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Regenerative Material (regenerative + material)
Selected AbstractsMicrobial colonization patterns predict the outcomes of surgical treatment of intrabony defectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2006Lisa Heitz-Mayfield Abstract Aim: To explore the impact of bacterial load and microbial colonization patterns on the clinical outcomes of periodontal surgery at deep intrabony defects. Materials and Methods: One hundred and twenty-two patients with advanced chronic periodontitis and at least one intrabony defect of >3 mm were recruited in 10 centres. Before recruitment, the infection control phase of periodontal therapy was completed. After surgical access and debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. Microbial colonization of the defect-associated pocket was assessed using a DNA,DNA checkerboard analysis. Results: Total bacterial load and counts of red complex bacteria were negatively associated with CAL gains 1 year following treatment. The probability of achieving above median CAL gains (>3 mm) was significantly decreased by higher total bacterial counts, higher red complex and T. forsythensis counts immediately before surgery. Conclusions: Presence of high bacterial load and specific periodontal pathogen complexes in deep periodontal pockets associated with intrabony defects had a significant negative impact on the 1 year outcome of surgical/regenerative treatment. [source] Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap aloneJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004A multicenter randomized controlled clinical trial Abstract Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material. Materials and Methods: One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full-mouth plaque scores and full-mouth bleeding scores (FMBS) were assessed. Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above-median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2,5.4) and by starting with deeper PPD (OR=1.7, 1.3,2.2) but were decreased by receiving treatment at the worst-performing clinical center (OR=0.9, 0.76,0.99). Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone. [source] The role of macrophages in the periodontal regeneration using Emdogain® gelJOURNAL OF PERIODONTAL RESEARCH, Issue 2 2008N. Fujishiro Background and Objective:, Emdogain® gel is clinically used as a periodontal regenerative material. However, the mechanism of the regeneration has not been completely elucidated. Although many studies have focused on the regenerative effect of Emdogain on connective tissue attachment and alveolar bone, the role of macrophages and the expression of growth factors remains unclear in the regeneration stimulated by Emdogain gel in vivo. The aim of this study was to investigate the effect of Emdogain gel on the expression of cytokines and growth factors by macrophages in vivo using a newly devised rat experimental periodontitis model. Material and Methods:, Rat experimental periodontitis was induced by elevating a full-thickness gingival flap and ligating silk threads around the first molars of the mandible. At 14 d after inducing experimental periodontitis, Emdogain gel or propylene glycol alginate was applied to the furcation area. The rats were killed 7 and 14 d after treatment with propylene glycol alginate or Emdogain gel. The expression of cytokines and growth factors, and the regeneration of periodontal tissue, were examined by histochemical and immunohistochemical methods. Results:, Fourteen days after the induction of periodontitis, the resorption of alveolar bone at furcation was observed and cytokines such as interleukin-1,, transforming growth factor-,1, receptor activator of nuclear factor-,B ligand, receptor activator of nuclear factor-,B and osteoprotegerin were found. In the Emdogain-treatment group, the formation of new acellular cementum and, more remarkably, recovery of the bone, were observed. The new bone formation ratio in the Emdogain treatment group was significantly higher than that of the propylene glycol alginate treatment group. Although the expression of cytokines such as interleukin-1,, transforming growth factor-,1, receptor activator of nuclear factor-,B ligand and receptor activator of nuclear factor-,B was very low, bone morphogenetic protein-2- and bone morphogenetic protein-4-expressing macrophages were observed close to the root, and bone morphogenetic protein-4-expressing macrophages were mainly observed close to the bone surface at the furcation in the Emdogain-treatment group. Conclusion:, These results suggest that wound-healing macrophages may express bone morphogenetic protein and play an important role in the regeneration of periodontal tissue at the furcation following the application of Emdogain gel. [source] Nanofiber Generation of Gelatin,Hydroxyapatite Biomimetics for Guided Tissue Regeneration,ADVANCED FUNCTIONAL MATERIALS, Issue 12 2005H.-W. Kim Abstract The development of biomimetic bone matrices is one of the major goals in the bone-regeneration and tissue-engineering fields. Nanocomposites consisting of a natural polymer and hydroxyapatite (HA) nanocrystals, which mimic the human bone matrix, are thus regarded as promising bone regenerative materials. Herein, we developed a biomimetic nanocomposite with a novel nanofibrous structure by employing an electrospinning (ES) method. The HA precipitate/gelatin matrix nanocomposites are lyophilized and dissolved in an organic solvent, and then electrospun under controlled conditions. With this process, we can successfully generate a continuous fiber with a diameter of the order of hundreds of nanometers. The internal structure of the nanofiber features a typical nanocomposite, i.e., HA nanocrystals well distributed within a gelatin matrix. These nanocomposite fibers improve the bone-derived cellular activity significantly when compared to the pure gelatin equivalent. This method of generating a nanofiber of the biomimetic nanocomposite was effective in producing a biomedical membrane with a composition gradient, which is potentially applicable in the field of guided tissue regeneration (GTR). [source] Release of gentamicin from bone regenerative materials: An in vitro studyJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2007M. Teller Abstract Antibiotic loading of bone regenerative materials is a promising way to protect augmentation procedures from infection during the resorption phase of bone substitutes. Especially in the early stage of implantation, it should protect the grafted site against microbiological pathogens. The present study reports the release kinetics of gentamicin after loading from two synthetic bone filling materials. The first, BONITmatrix®, is a biphasic calcium phosphate silica composite obtained by the sol,gel route consisting of 13% silicon dioxide (w/w) and calcium phosphates (hydroxyapatite/,-tricalcium phosphate 60/40 w/w). The second, Synthacer®, is a sintered hydroxyapatite ceramic. Gentamicin was loaded by dipping and by vacuum coating. Release kinetics of the loaded Gentamicin was investigated by fluorescence polarization immunoassay and by staphylococcus aureus assay. By dipping, loading failed for Synthacer, and it was 12.7 mg gentamicin per gram bone substitute for BONITmatrix. By vacuum coating, loading was 11.3 mg gentamicin per gram bone substitute for Synthacer and 7.4 mg gentamicin per gram bone substitute for BONITmatrix. Distinct release kinetics were measured. For Synthacer, a high initial release was followed by a lower protracted release level up to 28 days. For BONITmatrix release was continuous over the investigated 70-day period. The present data suggest that the porosity properties at the nano- and microscopic levels, or the composition are responsible for antibiotic loading and subsequent release. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] | |||||||||||||