This clinical study included three patients aged between 50 and 78 years who had chronic marginal periodontitis and type 2 diabetes mellitus, diseases that are frequently associated due to changes occurring in polymorphonuclear cells, as well as to alterations of microcirculation. No bone augmentation therapies were performed. Bone regeneration was strictly influenced by conventional periodontal therapy, supplemented with ten pulsed short wave sessions applied to the lower face shortly after closed periodontal curettage. The allocated time was ten minutes for the first two sessions, and 15 minutes for the following 8 sessions. Clinical and radiological evaluations were performed at the time of presentation, as well as after initiation of pulsed short wave therapy: in the first case, three weeks after initiation of therapy and three years after the end of complex oral rehabilitation; in the second case, eight weeks after the onset of pulsed short wave therapy and in the third case, five weeks after the onset of pulsed short wave therapy. The results were significant in all three cases, demonstrated radiologically by the same type of radiological examination at identical scales. Bone remineralization was obvious in the alveolar processes of the jaw. Although further studies in this direction are necessary, the results are both clinically and radiologically significant.
Key words: pulsed short waves, alveolar bone resorption, periodontal disease, diabetes,
The current experimental study was conducted in sheep, which present bone anisotropy and a predisposition to periodontal disease, with alveolar bone resorption, similar to that found in humans. In this study, alveolar bone augmentation was performed using a lyophilized bovine bone xenograft enriched with type 1 atelocollagen, which was combined with autologous platelet-rich plasma (PRP) and advanced platelet-rich fibrin (A-PRF) as a membrane. The results were radiologically and histologically evaluated at six weeks postoperatively. At that time, the transformation of the composite biomaterial was clearly visible, suggesting that the regeneration process started from the periphery of the augmentation mass, which was progressively transformed from a granular eosinophilic material into an undifferentiated hypercellular one, then into fibroblastic, cartilaginous tissue, and finally into new bone and desmodontal-like tissue. This process was most probably induced by all the compounds used, the growth factors found in autologous blood derivatives, including bone morphogenetic proteins (BMPs), as well as type 1 atelocollagen from the graft composition, especially in combination. The composite biomaterial at six weeks postoperatively provided excellent results regarding alveolar bone regeneration, and without any risk, as opposed to that found in overdose of recombinant growth factors.
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