Clinical healing following guided tissue regeneration (GTR) in intrabony pockets using a polyurethane membrane was compared to healing following gingival flap surgery (GFS).Ten patients with adult periodontitis and the presence of intrabony defects were selected. Oral hygienic treatments were performed during a 4- week's period prior to surgery.One intrabony defect on each patient was randomly chosen to be treated according to the guided tissue regeneration (GTR) procedure. The other side received the control treatment GFS. Test group received the GTP treatment including polyurethane membrane after reflecting the flap and curettage of defect. However, flap surgery and curettage were done in control group.The patients were evaluated for changes in probing depth (PD), clinical attachment level (CAL), recession changes in crystal resorting, and defect bone fill. Clinical examinations were performed again 6 months post operatively.The average of (PD), (CAL) and defect depth (DD) before surgery in test group was 3.23, 13.87 and 7.3 mm respectively and in control group was 3.1, 8.9, 7.4 mm. After 6 months the average of (PD), (CAL) and (DD) was 1.69, 1.68, 3.5 mm, respectively and in control group was 1.24, 1.09, and 2.90 mm. Test group and control group showed successful results in treatment of intrabony defects. Test group showed better results than control.No significant difference was observed between two treatment procedures from the point of view of pocket depth reduction, attachment gain, and recession.The bony fill and crystal resorption results suggest similar clinical potential of GTR procedures compared to GFS in treatment of intrabony pocket. However, in order to gain future insight, larger samples and longer observation periods should be evaluated.

Periodontal regeneration in a one-wall intrabony defect is a challenging and complex phenomenon. The combination therapy of commercially available bone grafts with the innovative tissue engineering strategy, the platelet rich plasma, has emerged as a promising grafting modality for two and three walled intrabony osseous defects. The application of this combination approach was attempted in a most challenging one-wall intrabony defect. Open flap debridement and placement of combination of autologous platelet rich plasma(PRP) and demineralized bone matrix was done in one-wall intrabony defect in relation to tooth #21 in a 30 year old female patient. The 6-month follow- up results showed significant improvement in clinical parameters. Radiographic evidence of bone formation was observed as early as 3 months with almost complete fill by 6 months post-operatively. The results were maintained over a period of 2 years.

Statement of problem: Digital measurement of RVG may improve diagnostic interpretation of radiographs in terms of accuracy, although it has been shown that validity of linear measurements of interproximal bone loss could not be improved by basic digital manipulations. Purpose: The aim of this study was to evaluate the accuracy of RadioVisioGraphy (RVG) in the linear measurement of interproximal bone loss in intrabony defects. Materials and Methods: Thirty two radiographs of 56 periodontally diseased teeth exhibiting interproximal intrabony defects were obtained by a standardized RVG technique and Intrabony defect depths were determined by linear measurement analysis of RVG. The following four distances were assessed intrasurgically: the cemento enamel junction (CEJ) to the alveolar crest, the CEJ to the deepest extention of the bony defect (BD), the occlusal plane to the BD and the OP to the AC. Comparison between RVG measures and intrasurgical estimates were performed using paired t-test. Results: The radiographic measurements overestimated interproximal bone loss as compared to the intrasurgical measurements: CEJ-BD measurement by RVG was 6.803±3.589 mm and intra-surgically was 6.492±3.492 (P<0.000). No statistically significant difference was seen between CEJ and occlusal references in RVG measurements (P<0.729). Conclusion: Radiographic assessment by either the CEJ or occlusal references overestimated bone loss as compared to the intrasurgical gold standard.

The aim of the present study was the histological evaluation of Enamel Matrix Derivative (EMD) effectiveness for regeneration of periodontal defects. EMD activates cementum synthesis, PDL and bone during the maturation stage of follicole. In this research, EMD was used in surgical defects of premolar teeth in four adult sheep. Muccoperiosteal flap was reflected in buccal site of teeth. The buccal bone plate was removed from mesial to distal in 4 mm depth. After eliminating the cementum by bur and its etching, EMD was applied on exposed dentine and flap was sutured. In opposite sites of those teeth (control sites) the same process was performed without etching. After 100 days, sheep were sacrificed and histological study through light microscopic was performed on black sections of operation sites. The results showed that in test sites, regeneration of cementum and bone was 62/5% and 42/5-50% respectively. But in control sites regeneration of cementum and bone was 37.5% and 32/5-42/5% respectively. Also the migration of junctional epithelium in control sites was 8-10% more than test sites. The important point is that in test sites, cementum was completely attached to undermining dentine. But, in control sites, the gap between cementum and dentine was visible. As a result, this study suggests that EMD promotes periodontal regeneration, and EMD application is a successful achievement in regenerative periodontal therapy.

