Browsing School of Dentistry by Subject "Bone-grafting"
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Comparison of Enamel Matrix Derivative Alone or in Combination with Bone Replacement Graft Materials in the Treatment of Intrabony Defects: A Systematic ReviewThe ultimate goal of any periodontal therapy is to regenerate all lost tissues of the periodontium: bone, cementum and periodontal ligament. The purpose of this systematic review was to compare the outcome when BRG was combined with EMD vs. EMD alone for the treatment of periodontal intrabony defects. A comprehensive literature search through February 11, 2015 was performed using Medline and EMBASE for all literature related to intrabony defects treatment using EMD with and without bone graft. Either EMD or combination of EMD with BG resulted in improved clinical outcomes. In conclusion, most studies report differences for gingival recession with the addition of bone graft but this trend was not statistically significant. Bone fill, as measured at reentry, was the only variable yielding more favorable outcome with the combined approach. Mean defect fill 2.36 ± 3.9 mm and 3.78 ± 0.7mm (p< 0.05) for EMD alone and combination therapy, respectively.
The effect of electrical stimulation on success of bone grafts: an in vivo studyPurpose: Bone grafting is often unpredictable and is associated with reduced success rate, extended healing times and morbidity. Methods that expedite healing and increase predictability will contribute to the overall success of reconstructive efforts. In this project, the effect of electrical stimulation on bone graft healing in rat calvaria was examined. Materials and Methods: Fifteen adult male Sprague-Dawley rats were used. A 7 mm diameter bone defect at the midline of the calvarium was grafted using freeze-dried mineralized bone. Bipolar platinum stimulating electrodes were overlaid on top of the periosteum on the center of the graft. Animals were divided randomly into two groups. The experimental group (n=8) received electrical stimulation (3 times/day for 10 days) and the control group (n=7) received no stimulation. At 6 weeks, the grafted areas together with the surrounding bone were harvested from the cranium. Tissue sections (5-7 μm) were prepared and stained using hematoxylin and eosin. Mounted slides were analyzed and for each animal, the grafted area was marked and the percent of new bone, remaining graft material and connective tissue was calculated. Data was analyzed using ANOVA. A p≤.05 was considered significant. Results: There were statistically significant differences between the experimental and control group. The electrical stimulation group had significantly more (p=0.034) bone (3.81+3.6 %) compared to the control group (0.47+0.52%). The amount of remaining graft material was also significantly higher (p=0.024)in the control group (26.11+6.54%) compared to the stimulation group (16.64+5.28%). No significant difference (p=0.15) was found between the 2 groups in the amount of connective tissue (stimulation: 79+5.47%; control: 73.2+6.82%). Conclusion: In this animal model of bone graft healing, electrical stimulation resulted in significantly more bone formation and less remaining graft material. These findings suggest that electrical stimulation expedites bone graft healing.