Evaluaton of the Use of Bone Implants as a Therapy for Deep Defects in the Parodoncium

Abstract

Reconstruction of infrabony defects created by the chronic inflammatory processes of parodontopathy represents a major clinical problem in paradontology.The objective of this research was to compare and evaluate the efficiency of two bone substituents at reversing the deep infrabony defects in the paradentium after the application of a new “Biohapel” material consisting of biphasic calcium phosphate/poly DL-lactide-co-glycolide.This study included 12 patients of both genders with an average age of 49.7 years who were suffering from clinically manifested parodontopathy. The main criteria for selecting patients were the presence of six similar infrabony periodontal defects that were at least 4 mm deep and in the lower side of the teeth on both sides of the jaw. After applying a basic causal parodontopathy treatment, defects were divided into two groups, including an experimental group (n=72) in which defects were reconstructed using the “Biohapel” bone substituent (on one side of the lower jaw) and a control group (n=72) in which infrabony defects were reconstructed using β tricalcium phosphate (βTCP) (CerasorbR), a preparation very commonly applied in regenerative parodontopathy treatment (on the other side of the lower jaw). Markers to assess treatment efficacy were determined before surgery and 6 months after surgery by measuring the depth of periodontal pocket and the level of the junctional epithelium.We observed statistically significant differences in the periodontal regeneration markers between the experimental and control groups (p<0.05).Application of “Biohapel” during the surgical treatment of infrabony defects in the paradentium significantly improves the bone regeneration of the paradentium when compared with the standard application of β-tricalcium phosphate .Osnovni klinički problem u terapiji parodontopatije predstavlja rekonstrukcija infrakoštanih defekata nastalih u toku hroničnog inflamatornog procesa.Cilj ovog istraživanja bio je da se uporede primene dva koštana substituenta i proceni uspešnost regeneracije dubokih infrakoštanih defekata parodoncijuma, posle primene novog materijala bifaznog kalcijum fosfata/poli-dl-laktid-koglikolida- “Biohapel”-a.U istraživanje je uključeno 12 pacijenata, oba pola, prosečne starosti 49, 7 godina, sa klinički manifestnom parodontopatijom. Osnovni uslov za odabir pacijenata za studiju bilo je prisustvo šest sličnih infrakoštanih parodontalnih defekta najmanje dubine 4 mm, u predelu istoimenih donjih bočnih zuba, sa obe strane vilice. Nakon sprovedene bazične kauzalne terapije parodontopatije, defekti su podeljeni u 2 grupe: eksperimentalnu grupu (n=72), koja je rekonstruisana “Biohapel” koštanim zamenikom (jedna strana donje vilice), i kontrolnu grupu (n=72), gde su infrakoštani defekti rekonstruisani β tri kalcijum fosfatom (βTCP) (CerasorbR- om), preparatom koji se vrlo često primenjuje u regenerativnoj terapiji parodontopatije, (druga strana donje vilice). Parametri uspešnosti terapije su određeni pre, kao i 6 meseci posle hirurškog zahvata, merenjem dubine parodontalnog džepa i nivoa pripojnog epitela.Uočeno je da ima statistički značajne razlike između eksperimentalne i kontrolne grupe (p<0, 05), u odnosu na ispitivane parametre parodontalne regeneracije. Primena “Biohapel”-a u hirurškoj terapiji infrakoštanih defekata parodoncijuma omogućava bolju koštanu regeneraciju parodoncijuma u odnosu na primenu β tri kalcijum fosfata koji je poznati standard u regenerativnoj terapiji .