Histological Examination of Retrieved ePTFE Membranes Following Regenerative Surgery of Intrabony Defects Treated with Platelet-rich Plasma and Bone Substitutes. 2022

Ferenc Dőri, and Anton Sculean, and Dániel Takács, and Zsuzsanna Suba

OBJECTIVE Regenerative periodontal therapy using platelet-rich plasma (PRP) and bone substitutes with guided tissue regeneration (GTR) have been proposed as a therapeutic method to enhance the outcome of regenerative surgery. This includes light microscopic evaluation of retrieved ePTFE membranes to assess formation of new connective tissue attachment, and following the regeneration process. The objectives of this study were to evaluate the histological findings of retrieved ePTFE membranes using PRP and bone substitutes, the effect of PRP on graft materials, and the correlation of the findings with the clinical outcomes. METHODS Seventy-two (72) patients with chronic periodontitis, each of whom had one deep intrabony defect, were randomly included in two studies and treated using the same type of membrane and different bone substitutes. In the first study, 17 cases were treated with a natural bone mineral and a non-resorbable membrane (NBM + GTR), and 17 cases were treated with PRP + NBM + GTR. In the second study, 19 patients were treated with β-tricalcium phosphate and a non-resorbable membrane (β-TCP + GTR), and 19 patients were treated with PRP + β-TCP + GTR. In both studies, tissue integration of the retrieved ePTFE membranes and attached remnants were evaluated histologically. RESULTS Histological scores showed that membranes combined with NBM are better integrated than membranes combined with β-TCP; the difference between the two decreased with the addition of PRP. The application of PRP had no significant effect on the quality of membrane integration combined with NBM, whilst significantly improving the integration quality when combined with β-TCP. No correlations were detected between the histological scores and the clinical attachment level (CAL) gain in any of the groups. CONCLUSIONS The present results indicate that: a) application of β-TCP and PRP may enhance membrane integration and periodontal healing, and b) histological examination of retrieved membranes may provide valuable additional information with regard to the clinical findings.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014945 Wound Healing Restoration of integrity to traumatized tissue. Healing, Wound,Healings, Wound,Wound Healings
D016557 Guided Tissue Regeneration, Periodontal Techniques for enhancing and directing cell growth to repopulate specific parts of the PERIODONTIUM that have been damaged by PERIODONTAL DISEASES; TOOTH DISEASES; or TRAUMA, or to correct TOOTH ABNORMALITIES. Repopulation and repair is achieved by guiding the progenitor cells to reproduce in the desired location by blocking contact with surrounding tissue by use of membranes composed of synthetic or natural material that may include growth inducing factors as well. Guided Periodontal Tissue Regeneration,Periodontal Guided Tissue Regeneration,Regeneration, Periodontal Guided Tissue
D017622 Periodontal Attachment Loss Loss or destruction of periodontal tissue caused by periodontitis or other destructive periodontal diseases or by injury during instrumentation. Attachment refers to the periodontal ligament which attaches to the alveolar bone. It has been hypothesized that treatment of the underlying periodontal disease and the seeding of periodontal ligament cells enable the creating of new attachment. Attachment Loss, Periodontal,Loss, Periodontal Attachment
D053657 Platelet-Rich Plasma A preparation consisting of PLATELETS concentrated in a limited volume of PLASMA. This is used in various surgical tissue regeneration procedures where the GROWTH FACTORS in the platelets enhance wound healing and regeneration. Plasma, Platelet-Rich,Platelet Rich Plasma
D018786 Bone Substitutes Synthetic or natural materials for the replacement of bones or bone tissue. They include hard tissue replacement polymers, natural coral, hydroxyapatite, beta-tricalcium phosphate, and various other biomaterials. The bone substitutes as inert materials can be incorporated into surrounding tissue or gradually replaced by original tissue. Bone Replacement Materials,Bone Replacement Material,Bone Substitute,Replacement Material, Bone,Replacement Materials, Bone,Substitutes, Bone,Material, Bone Replacement,Materials, Bone Replacement,Substitute, Bone

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