SİGARANIN MİNE MATRİKS PROTEİNLERİ VE BİYOAKTİF CAM ESASLI VEYA SIĞIR KAYNAKLI KEMİK GREFT MATERYALİ KOMBİNASYONLARI ÜZERİNE ETKİLERİ

Abstract

Bu çalışmada, sigaranın, mine matriks proteinleri (MMP) ve biyoaktif cam esaslı (BC) veya sığır kaynaklı kemik greft (SKKG) materyali ile kombine kullanımı üzerindeki etkisinin değerlendirilmesi amaçlandı. Çalışmaya 10 sigara içen 10 sigara içmeyen 20 generalize agresif periodontitis hastası dahil edildi. Her hastada MMP+BC ve MMP+SKKG kombinasyonları sondalama derinliği (SD) > 5 mm ve kemik içi defekt derinliği > 3 mm olan kemik içi defektlere uygulandı. Klinik ve radyografik değerlendirmeler operasyondan önce ve operasyon sonrası 8. ayda yapıldı. Defektin en derin noktasında, sigara içen bireylerde, MMP+BC ve MMP+SKKG gruplarında sırasıyla, 3.16±0.96 mm ve 3.09±1.18 mm SD azalması, 1.86 ±0.72 mm ve 1.93±0.64 mm ataşman kazancı, 0.92±0.31 mm ve 1.24±0.33 mm klinik kemik kazancı, 0.59±0.80 mm ve 0.58±0.31 mm radyografik kemik kazancı, sigara içmeyen bireylerde, MMP+BC ve MMP+SKKG gruplarında sırasıyla, 3.43±1.30 mm ve 3.55±1.07 mm SD azalması, 2.0±0.69 mm ve 2.17±0.61 mm ataşman kazancı, 1.20±0.25 mm ve 1.29±0.31 mm klinik kemik kazancı, 0.60± 0.75 mm ve 0.69±0.37 mm radyografik kemik kazancı elde edildi. Her iki tedavi grubunda da sigara içen ve içmeyen bireyler arasında incelenen parametreler açısından istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Bu çalışmanın sınırları dahilinde sigaranın her iki rejeneratif materyal kombinasyonları üzerinde anlamlı bir etkisinin olmadığı sonucuna varılabilir.

Keywords

• Mine matriks proteinleri, biyoaktif cam, sığır kaynaklı kemik grefti, generalize agresif periodontitis, sigara

References

1. Armitage GC. Development of classification system for periodontal diseases and conditions. Ann Periodontal, 1999; 4: 1-6.
2. American Academy of Periodontology. Para­ meter on aggressive periodontitis. J Perio­ dontal, 2000; 71: 867-869.
3. Page RC, Kornman KS. The pathogenesis of human periodontitis: an introduction. Periodontal, 2000; 1997, 14: 9-11.
4. A h M K , Johnson GK, Kaldahl WB, Patil K D , Kalkwarf K L . The effect of smoking on the response to periodontal therapy. J Clin Periodontol, 1994; 21: 91-97.
5. Kinane DF, Radvar M . The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol, 1997; 68: 467-472.
6. Salvi GE, Lawrence HP, Offenbacher S, Beck JD. Influence of risk factors on the pathogenesis of periodontitis. Periodontol 2000, 1997; 14: 173-201.
7. Tonetti MS, Pini-Prato G, Cortellini P. Effect of cigarette smoking on periodontal healing following GTR i n infrabony defects. A preliminary retrospective study. J Clin Periodontol, 1995; 22: 229-234.
8. Cattaneo V, Cetta G, Rota C, Vezzo F, Rota M T , Gallanti A, Borrato R, Poggi P. Volatile components of cigarette smoke: effect of acrolein and acetaldehyde on human gingival fibroblasts i n vitro. J Periodontol, 2000; 71: 425- 432.

