Efficacy of biologics for alveolar ridge preservation/reconstruction and implant site development: An American Academy of Periodontology best evidence systematic review

Journal of Periodontology, Год журнала: 2022, Номер 93(12), С. 1827 - 1847

Опубликована: Июль 16, 2022

Abstract Background The use of biologics may be indicated for alveolar ridge preservation (ARP) and reconstruction (ARR), implant site development (ISD). present systematic review aimed to analyze the effect autologous blood‐derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet‐derived growth factor‐BB (rhPDGF‐BB), bone morphogenetic protein‐2 (rhBMP‐2), on outcomes ARP/ARR ISD therapy (i.e., augmentation [ARA] maxillary sinus floor [MSFA]). Methods An electronic search eligible articles published from January 2000 October 2021 was conducted. Randomized clinical trials evaluating efficacy ABPs, EMD, rhBMP‐2, rhPDGF‐BB were included according pre‐established eligibility criteria. Data linear volumetric dimensional changes, histomorphometric findings, a variety secondary clinical, implant‐related, digital imaging, safety, patient‐reported outcome measures [PROMs]) extracted critically analyzed. Risk bias assessment selected investigations also Results A total 39 analyzed qualitatively. Due high level heterogeneity across studies, quantitative analyses not feasible. Most studies in topic revealed that rendered similar results compared with conventional protocols. However, when juxtaposed unassisted healing or socket filling using collagen sponges, application did contribute attenuate post‐extraction atrophy most investigations. Additionally, positively influenced by biologics. ARA interventions yield superior radiographic control therapies. Nevertheless, ABPs enhanced new formation reduced likelihood early wound dehiscence. MSFA translate into outcomes. It observed, though, some promote during earlier stages healing. Only four evaluated PROMs reported modest beneficial impact pain swelling. No severe adverse events association this noted. Conclusions Outcomes after edentulous ridges comparable among different therapeutic modalities review. PRF, rhPDGF‐BB, rhBMP‐2) combination graft material generally faster groups.

Язык: Английский

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American Academy of Periodontology best evidence consensus statement on the use of biologics in clinical practice

Journal of Periodontology, Год журнала: 2022, Номер 93(12), С. 1763 - 1770

Опубликована: Окт. 24, 2022

Abstract A biologic is a therapeutic agent with biological activity that administered to achieve an enhanced regenerative or reparative effect. The use of biologics has progressively become core component contemporary periodontal practice. However, some questions remain about their safety, indications, and effectiveness in specific clinical scenarios. Given availability for routine the existing amount related evidence, goal this American Academy Periodontology (AAP) best evidence consensus (BEC) was provide state‐of‐the‐art, evidence‐based perspective on application autologous blood‐derived products (ABPs), enamel matrix derivative (EMD), recombinant human platelet‐derived growth factor BB (rhPDGF‐BB), bone morphogenetic protein 2 (rhBMP‐2). panel experts extensive knowledge science convened. Three systematic reviews covering areas plastic surgery, treatment infrabony defects, alveolar ridge preservation/reconstruction implant site development were conducted priori provided foundation deliberations. expert debated merits published data exchanged experiential information formulate statements recommendations practice future research. Based analysis current opinion, concluded appropriate generally safe provides added benefits conventional approaches. risks range based used as well patient‐related local systemic factors. limited available indications (e.g., gingival augmentation therapy, preservation/reconstruction, development), studies can expand base are warranted.

Язык: Английский

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Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision‐making process

Periodontology 2000, Год журнала: 2023, Номер 93(1), С. 107 - 128

Опубликована: Авг. 2, 2023

Abstract Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between simultaneous staged approach involves considering multiple variables. This paper proposed decision‐making process serves as guideline for choosing the best treatment choice based on available evidence and author's clinical experience.

Язык: Английский

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Twenty‐five years of recombinant human growth factors rhPDGF‐BB and rhBMP‐2 in oral hard and soft tissue regeneration

Periodontology 2000, Год журнала: 2023, Номер 94(1), С. 483 - 509

Опубликована: Сен. 8, 2023

Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant applications in hard soft regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical aim accelerate healing, reconstruction, patient recovery. Thus, regenerative involving factors such as platelet-derived factor-BB (rhPDGF-BB) bone morphogenetic proteins (rhBMPs) shown certain advantages invasive traditional severe defects. Several clinical studies assessed outcomes of rhBMP-2 for implant site development augmentation. Current evidence regarding benefits compared conventional therapies is inconclusive. Nevertheless, it seems that can promote faster wound healing enhance de novo formation, which may be particularly favorable patients with compromised capacity or limited donor sites. rhPDGF-BB has extensively applied periodontal procedures treatment gingival recessions, showing consistent positive outcomes. current its edentulous sites limited. The present review explores depicts applications, outcomes, evidence-based recommendations rhBMPs regeneration.