One of the important indications for the extraction of mandibular impacted third molar is to preserve the periodontal health of the adjacent second molar from the destructive effects of plaque accumulation, acute and chronic inflammation.Aim: The purpose of this study was to determine the effect of mandibular third molar surgery on the PDL of the adjacent molar.Materials and Methods: Thirty patients, referred to the department of maxillofacial surgery, Tehran University of Medical Sciences, were selected, based on the desirable conditions. They had no history of systemic diseases and their adjacent molar was healthy. Probing depth (PD) at seven points and attachment level (AL) at three points were measured preoperatively. Standardized periapical radiographies were taken regularly for all patients. All the above-mentioned procedures repeated after three months of surgery. Findings were analyzed by Paired t-test.Results: A significant difference in probing depth (PD) was observed before and after surgery. Meaning that probing depth decreased after mandibular third molar surgery. Attachment level was also decreased post operatively: moreover. Intrabony defects (IBD) showed healing after surgery.Conclusion: Considering the limitations of the present study, impacted third molar surgery is suggested to prevent periodontal problems of the adjacent molar.

Background: Platelet derivatives are enriched growth factors that ameliorate various cellular processes in regeneration. The present clinical trial aimed to evaluate and compare the effects of sticky bone and concentrated growth factors (CGFs) in the treatment of intrabony osseous defects by cone‑, beam computed tomography (CBCT). Materials and Methods: The study included 20 patients having 40 intrabony defects. 20 sites each were included in both test group (Sticky bone) and Control group (CGF alone). The clinical parameters including probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline and 6 and 12 months posttherapy. The radiographic parameters including the depth, mesiodistal (MD), and the buccolingual (BL) width of the defect to assess the amount of bone fill were examined at baseline and after 12 months using CBCT. Results: Twelve months posttherapy clinical results indicated a significant reduction of PPD and gain in CAL in both the study groups. Similar observations were recorded with CBCT radiographic parameters where the intrabony defect depth and MD defect width for the test group and control group significantly reduced after 12 months’,posttherapy (P < 0. 0001). However, no significant reduction in BL defect width was observed in control group (P = 0. 577) in contrast to the test group (P = 0. 028) after 12 months’,posttherapy. Conclusion: Intrabony defects treated with sticky bone showed improved clinical and radiographic parameters indicative of enhanced periodontal regeneration as compared to CGF alone treated sites.

Statement of Problem: The goal of bone regenerative therapy is to reconstruct the damaged tissues to initial condition, which seems so important in periodontology and implantology. In such therapies, different biomaterials, with some advantages and disadvantages, may by use.Purpose: The aim of this research was to evaluate the quality, bone trabecular density and thickness of newly forming bone as well as foreign body reaction against Biostite®, in comparison with the control group.Material and Methods: In this experimental study the total number of 5 sheep was operated with general anesthesia. At first 10 standard defects were created in 5x5x5 mm on the left and right edentulous mandibular ridge. Five defects were randomly treated by Biostite®, the remaining five were considered as controls. After six months, the sheep were sacrificed and the separated defect areas with intact margin were placed in 10% formalin and prepared for histologic and histomorphometric study. To analyze the data, Mann- Whitney U test was used.Results: The mean percentage of new bone formation in Biostite®group was statistically more han the control group (P<0.05). Newly formed bone was vital in both groups which was a combination of lamellar and woven types, however, the thickness and density of new bone in biostite® group was more than the controls. Foreign body reaction was observed in Biostite® group. Conclusion: It is suggested that Biostite® synthetic material can be useful in bone regenerative therapies.

Introduction: The quest for finding a regenerative material for periodontal defects is everlasting. Numerous resorbable, nonresorbable, synthetic, and autogenous materials have been tried and tested in this regard. The periosteum has gained popularity in this field as it has exhibited osteogenic properties. The harvest of the periosteum is hassle-freeanddoes not cause additional surgical sites. Case Presentation: The present case report demonstrates the successful use of the periosteum as a barrier membrane in the treatment of an intrabony defect. A 25-year-old female patient reported a complaint of food lodgement and bleeding gums. Clinical and radiographic examinations suggested an intrabony defect concerning the maxillary molar. The periosteum pedicle as a barrier membrane, along with bone graft, was used to treat the defect. Conclusions: The outcome was favorable in defect filling and soft tissue thickness.

