The comparative efficacy of decalcified allogenic bone matrix and intra-oral free osseous autografts in the treatment of periodontal intrabony defects

Abstract

Background and Objectives:The primary goal of periodontal treatment is the maintenance of the natural dentition in health and comfortable function. The shift in therapeutic concepts from resection to regeneration has significantly impacted the practice of periodontology. The objective of the present study is to compare the relative efficacy of intra-oral autogenous graft and decalcified allogenic bone matrix (DABM) in the treatment of periodontal intrabony defects.Materials and Methods:In the present study, 30 patients in the age group of 30-50 years with two almost identical intrabony defects, on either side of the mouth/upper and lower jaw, based upon the radiographic observations were selected from amongst the patients visiting the Department of Periodontology and Oral Medicine, Punjab Government Dental College and Hospital, Amritsar. One of the defect was selected randomly and filled with autogenous cancellous graft and the other with DABM. Post-operative assessment was done by taking radiographs, 12 weeks and 24 weeks post-operatively.Results:Definite bone fill was achieved both with intra-oral free osseous autograft and with DABM at 12 weeks observation, which further increased significantly at 24 weeks observation. The bone fill obtained with intra-oral free osseous autograft was found to be significantly higher than that with DABM both at 12 weeks and 24 weeks post-operative observation.Conclusion:Within the limitations of this study, it establishes the superiority of the intra-oral free osseous autograft over that of DABM graft in correcting the intrabony defects.

Comparison of the effect of three autogenous bone harvesting methods on cell viability in rabbits

“…Autogenous bone grafts are the ideal choice for bone grafting, mainly because of osteoinductivity, osteogenicity and osteoconductivity properties and the possibility of having living bone cells. 1 - 3 However, the viability of the transplanted cells of bone graft can be affected by several factors such as the method used for harvesting the graft, which is in concordance with the damage induced to the bone structure and cells during the harvesting procedure. 12 Therefore, application of a method that minimizes the trauma to the bone would be effective in maintaining the cell viability.…”

“…One of the most common problems in the treatment of periodontal diseases is bony defect that compromises the prognosis of the treatment. 1 - 3 In these situations the most favorable result is achieved by using reconstructive treatment. 3 , 4 Hegedus in 1923 was the first to use autogenous bone grafts for reconstruction of bony defects.…”

Optimized bone grafting

“…17 A number of studies using autogenous bone alone have been documented with respect to defect healing. [19][20][21][22] Autografts remain the gold standard, and complicated bone defects often require at least partial incorporation of autografts to improve graft consolidation.…”

“…Grafts, which are primarily composed of bone matrix and osteocytes, are known to release a wide variety of growth factors, including BMPs, PDGF, TGF‐beta, and VEGF, as well as to regulate bone formation/resorption via the RANKL/OPG pathway 17 . A number of studies using autogenous bone alone have been documented with respect to defect healing 19–22 . Autografts remain the gold standard, and complicated bone defects often require at least partial incorporation of autografts to improve graft consolidation.…”