Efficacy of Periodontal Minimally Invasive Surgery with and Without Regenerative Materials for Treatment of Intrabony Defect: a Randomized Clinical Trial

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2021 Aug 20

PMID 34414521

Citations 5

Authors

Bei Liu

Xiangying Ouyang

Jun Kang

Shuangying Zhou

Chao Suo

Lingqiao Xu

Jianru Liu

Wenyi Liu

Affiliations

Soon will be listed here.

Abstract

Objectives: The minimally invasive surgical technique was modified in suture (MISTms) in this study. The trial was to determine the efficacy of MISTms with and without regenerative materials for the treatment of intrabony defect and to identify factors influencing 1-year clinical attachment level (CAL) gain.

Methods: Thirty-six patients with interdental intrabony defects were randomly assigned to MISTms (MISTms alone, 18) or MISTms plus deproteinized bovine bone mineral and collagen membrane (MISTms combined, 18). Wound healing was evaluated by early healing index (EHI) at 1, 2, 3, and 6 weeks. Probing depth (PD), CAL, gingival recession, radiographic defect depth, and distance from the base of defect to the cementoenamel junction were recorded at baseline and 1 year postoperatively. A one-year composite outcome measure based on the combination of CAL gain and post-surgery PD was evaluated. Factors influencing 1-year CAL gain were analyzed.

Results: Fifteen patients in MISTms-alone and 16 in the MISTms-combined group finished the study. The MISTms-alone group showed significantly better wound healing at 1 week. CAL significantly gained in the MISTms-alone and MISTms-combined group, with 2.53 ± 1.80 mm and 2.00 ± 1.38 mm respectively. The radiographic bone gain was 3.00 ± 1.56 mm and 3.85 ± 1.69 mm respectively. However, there were no significant differences between the two groups about 1-year outcomes. Lower EHI (optimal wound healing) and more baseline CAL positively influenced 1-year CAL gain.

Conclusions: MISTms is an effective treatment for intrabony defects. The regenerative materials do not show an additional effect on 1-year outcomes. Early wound healing and baseline CAL are factors influencing 1-year CAL gain.

Clinical Relevance: MISTms with and without regenerative materials are both effective treatments for intrabony defect.

Trial Registration: ClinicalTrials.gov Identifier: ChiCTR2100043272.

Citing Articles

A narrative review of papilla preservation techniques in clinical dentistry.

Fu Y, Zhang Z, Tang X, Su J Medicine (Baltimore). 2025; 104(3):e41033.

PMID: 39833085 PMC: 11749603. DOI: 10.1097/MD.0000000000041033.

Exploratory study on a novel minimally invasive tunnel like flap approach for orthodontic movement of dental implants.

Adly M, Cuisinier F, Adly A, Estephan E, Adly A, Bousquet P Clin Oral Investig. 2024; 28(11):595.

PMID: 39400762 DOI: 10.1007/s00784-024-05992-w.

Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 in combination with carbonate apatite granules or rhFGF-2 alone: 12-month randomized controlled trial.

Imamura K, Yoshida W, Seshima F, Aoki H, Yamashita K, Kitamura Y Clin Oral Investig. 2024; 28(11):574.

PMID: 39373727 DOI: 10.1007/s00784-024-05979-7.

From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials.

De Lauretis A, Ovrebo O, Romandini M, Lyngstadaas S, Rossi F, Haugen H Adv Sci (Weinh). 2024; 11(17):e2308848.

PMID: 38380549 PMC: 11077667. DOI: 10.1002/advs.202308848.

Clinical and radiographic evaluation of Bio-Oss granules and Bio-Oss Collagen in the treatment of periodontal intrabony defects: a retrospective cohort study.

Wang J, Cui W, Zhao Y, Lei L, Li H J Appl Oral Sci. 2024; 32:e20230268.

PMID: 38198370 PMC: 11019911. DOI: 10.1590/1678-7757-2023-0268.

