Impact of smoking on guided tissue regeneration using a biocomposite poly (lactic-co-glycolic) acid/sub-micron size hydroxyapatite with a rubber dam as an alternative barrier

Abstract

The purpose of our study was to critically evaluate the results obtained from a guided tissue regeneration technique after 12 months using a bocomposite poly (lactic-co-glycolic) acid/sub-micron size hydroxyapatite (PLGA/HA) with a rubber dam as a barrier in smoking and non-smoking patients. We selected 36 patients (18 current smokers and 18 non-smokers) diagnosed with chronic advanced periodontitis with a periodontal site (probing depth [PD] >5) amenable to regenerative surgery. Twelve months after surgery, the periodontal parameters were found to have statistically improved, when non-smokers were compared with smokers, in: PD reduction (6.3 ± 2.1 mm vs. 3.6 ± 1.9 mm); CAL gain (4.4 ± 1.1 vs. 2.8 ± 2.2 mm); recession (1.8 ± 1.4 mm vs. 0.8 ± 0.9 mm); and hard tissue fill (4.7 ± 0.8 mm vs. 2.8 ± 2.1 mm). Furthermore, since we found PD baseline differences between groups, smoking seemed not to influence the outcomes achieved (CAL gain and ΔREC) 12 months post surgery with respect to PD baseline. The use of PLGA/HA with a rubber dam significantly improved the periodontal parameters in both smoking and non-smoking subjects. This improvement was nevertheless lower in smokers than the non-smokers, confirming the negative impact of smoking on periodontal regeneration.

Efficacy of Adjunctive Bioactive Materials in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis

“…A variety of allografts, xenografts, and synthetic materials such as DFDBA, anorganic bovine bone, hydroxyapatite (HA), and tricalcium phosphate (TCP) are now available and widely used as regeneration materials. Also, a biocomposite poly(lactic-co-glycolic) acid/submicron size hydroxyapatite (PLGA/HA) was used successfully for periodontal regeneration [ 3 ]. These bone substitutes have been proven to be osteoconductive in repairing defects, serving as mechanical scaffolding for new bone formation.…”

Emdogain (EMD) and platelet-rich plasma (PRP) in periodontal regeneration

“…Various allografts, xenografts, and synthetic materials such as DFDBA, inorganic bovine bone, hydroxyapatite (HA) and tricalcium phosphate (TCP) are available and widely used materials. Also, biocomposite hydroxyapatite is successfully used for periodontal regeneration (4). Some authors report full bone regeneration and high volume stability around implants using high porosity synthetic biphasic calcium phosphate, sintered deproteinized bovine bone mineral, and synthetic twophase nano-hydroxyapatite paste in combination with a pericardial collagen membrane (5).…”