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Published in: Clinical Oral Investigations 1/2007

01-03-2007 | Original Article

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

Authors: Tunç Ilgenli, Nesrin Dündar, Betül Ilhan Kal

Published in: Clinical Oral Investigations | Issue 1/2007

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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.
Literature
1.
go back to reference Aghaloo TL, Moy PK, Freymiller EG (2002) Investigation of platelet-rich plasma in rabbit cranial defects: a pilot study. J Oral Maxillofac Surg 60:1176–1181PubMedCrossRef Aghaloo TL, Moy PK, Freymiller EG (2002) Investigation of platelet-rich plasma in rabbit cranial defects: a pilot study. J Oral Maxillofac Surg 60:1176–1181PubMedCrossRef
2.
go back to reference Benn DK (1992) A computer-assisted method for making linear radiographic measurements using stored regions of interest. J Clin Periodontol 19:326–332CrossRef Benn DK (1992) A computer-assisted method for making linear radiographic measurements using stored regions of interest. J Clin Periodontol 19:326–332CrossRef
3.
go back to reference 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 60:675–682PubMed 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 60:675–682PubMed
4.
go back to reference 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 62:690–702PubMed 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 62:690–702PubMed
5.
go back to reference 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 37:300–306PubMedCrossRef 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 37:300–306PubMedCrossRef
6.
go back to reference Carlson NE, Roach RB (2002) Platelet-rich plasma: clinical applications in dentistry. J Am Dent Assoc 133:1383–1386PubMed Carlson NE, Roach RB (2002) Platelet-rich plasma: clinical applications in dentistry. J Am Dent Assoc 133:1383–1386PubMed
7.
go back to reference 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 66:488–493PubMed 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 66:488–493PubMed
8.
go back to reference 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 66:797–803PubMed 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 66:797–803PubMed
9.
go back to reference 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 25:981–987PubMedCrossRef 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 25:981–987PubMedCrossRef
10.
go back to reference Cortellini P, Tonetti MS (1999) Radiographic defect angle influences the outcomes of GTR therapy in intrabony defects. J Dent Res 78:381 (special issue) Cortellini P, Tonetti MS (1999) Radiographic defect angle influences the outcomes of GTR therapy in intrabony defects. J Dent Res 78:381 (special issue)
11.
go back to reference 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 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
12.
go back to reference 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 33:156–165PubMedCrossRef 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 33:156–165PubMedCrossRef
13.
go back to reference 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 33:48–55PubMedCrossRef 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 33:48–55PubMedCrossRef
14.
go back to reference 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 15:301–307CrossRef 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 15:301–307CrossRef
15.
go back to reference 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 14:500–508PubMedCrossRef 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 14:500–508PubMedCrossRef
16.
go back to reference 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 19:570–577PubMedCrossRef 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 19:570–577PubMedCrossRef
17.
go back to reference Garrett S, Bogle G (1994) Periodontal regeneration with bone grafts. Curr Opin Periodontol 168–177 Garrett S, Bogle G (1994) Periodontal regeneration with bone grafts. Curr Opin Periodontol 168–177
18.
go back to reference Genco RJ (1987) Highlights of the conference and perspectives for the future. J Periodontal Res 22:164–171PubMedCrossRef Genco RJ (1987) Highlights of the conference and perspectives for the future. J Periodontal Res 22:164–171PubMedCrossRef
19.
go back to reference Gunsolley J, Elswick RK, Davenport JM (1998) Equivalence and superiority testing in regeneration clinical trials. J Periodontol 69:521–527PubMed Gunsolley J, Elswick RK, Davenport JM (1998) Equivalence and superiority testing in regeneration clinical trials. J Periodontol 69:521–527PubMed
20.
go back to reference 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 14:578–583PubMedCrossRef 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 14:578–583PubMedCrossRef
21.
go back to reference 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 60:1018–1025PubMedCrossRef 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 60:1018–1025PubMedCrossRef
22.
go back to reference 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 72:1639–1646PubMedCrossRef 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 72:1639–1646PubMedCrossRef
23.
go back to reference Kornman KS, Robertson PB (2000) Fundamental principles affecting the outcomes of therapy for osseous lesions. Periodontol 2000 22:22–43PubMedCrossRef Kornman KS, Robertson PB (2000) Fundamental principles affecting the outcomes of therapy for osseous lesions. Periodontol 2000 22:22–43PubMedCrossRef
24.
go back to reference 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 71:1110–1116PubMedCrossRef 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 71:1110–1116PubMedCrossRef
25.
go back to reference 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 72:1157–1163PubMedCrossRef 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 72:1157–1163PubMedCrossRef
26.
go back to reference 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 73:198–205PubMedCrossRef 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 73:198–205PubMedCrossRef
27.
go back to reference 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 85:638–646PubMedCrossRef 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 85:638–646PubMedCrossRef
28.
go back to reference Mellonig JT (1984) Decalcified freeze-dried bone allografts as an implant material in human periodontal defects. Int J Periodontics Restorative Dent 4:40–55PubMed Mellonig JT (1984) Decalcified freeze-dried bone allografts as an implant material in human periodontal defects. Int J Periodontics Restorative Dent 4:40–55PubMed
29.
go back to reference Mellonig JT (1992) Autogenous and allogeneic bone grafts in periodontal therapy. Crit Rev Oral Biol Med 3:333–352PubMed Mellonig JT (1992) Autogenous and allogeneic bone grafts in periodontal therapy. Crit Rev Oral Biol Med 3:333–352PubMed
30.
go back to reference Mellonig JT, Bowers GM, Bailey RC (1981b) Comparison of bone graft materials. Part II. A histological evaluation. J Periodontol 52:297–302PubMed Mellonig JT, Bowers GM, Bailey RC (1981b) Comparison of bone graft materials. Part II. A histological evaluation. J Periodontol 52:297–302PubMed
31.
go back to reference 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 52:291–296PubMed 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 52:291–296PubMed
32.
go back to reference 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 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
33.
go back to reference 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 26:833–840PubMedCrossRef 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 26:833–840PubMedCrossRef
34.
go back to reference 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 53:726–730PubMed 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 53:726–730PubMed
35.
go back to reference 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 34:80–90PubMedCrossRef 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 34:80–90PubMedCrossRef
36.
go back to reference 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 73:423–432PubMedCrossRef 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 73:423–432PubMedCrossRef
37.
go back to reference 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 67:918–926PubMed 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 67:918–926PubMed
38.
go back to reference 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 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
39.
go back to reference Tonetti M, Pini-Prato G, Cortellini P (1993) Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol 64:934–940PubMed Tonetti M, Pini-Prato G, Cortellini P (1993) Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol 64:934–940PubMed
40.
go back to reference Tonetti M, Cortellini P (1997) Case selection and treatment considerations of guided tissue regeneration in deep intrabony defects. Curr Opin Periodontol 4:82–88PubMed Tonetti M, Cortellini P (1997) Case selection and treatment considerations of guided tissue regeneration in deep intrabony defects. Curr Opin Periodontol 4:82–88PubMed
41.
go back to reference 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 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
42.
go back to reference 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 31:643–647PubMedCrossRef 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 31:643–647PubMedCrossRef
43.
go back to reference 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 71:1671–1679PubMedCrossRef 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 71:1671–1679PubMedCrossRef
44.
go back to reference 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 71:752–759PubMedCrossRef 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 71:752–759PubMedCrossRef
Metadata
Title
Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation
Authors
Tunç Ilgenli
Nesrin Dündar
Betül Ilhan Kal
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 1/2007
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-006-0083-y

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