References

Abusleme L, Hoare A, Hong B, Diaz P . Microbial signatures of health, gingivitis, and periodontitis. Periodontol 2000. 2021; 86(1):57-78. DOI: 10.1111/prd.12362. View

Jakubovics N, Goodman S, Mashburn-Warren L, Stafford G, Cieplik F . The dental plaque biofilm matrix. Periodontol 2000. 2021; 86(1):32-56. PMC: 9413593. DOI: 10.1111/prd.12361. View

Camelo M, Nevins M, Schenk R, Simion M, Rasperini G, Lynch S . Clinical, radiographic, and histologic evaluation of human periodontal defects treated with Bio-Oss and Bio-Gide. Int J Periodontics Restorative Dent. 2003; 18(4):321-31. View

Mellonig J . Human histologic evaluation of a bovine-derived bone xenograft in the treatment of periodontal osseous defects. Int J Periodontics Restorative Dent. 2001; 20(1):19-29. View

Tonetti M, Cortellini P, Lang N, Suvan J, Adriaens P, Dubravec D . Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap alone. A multicenter randomized controlled clinical trial. J Clin Periodontol. 2004; 31(9):770-6. DOI: 10.1111/j.1600-051X.2004.00562.x. View

Camargo P, Lekovic V, Weinlaender M, Nedic M, Vasilic N, Wolinsky L . A controlled re-entry study on the effectiveness of bovine porous bone mineral used in combination with a collagen membrane of porcine origin in the treatment of intrabony defects in humans. J Clin Periodontol. 2001; 27(12):889-96. DOI: 10.1034/j.1600-051x.2000.027012889.x. View

Nowzari H, Matian F, Slots J . Periodontal pathogens on polytetrafluoroethylene membrane for guided tissue regeneration inhibit healing. J Clin Periodontol. 1995; 22(6):469-74. DOI: 10.1111/j.1600-051x.1995.tb00179.x. View

De Sanctis M, Zucchelli G, Clauser C . Bacterial colonization of barrier material and periodontal regeneration. J Clin Periodontol. 1996; 23(11):1039-46. DOI: 10.1111/j.1600-051x.1996.tb00534.x. View

Harrel S, Rees T . Granulation tissue removal in routine and minimally invasive procedures. Compend Contin Educ Dent. 1995; 16(9):960, 962, 964 passim. View

10.

Cortellini P, Prato G, Tonetti M . The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. J Periodontol. 1995; 66(4):261-6. DOI: 10.1902/jop.1995.66.4.261. View

11.

Cortellini P, Prato G, Tonetti M . The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures. Int J Periodontics Restorative Dent. 2000; 19(6):589-99. View

12.

Cortellini P, Tonetti M . Microsurgical approach to periodontal regeneration. Initial evaluation in a case cohort. J Periodontol. 2001; 72(4):559-69. DOI: 10.1902/jop.2001.72.4.559. View

13.

Cortellini P, Tonetti M . Clinical performance of a regenerative strategy for intrabony defects: scientific evidence and clinical experience. J Periodontol. 2005; 76(3):341-50. DOI: 10.1902/jop.2005.76.3.341. View

14.

Cortellini P, Tonetti M . A minimally invasive surgical technique with an enamel matrix derivative in the regenerative treatment of intra-bony defects: a novel approach to limit morbidity. J Clin Periodontol. 2007; 34(1):87-93. DOI: 10.1111/j.1600-051X.2006.01020.x. View

15.

Cortellini P, Tonetti M . Minimally invasive surgical technique and enamel matrix derivative in intra-bony defects. I: Clinical outcomes and morbidity. J Clin Periodontol. 2007; 34(12):1082-8. DOI: 10.1111/j.1600-051X.2007.01144.x. View

16.

Ribeiro F, Nociti Junior F, Sallum E, Sallum A, Casati M . Use of enamel matrix protein derivative with minimally invasive surgical approach in intra-bony periodontal defects: clinical and patient-centered outcomes. Braz Dent J. 2010; 21(1):60-7. DOI: 10.1590/s0103-64402010000100010. View

17.

Ribeiro F, Casarin R, Junior F, Sallum E, Casati M . The role of enamel matrix derivative protein in minimally invasive surgery in treating intrabony defects in single-rooted teeth: a randomized clinical trial. J Periodontol. 2010; 82(4):522-32. DOI: 10.1902/jop.2010.100454. View

18.

Ribeiro F, Casarin R, Palma M, Junior F, Sallum E, Casati M . Clinical and patient-centered outcomes after minimally invasive non-surgical or surgical approaches for the treatment of intrabony defects: a randomized clinical trial. J Periodontol. 2011; 82(9):1256-66. DOI: 10.1902/jop.2011.100680. View

19.

Wachtel H, Schenk G, Bohm S, Weng D, Zuhr O, Hurzeler M . 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. DOI: 10.1034/j.1600-051x.2003.00013.x. View

20.

Fickl S, Thalmair T, Kebschull M, Bohm S, Wachtel H . Microsurgical access flap in conjunction with enamel matrix derivative for the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2009; 36(9):784-90. DOI: 10.1111/j.1600-051X.2009.01451.x. View