Background: Intrabony lesions caused by periodontal disease are of particular importance in terms of treatment. Such lesions have been treated with different methods including the use of autogenous bone harvested or allogeneic grafts, guided tissue regeneration (GTR) and enamel matrix proteins use (EMP) or a combination of these methods. Recently, the use of low power laser or Low-level lasertherapy (LLLT) as one of the new methods to improve bone repair has been of great interest. The purpose of this study was to compare the use of autogenous bone alone and in combination with Low-level laser therapy (LLLT) in the treatment of two and three wall periodontal intrabony defects in vivo.Material and Methods: A number of 14 patients with moderate to severe chronic periodontitis were with bilateral intrabony defect (probing pocket depth of at least 5 mm and intrabony component of at least 3 mm) were included. In a split mouth study, 14 defects were treated in one side by OFD and autogenous bone while in the contralateral side Low-level laser therapy was done as an adjunct treatment to the OFD and autogenous bone grafting. A GaAlAs diode laser (830 nm) (continuous wave 40 Mw and fluence 4 J/cm2 with total energy density of 16 J/cm2) was used. Laser therapy was repeated at days 3, 5 and 7 with the same parameters. Re-entry surgeries were done after 3 months. Clinical probing pocket depth, clinical attachment level, gingival margin level, alveolar crest level and the deepest part of the defect all were recorded relative to an acrylic stent at baseline and after 3 months. intrabony defect depth was also recorded at baseline and after 3 months.Results: Application of a low level laser with the parameters listed reduced probing depth (3.78 ± 0.72 mm vs. 2.39 ± 1.02 mm), improved the clinical attachment level (3.42 ± 0.93 mm vs. 2.25 ± 1.12 mm), reduced the distance between deepest part of the defect to stent (3.21 ± 1.03 mm vs. 1.44 ± 0.20 mm) and also reduced defect depth (1.33 ± 0.18mm versus 2.50 ± 0.91 mm ) significantly when compared to control group, while it had no significant effect on gingival margin level and alveolar crest level.Conclusion: The results of this study suggest the use of low level laser therapy in combination with autogenous bone can improve the periodontal treatment outcome in terms of probing depth reduction, clinical attachment level improvement and reduction of the defect depth.

Objective: This randomized clinical trial was aimed at comparing the outcomes of palatal connective tissue + Bio-Oss + PRGF versuscollagen membrane + Bio-Oss+ PRGFin the treatment of intrabny defects.Methods: Fifteen patients affected by chronic periodontitis were enrolled. Each patient had at least two intrabonydefect (³3 mm). They were randomly assigned into two groups: patients treated i) with collagen membrane + PRGF + Bio-oss (control group) and ii) with palatal connective tissue as membrane + PRGF + Bio-Oss (experimental group). Clinical and intrasurgical examinations included probing depth (PD), clinical attachment level (CAL), gingival recession (GR), defect fill (DF), alveolar crest level (AC) and defect resolution (DR) were measured at baseline and after 6 months with re-entry surgery. Statistical analysis was performed usingTwo-way Repeated Measure ANOVA and Wilcoxon.Results: After 6 months, all of the evaluated clinical parameters showed statistically significant changes from baseline within each group (p<0.05). The test group showed a significantly smaller amount of gingival recession as compared with control group (0.8 mm versus 1.7 mm respectively; P<0.05). But there were not any statistically differences in other clinical parameters between the test and control groups (P>0.05): pocket depth reduction (3.7 mm versus 3.5 mm), clinical attachment gain (1.8 mm versus 1.6 mm), alveolar crest loss (1.8 mm versus 1.7 mm), defect fill (2.3 mm versus 2.2 mm) and defect resolution (4.1 mm versus 3.9 mm).Conclusion: According to the results obtained from this study it can be suggested that clinical effects of application of palatal connective tissue as a membrane and collagen membrane, in combination with Bio-Oss and PRGF in treatment of vertical bone defects, did not have any statistical significant differences except for gingival recession that was statistically smaller in connective tissue group.