9. Sayers N M , James JA, Drucker DB, Blinkhorn AS. Possible potentiation of toxins from prevotella intermedia, prevotella nigrescens and porphyromonas gingivalis by cotitine. J Periodontol, 1999; 70: 1269-1275.
10. Tanur E, Mc Quade MJ, Mc Pherson JC, A l - Hashimi I H , Rivera-Hidalgo F. Effects of nicotine on strength of attachment of gingival fibroblasts to glass and non-diseased human root surfaces. J Periodontol, 2000; 71: 717-722.
11. Hollinger JO, Schmitt JM, Hwang K, Soleymani P, Buck D. Impact of nicotine on bone healing. J Biomed Mater Res, 1999; 45: 294-301.
12. Mullally B H , Bren B, Linden GJ. Smoking and patterns of bone loss i n early- onset periodontitis. J Periodontol, 1999; 70: 394-401.
13. Froum S, Weinberg M A , Tarnow D. A comparison study utilizing open flap debridement with and without enamel matrix derivative i n the treatment o f periodontal intrabony defects. A 12 month re-entry study. J Periodontol, 2001; 72: 25-34.
14. Heden G. A case report study of 72 consecutive Emdogain-treated intrabony periodontal defects: Clinical and radiographic findings after 1 year. Int J Periodont Rest Dent, 2000; 20: 127-139.
15. Kuru B, Yılmaz S, Argın K, Noyan Ü. Enamel matrix protein derivative alone or combination with bioactive glass i n wide intrabony defects. Clin Oral Invest, 2006; 10: 227-234.
16. Vandana K L , Shah K, Prakash S. Clinical and radiographic evaluation of Emdogain as a regenerative material in the treatment of interproximal vertical defects i n chronic and aggressive periodontitis patients. Int J Periodontics Restorative Dent, 2004; 24: 185ı 191.
17. Camargo PM, Lekovic V, Weinlaender M , Vasilic N , Kenney EB Madzarevic M . The effectiveness of enamel matrix proteins used in combination with bovine porous bone mineral in the treatment of intrabony defects i n humans. J Clin Periodontol, 2001; 29: 1016ı 1022.
18. Cochran CD, Jones A, Heijl L , Mellonig JT, Schoolfield J, King GN. Periodontal regeneration with a combination of enamel matrix proteins and autogenous bone grafting. J Periodontol, 2003; 74: 1269-1281.
19. Döri F, Arweiller N , Gera I , Sculean A. Clinical evaluation of an enamel matrix protein derivative combined with either a natural bone mineral or p- tricalcium phosphate. J Periodontol, 2005; 76: 2236-2243.
20. Gurinsky BS, Mills MP, Mellonig JT. Clinical evaluation of demineralized freeze-dried bone allograft and enamel matrix derivative versus enamel matrix derivative alone for the treatment of periodontal osseous defects i n humans. J Periodontol, 2004; 75: 1309-1318.
21. Lekovic V, Camargo PM, Weinlaender M , Nedic M , Aleksic Z, Kenney EB. A comparison between enamel matrix protein used alone or i n combination with bovine porous bone mineral i n the treatment of intrabony periodontal defects i n human. J Periodontol, 2000; 71: 1110-1116.
22. Scheyer ET, Velasquez-Plata D, Brunsvold M A , Lasho DJ, Mellonig JT. A clinical comparison of a bovine-derived xenograft used alone and in combination with enamel matrix derivative for the treatment of periodontal osseous defects. J Periodontol, 2002; 73: 423ı 432.
23. Sculean A, Barbe G, Chiantella GC, Arweiler NB, Berakdar M , Brecx M . Clinical evaluation of enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans. J Periodontol, 2002; 73: 401-408.
24. Sculean A, Chiantella GC, Windisch P, Gera I , Reich E. Clinical evaluation of an enamel matrix protein derivative (Emdogain) combined with a bovine derived xenograft (Bio-Oss) for the treatment of intrabony periodontal defects in humans. Int J Periodontics Restorative Dent, 2002; 22: 259ı 267.
25. Sculean A, Windisch P, Keglevich T, Gera I . Clinical and histologic evaluation of an enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans. Int J Periodontics Restorative Dent, 2005; 25: 139ı 147.
