bone formation. J Periodontol 67:918–926

    PubMed  Google Scholar 

  38. Shahamiri S, Singh IJ, Stahl SS (1992) Clinical response to the use of the HTR polymer implant in human intrabony lesions. Int J Periodontics Restorative Dent 12:295–299

    Google Scholar 

  39. Tonetti M, Pini-Prato G, Cortellini P (1993) Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol 64:934–940

    PubMed  Google Scholar 

  40. Tonetti M, Cortellini P (1997) Case selection and treatment considerations of guided tissue regeneration in deep intrabony defects. Curr Opin Periodontol 4:82–88

    PubMed  Google Scholar 

  41. Trejo PM, Weltman R, Caffesse R (1999) Treatment of intaosseous defects with bioabsorbable barriers alone or in combination with decalcified freeze-dried bone allograft: a randomized clinical trial. J Periodontol 70:1852–1861

    Google Scholar 

  42. Tsitoura E, Tucker R, Suvan J, Laurell L, Cortellini P, Tonetti M (2004) Baseline radiographic defect angle of the intrabony defect as a prognostic indicator in regenerative periodontal surgery with enamel matrix derivative. J Clin Periodontol 31:643–647

    Article  PubMed  Google Scholar 

  43. Yukna RA, Krauser JT, Callan DP, Evans GH, Cruz R, Martin M (2000) Multi-center clinical comparison of combination anorganic bovine-derived hydroxyapatite matrix (ABM)/cell binding peptide (P-15) and ABM in human periodontal osseous defects. Six-month results. J Periodontol 71:1671–1679

    Article  PubMed  Google Scholar 

  44. Yukna RA, Mellonig JT (2000) Histologic evaluation of periodontal healing in humans following regenerative therapy with enamel matrix derivative. A 10 case series. J Periodontol 71:752–759

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey

    Tunç Ilgenli

  2. Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ege University, 35100, Izmir, Turkey

    Nesrin Dündar & Betül Ilhan Kal

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  1. Tunç Ilgenli
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Correspondence to Betül Ilhan Kal.

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Ilgenli, T., Dündar, N. & Ilhan Kal, B. Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation. Clin Oral Invest 11, 51–59 (2007). https://doi.org/10.1007/s00784-006-0083-y

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