Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2018, vol. 55, nr 3, July-September, p. 289–297

doi: 10.17219/dmp/94204

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Early postoperative healing following guided tissue regeneration in aggressive periodontitis patients

Wczesne gojenie pozabiegowe po sterowanej regeneracji tkanek u pacjentów z agresywnym zapaleniem przyzębia

Bartłomiej Górski1,A,B,C,D, Tomasz Kaczyński1,B,C, Andrzej Miskiewicz1,B,C, Renata Górska1,E,F

1 Department of Periodontology and Oral Diseases, Medical University of Warsaw, Poland

Abstract

Background. In order to regenerate periodontal tissues, necessary conditions for this process must be created during surgery, primarily by allowing uninfected adhesion of the clot to the root surface, and then its stable position in the defect.
Objectives. The aim of this secondary analysis was to evaluate early postoperative healing of papillary incisions and its correlations with patient-, siteand technique-related factors following guided tissue regeneration (GTR) in treatment of intrabony defects in patients with aggressive periodontitis (AgP).
Material and Methods. The analysis included the data from 25 patients and 59 treatment sites. Surgical treatment consisted of using grafts together with collagen membranes. Post-operative healing was assessed 1 week and 2 weeks after GTR using the Early Wound-Healing Index (EHI).
Results. Early Wound-Healing Index values ranged from 1 (complete flap closure and primary healing) to 4 (incomplete flap closure, partial tissue necrosis, secondary healing). After 1 week, primary healing (EHI ≤ 3) was observed in 55 sites, and secondary healing (EHI = 4) in 4 sites. After 2 weeks, the values were 45 and 14, respectively. No correlations between EHI and patient-related factors were found. However, 1-rooted teeth, sites with thin phenotype and the presence of gingival recessions were associated with impaired healing (higher EHI recordings and secondary healing), as was analyzed in a multiple regression model.
Conclusion. Site-related factors may impinge on the early postoperative healing of papillary incisions succeeding GTR in AgP patients.

Key words

wound healing, aggressive periodontitis, guided tissue regeneration, papilla preservation flap

Słowa kluczowe

gojenie się ran, agresywne zapalenie przyzębia, sterowana regeneracja tkanek, płat oszczędzający brodawkę

References (28)

  1. Lang NP, Bartold PM, Cullinan M, et al. Consensus report: Aggressive periodontitis. Ann Periodontol. 1999;4(1):53.
  2. Agari R, Yari K, Mansouri K, Bakhtiari M. Association analysis of FAS-670A/G and FASL-844C/T polymorphisms with risk of generalized aggressive periodontitis disease. Biomed Rep. 2018;8(4):391–395.
  3. Susin C, Haas AN, Albandar JM. Epidemiology and demographics of aggressive periodontitis. Periodontol 2000. 2014;65(1):27–45.
  4. Susin C, Wikesjö UM. Regenerative periodontal therapy: 30 years of lessons learned and unlearned. Periodontol 2000. 2013;62(1):232–242.
  5. Burkhardt R, Lang NP. Fundamental principles in periodontal plastic surgery and mucosal augmentation: A narrative review. J Clin Periodontol. 2014;41(Suppl 15):S98–S107.
  6. Polimeni G, Xiropaidis AV, Wikesjö UM. Biology and principles of periodontal wound healing/regeneration. Periodontol 2000. 2006;41:30–47.
  7. Cortellini P, Tonetti MS. Clinical concepts for regenerative therapy in intrabony defects. Periodontol 2000. 2015;68(1):282–307.
  8. Bosshardt DD, Sculean A. Does periodontal tissue regeneration really work? Periodontol 2000. 2009;51:208–219.
  9. Kleinhein J, Büchter A, Kruse-Lösler B, Weingart D, Joos U. Incision design in implant dentistry based on vascularization of the mucosa. Clin Oral Implants Res. 2005;16(5):518–523.
  10. Cortellini P, Prato GP, Tonetti MS. The modified papilla preservation technique: A new surgical approach for interproximal regenerative procedures. J Periodontol. 1995;66(4):261–266.
  11. Cortellini P, Prato GP, Tonetti MS. The simplified papilla preservation flap: A novel surgical approach for the management of soft tissues in regenerative procedures. Int J Periodontics Rest Dent. 1999;19(6):589–599.
  12. Farina R, Simonelli A, Rizzi A, Pramstraller M, Cucchi A, Trombelli L. Early postoperative healing following buccal single flap approach to access intraosseous periodontal defects. Clin Oral Invest. 2013;17(6):1573–1583.
  13. Laugisch O, Ramseier CA, Salvi GE, et al. Effects of two different post-surgical protocols including either 0.05% chlorhexidine herbal extract or 0.1% chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement. Clin Oral Invest. 2016;20(8):2175–2183.
  14. Wachtel H, Schenk G, Böhm S, Weng D, Zuhr O, Hürzeler MB. Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects: A controlled clinical study. J Clin Periodontol. 2003;30(6):496–504.
  15. O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43(1):38–46.
  16. Ainamo J, Bay I. Problems and proposal for recording gingivitis and plaque. Int Dent J. 1975;25(4):229–235.
  17. Baker DL, Stanley Pavlow SA, Wikesjö UM. Fibrin clot adhesion to dentin conditioned with protein constructs: An in vitro proof-of-principle study. J Clin Periodontol. 2005;32(6):561–566.
  18. Mörmann W, Meier C, Firestone A. Gingival blood circulation after experimental wounds in man. J Clin Periodontol. 1979;6(6):417–424.
  19. Kohl JT, Zander HA. Morphology of interdental gingival tissues. Oral Surg Oral Med Oral Pathol. 1961;14:287–295.
  20. Jeffcoat MK, Kaplan ML, Rumbaugh CL, Goldhaber P. Magnification angiography in beagles with periodontal disease. J Periodontal Res. 1982;17(3):294–299.
  21. Hwang D, Wang HL. Flap thickness as a predictor of root coverage: A systematic review. J Periodontol. 2006;77(10):1625–1634.
  22. Rakmanee T, Griffiths GS, Auplish G, et al. Treatment of intrabony defects with guided tissue regeneration in aggressive periodontitis: Clinical outcomes at 6 and 12 months. Clin Oral Invest. 2016;20(6):1217–1225.
  23. Machtei EE. The effect of membrane exposure on the outcome of regenerative procedures in humans: A meta-analysis. J Periodontol. 2001;72(4):512–516.
  24. Ling LJ, Hung SL, Lee CF, Chen YT, Wu KM. The influence of membrane exposure on the outcomes of guided tissue regeneration: Clinical and microbiological aspects. J Periodontol Res. 2003;38(1):57–63.
  25. Mengel R, Soffner M, Flores-de-Jacoby L. Bioabsorbable membrane and bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis: Results of a 12-month clinical and radiological study. J Periodontol. 2013;74(6):899–908.
  26. Vergara JA, Quiñones CR, Nasjleti CE, Caffesse RG. Vascular response to guided tissue regeneration procedures using non-resorbable and bioresorbable membranes in dogs. J Periodontol. 1997;68(3):217–224.
  27. Zanetta-Barbosa D, Klinge B, Svennson H. Laser Doppler flowmetry of blood perfusion in mucoperiosteal flaps covering membrane sin bone augmentation and implant procedures: A pilot study in dogs. Clin Oral Implants Res. 1993;4:35–38.
  28. Esposito M, Grusovin MG, Papanikolaou N, Coulthard P, Worthington HV. Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects: A Cochrane systematic review. Eur J Oral Implantol. 2009;2(4):247–266.
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