26. Sculean A, Pietruska M , Schwartz F, Willershausen B, Arweiler N.B, Auschill T M . Healing of human intrabony defects following regenerative periodontal therapy with an enemal matrix protein derivative alone and combinated with a bioactive glass. J Clin Periodontol, 2005; 32: 111-117.
27. Velasquez-Plata D, Scheyer TE, Mellonig JT. Clinical comparison of an enamel matrix derivative used alone or i n combination with a bovine-derived xenograft for the treatment of periodontal osseous defects i n humans. J Periodontol, 2002; 73: 433-440.
28. Zucchelli G, Amore C, Montebugnoli L , De Sanctis M . Enamel matrix proteins and bovine porous bone mineral in the treatment of intrabony defects: A comparative controlled clinical trial. J Periodontol, 2003; 74: 1725ı 1735.
29. Yılmaz S, Çakar G, Yıldırım B, Sculean A. Healing of two and three wall intrabony periodontal defects following treatment with an enamel matrix derivative combined with autogenous bone. J Clin Periodontol, 2010; 544-550.
30. Lovelace TB, Mellonig JT, Meffert RM, Jones AA, Numikoski PV, Cochran D L . Clinical evaluation of bioactive glass i n the treatment of periodontal osseous defects i n humans. J Periodontol, 1998; 69: 1027-1035.
31. Berglundh T, Lindhe J. Healing around implants placed i n bone defects treated with Bio-Oss. A n experimental study i n the dog. Clin Oral Imp Res, 1997; 8: 117-124.
32. Silness J, Löe H . Periodontal disease in pregnancy (II). Correlation between oral hygiene and periodontal conditioning. Acta Odontologica Scandinavica, 1964; 22: 121ı 135.
33. Mühlemann HR, Son S. Gingival sulcus bleeding: a leading symptom i n initial gingivitis. Helvetica Odontologica Acta, 1971; 15: 107-112.
34. Schei O, Waerhaug J, Lovdal A, Arro A. Alveolar bone loss as related to oral hygiene and age. J Periodontol, 1959; 30: 7-16.
35. Nery EB, Olson JV, Henkin JM, Halbtleisch JH. Film holder device for radiographic assessment of periodontal tissues. J Periodont Res, 1985; 20: 97-105.
36. Sculean A, Windisch P, Keglevich T, Fabi B , Lundgren, E, Lyngstadaas PS. Presence of an enamel matrix protein derivative on human teeth following periodontal surgery. J Clin Oral Invest, 2002; 6: 183-187.
37. Wilson J, Pigott GH, Schoen FJ, Hench L L . Toxicology and biocompatibility of bioglasses. J Biomed Material Research, 1981; 15: 805ı 817.
38. Zamet JS, Darbar UR, Griffhiths S, Bulman JS, Bragger U , Burgin W, Newman H N . Particulate bioglass as a grafting material i n the treatment of periodontal intrabony defects. J Clin Periodontol, 1997; 24: 410-418.
39. Mellonig JT. Human histologic evaluation of a bovine derived xenograft i n the treatment of periodontal osseous defects. Int J Periodontics Restorative Dent, 2000; 20: 19-29.
40. Camelo M , Nevins M L , Lynch SE, Schenk RK, Simion M , Nevins M . Periodontal regeneration with an autogenous bone-Bio-Oss composite graft and a Bio-Gide membrane. Int J Periodont Rest Dent, 2000; 21: 109-119.
41. Calsina G, Ramon JM, Echeveria JJ. Effects of smoking on periodontal tissues. J Clin Periodontol, 29: 771-776, 2002.
42. Heard RH, Mellonig JT, Brunsvold M A , Lasho DJ, Meffert R M , Cochran D L . Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative i n the treatment of intrabony defects. J Periodontol, 2000; 71: 1715-1721.
43. Spahr A, Lyngstaads SP, Boeckh C, Andersson C, Podbielski A, Haller B. Effect of the enamel matrix derivative (Emdogain) on the growth of periodontal pathogens i n vitro. J Clin Periodontol, 2002; 29: 2-72.
44. Silverstein P. Smoking and wound healing. A m J Med, 93: 22-24, 1992.
45. Bosshardt DD. Biological mediators and periodontal regeneration: A review of enamel matrix proteins at the cellular and molecular levels. J Clin Periodontol, 35: 87-105, 2008.
46. Renvert S, Garret S, Nilveus R, Chamberlain A.D, Egelberg J. Healing after treatment of periodontal intraosseous defects. V I . Factors influencing the healing response. J Clin Periodontol, 1985; 12: 707-715.