Association between defect morphology and healing of intrabony defects treated with minimally invasive non‐surgical therapy: A pilot exploratory analysis of two cohorts

Nibali, Luigi; Mehta, Jaimini; Al-Shemeri, Dhare; Anoixiadou, Styliani; Parashis, Andreas O.; Vouros, Ioannis

doi:10.1111/jre.13119

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Many regenerative studies have also highlighted greater chances of treatment success in defects with a greater number of residual walls (Rosling et al, 1976;Tonetti et al, 2002). It is worth noting that radiographic estimations of defect morphology are often inconsistent with intra-surgical findings (Nibali et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive non‐surgical periodontal therapy of intrabony defects: A prospective multi‐centre cohort study

Mehta,

Montevecchi,

Garcia‐Sanchez

et al. 2024

J Clinic Periodontology

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AimTo assess the potential benefits of minimally invasive non‐surgical therapy (MINST) in teeth with intrabony defects and to explore factors associated with the outcomes.Materials and MethodsA multi‐centre trial was conducted in 100 intrabony defects in periodontitis patients in private practice. Steps 1 and 2 periodontal therapy including MINST were provided. Clinical and radiographic data were analysed at baseline and 12 months after treatment, with the primary aim being change in radiographic defect depth at 12 months.ResultsEighty‐four patients completed the 12‐month follow up. The mean total radiographic defect depth reduced by 1.42 mm and the defect angle increased by 3° (both p < .05). Statistically significant improvements in probing pocket depth (PPD) and clinical attachment level (CAL) were seen at 12 months compared to baseline (p < .001). Fifty‐six defects (66.7%) achieved pocket closure (PPD ≤ 4 mm) and 49 defects (58.3%) achieved the composite outcome (PPD ≤ 4 mm and CAL gain ≥3 mm). Deeper and narrower angled defects were positively correlated with radiographic and clinical improvements, respectively.ConclusionsImprovements in clinical and radiographic outcomes were seen after MINST. This study highlights the generalizability and wide applicability of this approach, further supporting its effectiveness in the treatment of intrabony defects. Clinical trial registration: NCT03741374. https://clinicaltrials.gov/study/NCT03741374?cond=minimally%20invasive%20non%20surgical%20therapy&locStr=UK&country=United%20Kingdom&distance=50&rank=2.

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Section: Discussionmentioning

confidence: 99%

“…Defect morphology estimation was based on clinical and radiographic data. The following categories were used (as described in Nibali et al, 2023):…”

Section: Radiographic Examinationmentioning

confidence: 99%

Minimally invasive non‐surgical periodontal therapy of intrabony defects: A prospective multi‐centre cohort study

Mehta,

Montevecchi,

Garcia‐Sanchez

et al. 2024

J Clinic Periodontology

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“…As reported in the literature, the various surgical techniques and biomaterials developed in the last 30-40 years with the aim of 2 of 16 predictable periodontal regeneration have achieved variable success [12][13][14]. The benefits reported are often limited to deep intrabony defects and class II mandibular FI, while supracrestal defects, non-containing intrabony defects, and maxillary class II or III FI still have less predictable outcomes [15][16][17][18]. For this reason, new tissue engineering strategies are being sought, and the implementation of innovative techniques using orally derived stem cells is growing in terms of scientific research in periodontology [19,20].…”

Section: Introductionmentioning

confidence: 99%

Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies

Campagna,

Baima,

Romano

et al. 2024

Dentistry Journal

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The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?”. Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (−0.88, 2.97) p = 0.29] and PPD reduction [MD = 1.32; 95% CI (−0.25, 2.88) p = 0.10]. The same also applied to GR [MD = −0.08; 95% CI (−0.79, 0.63) p = 0.83] and RBG [MD = 0.50; 95% CI (−0.88, 1.88) p = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures.

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The flapless approach with and without enamel matrix derivatives for the treatment of intrabony defects: A randomized controlled clinical trial

Aimetti,

Stasikelyte,

Mariani

et al. 2024

J Clinic Periodontology

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AimTo compare the clinical and radiographic outcomes of flapless procedure alone or in combination with enamel matrix derivatives (EMD) in the treatment of deep intrabony defects.Materials and MethodsForty‐six patients re‐evaluated after non‐surgical therapy were randomly assigned to the test (flapless with EMD) or control group (flapless alone). Clinical measurements were recorded pre‐surgery and at 6 and 12 months after surgery, and radiographic measurements were taken pre‐surgery and after 12 months.ResultsForty‐six patients completed the study. Improvements were observed in both groups at 12 months for mean clinical attachment level (CAL) gain, with significant differences between test (3.9 ± 1.1 mm) and control groups (3.0 ± 1.2) (p = .017). Probing pocket depth (PPD) reduction (4.0 ± 0.7 vs. 3.3 ± 1.4 mm) was also near to statistical significance (p = .051). Also, more sites achieved successful composite outcome measure (final PPD ≤ 4 mm and CAL gain ≥3 mm) for the regenerative treatment in the flapless + EMD group (82.6% vs. 52.2%; p = .028). In terms of radiographic outcomes, EMD yielded a greater defect bone fill than flapless treatment alone (3.0 ± 1.0 mm vs. 1.8 ± 1.5 mm; p < .001).ConclusionsThe additional application of EMD during the flapless procedure for intrabony defects slightly improved clinical and radiographic outcomes. ClinicalTrials.gov identification number: NCT05456555.

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Association between defect morphology and healing of intrabony defects treated with minimally invasive non‐surgical therapy: A pilot exploratory analysis of two cohorts

Cited by 4 publications

References 23 publications

Minimally invasive non‐surgical periodontal therapy of intrabony defects: A prospective multi‐centre cohort study

Minimally invasive non‐surgical periodontal therapy of intrabony defects: A prospective multi‐centre cohort study

Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies

The flapless approach with and without enamel matrix derivatives for the treatment of intrabony defects: A randomized controlled clinical trial

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