Язык: Английский

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Clinical and radiographic assessment of cross-linked hyaluronic acid addition in demineralized bovine bone based alveolar ridge preservation: A human randomized split-mouth pilot study

Journal of Stomatology Oral and Maxillofacial Surgery, Год журнала: 2023, Номер 124(4), С. 101426 - 101426

Опубликована: Фев. 16, 2023

Язык: Английский

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Autologous platelet concentrates in alveolar ridge preservation: A systematic review with meta‐analyses

Periodontology 2000, Год журнала: 2024, Номер unknown

Опубликована: Сен. 30, 2024

Abstract In order to evaluate the therapeutic advantages of various autologous platelet concentrates (APC) as a single biomaterial during alveolar ridge preservation (ARP), systematic review with meta‐analyses was conducted. PubMed, EMBASE, Web Science, and Scopus were screened for randomized controlled trials (RCTs) that released prior 2024. The selected papers compared an APC either unassisted healing (blood clot) or another ARP (third molars not included). outcome parameters included bone dimension alterations, soft tissue healing, post‐op pain intensity. search yielded 35 (33 studies), one applying platelet‐rich plasma (PRP), six using rich in growth factors (PRGF), 28 leukocyte‐ fibrin (L‐PRF). These studies showed large heterogeneity (e.g., parameters, timing, surgical approach, inclusion criteria), which hindered drawing strong conclusions. most studies, however, PRP, PRGF, L‐PRF alone produced faster less post‐extraction pain, resorption, more socket fill, higher density when (spontaneous) healing. ultimate benefit appears be significantly influenced by approach. Limited literature exists comparing other biomaterials ARP, resulting inconclusive data. application is promising strategy improve hard reduce pain.

Язык: Английский

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Treatment alternatives for the rehabilitation of the posterior edentulous maxilla

Periodontology 2000, Год журнала: 2023, Номер 93(1), С. 183 - 204

Опубликована: Июль 24, 2023

Abstract Rehabilitation of the edentulous maxilla with implant‐supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability and surgical access, among other factors. This review addresses several treatment options replace missing teeth in posterior maxillary segments, namely placement standard implants conjunction sinus floor augmentation, short implants, tilted distal cantilever extensions. Pertinent technical information concise summary relevant evidence on reported outcomes these different therapeutic approaches are presented, along set guidelines facilitate decision‐making processes optimize therapy.

Язык: Английский

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Selecting biomaterials in the reconstructive therapy of peri‐implantitis

Periodontology 2000, Год журнала: 2023, Номер 94(1), С. 192 - 212

Опубликована: Сен. 20, 2023

Abstract Peri‐implantitis is a pathogenic inflammatory condition characterized by progressive bone loss and clinical inflammation that may compromise the stability of dental implants. Therapeutic modalities have been advocated to arrest disorder establish peri‐implant health. Reconstructive therapy indicated for defects exhibiting contained/angular components. This therapeutic modality based upon application biological technical principles periodontal regeneration. Nonetheless, comparative efficacy reconstructive nonreconstructive remains unclear. Therefore, aim this narrative review address major concerns regarding efficacy, effectiveness, feasibility using biomaterials in peri‐implantitis therapy. In particular, use grafting materials, barrier membranes, biologics comprehensively explored.

Язык: Английский

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Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices

Journal of Dentistry, Год журнала: 2024, Номер 145, С. 104986 - 104986

Опубликована: Апрель 3, 2024

This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during ii) dimensional ridge alterations after healing controversies relating sinus pneumatisation, iii) patient-specific factors, procedural elements, site-related variables influencing iv) techniques effectiveness preservation (ARP) procedure, v) philosophies cost-effectiveness ARP in clinical practice. To investigate profiles following unassisted an overview systematic reviews conducted February 2024 by two independent reviewers. Four electronic databases were searched Pubmed, Embase, Web science Cochrane Library between 2004-2024 identify all relevant healing. A further manual search also conducted. The articles reviewed full text for relevance. AMSTAR-2 appraisal tool adopted assess methodological quality. Current research pertaining other listed objectives objectively analyzed narration. 11 out 459 retrieved studies selected ultimately covered this changes natural healing: Three four with meta-analyses. quality included critically low. thoroughly examines sockets highlights dynamic process overlapping phases inter-individual variability outcomes. Alveolar procedure is potential strategy facilitating prosthetic site development, while current limited. Herein, individualized prosthetically driven approach crucial. Further well sized designed trials novel biomaterials need be undertaken, role artificial intelligence predicting assisting decision-making could explored. (293 words) By advancing our understanding its management strategies, clinicians can make more informed decisions regarding patient level assessment selection, surgical techniques, biomaterial choices, contributing enhanced reduced complications improved life patients undergoing tooth extraction dental implant treatments.

Язык: Английский

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Mesenchymal stem cell-derived extracellular vesicles for treatment of bone loss within periodontitis in pre-clinical animal models: a meta-analysis

BMC Oral Health, Год журнала: 2023, Номер 23(1)

Опубликована: Сен. 29, 2023

Abstract Background Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) represent an effective and promising strategy for periodontitis, although studies remain pre-clinical. Herein, a meta-analysis was conducted to assess the efficacy of MSC-EVs in animal models periodontitis. Methods The PubMed, Web Science, Embase electronic databases were searched up Dec 2022 retrieve preclinical examining use periodontitis treatment. Meta-analyses sub-group analyses performed effect on Bone Volume/Total Volume (BV/TV) or distance between cementoenamel junction alveolar bone crest (CEJ-ABC) pre-clinical Results 11 published from Mar 2019 Oct met inclusion criteria. Overall, contributed periodontal regeneration inflammatory loss area due as represented by weighted mean difference (WMD) 14.07% (95% CI = 6.73, 21.41%, p < 0.001) BV/TV WMD -0.12 mm CI= -0.14, -0.11 mm, CEJ-ABC. However, sub-analysis suggested that there no significant CEJ-ABC with bioactive scaffolds without ( 0.60). Conclusions present study suggests may attractive therapy treatment within

Язык: Английский

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