Use of enamel matrix derivatives and autogenous bone graft combination in the treatment of periodontal intrabony defects

Yıl 2013, Cilt: 3 Sayı: 1, 48 - 54, 30.01.2014

Ömer Birkan Ağralı , Bahar Kuru Leyla Kuru

Öz

Objective: Enamel matrix derivatives (EMD) are the purified form of the acidic extract related to embryonic period that contain amelogenin type proteins and have stimulation effect on cementum, periodontal ligament and bone formation. Autogenous bone graft (ABG) is the only bone graft that is originated intra- or extra-orally from patients and accepted as the gold standard since it contains osteoblasts and osteoprogenitor cells. In this case report, the treatment of two periodontal defects of a 43 year-old systemically healthy male patient with chronic periodontitis was presented. 

Methods: The defects had probing depths of 11 mm and 8 mm and were treated by the use of EMD combined with ABG. Before and 8 months after the periodontal flap surgery, full mouth plaque index, gingival index, bleeding on probing, on defects sites; probing deth, relative attachment level, gingival recession were measured and intrabony defect fill percentage was calculated on the standardized radiographs. 

Results: At the end of 8 months, parallel with clinical healing, changes in plaque index, gingival index and bleeding on probing were 0.18±0.13, 0.05±0.03 and 3.78% respectively. Probing depth reductions of defect #1 and #2 were 8 mm and 5 mm, attachment gains were 5 mm and 3 mm, respectively. Percentage of bone fill in #1 and #2 intrabony defects were calculated as 89% and 53%, respectively. 

Conclusions: Clinical and radiographical findings of this report suggest that treatment of deep intrabony periodontal defects in chronic periodontitis patient by the use of EMD and ABG combination provides favourable clinical healing without any complication.

Key words: Enamel matrix derivatives, autogenous bone graft, periodontal flap surgery

Anahtar Kelimeler

Enamel matrix derivatives, autogenous bone graft, periodontal flap surgery

Periodontal kemik içi defektlerin tedavisinde mine matriks proteini ve otojen kemik grefti kombinasyonu kullanımı

Öz

Amaç: Mine matriks türevleri (MMT), embriyonik döneme ait amelogenin proteinlerini içeren asidik ekstrenin saflaştırılmış şeklidir ve sement, periodontal ligament ve alveol kemiği oluşumu üzerine stimüle edici etkisi bulunmaktadır. Otojen kemik grefti (OKG), bireyin kendisinden elde edilen canlı osteoblast ve osteoprogenitör hücreler içermesi sebebiyle altın standart kabul edilen tek kemik greftidir. Bu olguda, kronik periodontitis tanısı konmuş ve başlangıç periodontal tedavisi tamamlanmış sistemik olarak sağlıklı 43 yaşındaki erkek hastada iki periodontal defektin tedavisi sunulmaktadır. 

Yöntemler: Sondalama derinliği 11 mm ve 8 mm olan iki adet kemik içi periodontal defekte MMT ve OKG kombinasyonu uygulandı. Periodontal flep operasyonundan önce ve 8 ay sonra tüm ağız plak indeks, gingival indeks, sondalamada kanama, defekt bölgelerinde sondalama derinliği, rölatif ataşman seviyesi, rölatif dişeti kenarı seviyesi ölçüldü ve standart radyografiler üzerinde kemik içi defekt dolum yüzdesi hesaplandı.

Bulgular: Sekizinci ayın sonunda ortalama plak indeks, gingival indeks ve sondalamada kanama değerlerinde sırasıyla 0.18±0.13, 0.05±0.03 ve %3.78 azalmaya, 1 ve 2 nolu defektlerde sondalama derinliği değerlerinde sırasıyla 8 mm ve 5 mm azalmaya ek olarak sırasıyla 5 mm ve 3 mm ataşman kazancı elde edilerek klinik iyileşmenin sağlandığı gözlendi. Standart radyografilerin değerlendirilmesi sonucunda defekt dolumu 1 ve 2 nolu defektler için sırasıyla %89 ve %53 olarak hesaplandı. 

Sonuç: Bu olgu sunumunun 8. ayda elde edilen klinik ve radyografik sonuçları, kronik periodontitisli hastadaki derin kemik içi periodontal defektlerin tedavisinde MMT+OKG kombine kullanımının herhangi bir komplikasyon gelişmeksizin olumlu düzeyde iyileşme sağladığını ortaya koymaktadır.

Anahtar Kelimeler : Mine matriks türevleri, otojen kemik grefti, periodontal flep operasyonu

Anahtar Kelimeler

Mine matriks türevleri, otojen kemik grefti, periodontal flep operasyonu

Kaynakça

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