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      Periosteum as a barrier membrane in the treatment of intrabony defect: A new technique

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          Abstract

          Objective:

          The purpose of the study was to evaluate the clinical effectiveness of periosteum as a barrier membrane for the treatment of intrabony defects.

          Materials and Methods:

          The study was conducted in patients having bilateral intrabony defects. A total of 20 intrabony defects in 10 patients were treated, out of which 10 defects received periosteal barrier and the other 10 defects received conventional open flap debridement procedure. The efficacy of the treatment was assessed using clinical parameters and dentascan.

          Results:

          Statistically significant gain in clinical attachment level (CAL) was found in the test group (2.00 ± 0.26 mm) as compared to the control group (0.60 ± 0.22 mm). In both the treatment modalities (test and control groups), a significant decrease in probing pocket depth of 3.90 ± 0.35 mm and 2.90 ± 0.31 mm was observed, respectively. The difference between the two groups was not statistically significant. Bone defect fill was 1.40 ± 0.16 mm for the test group and 0.90 ± 0.18 mm for the control group, but the difference observed was not statistically significant.

          Conclusion:

          The results of this study show that periosteal barrier membrane can be a better alternative of barrier membranes for the treatment of intrabony defects.

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          Most cited references31

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          On the repair potential of periodontal tissues.

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            New attachment following surgical treatment of human periodontal disease.

            The present experiment was undertaken to test the hypothesis that new connective tissue attachment may form on a previously periodontitis involved root surface provided cells originating from the periodontal ligament are enabled to repopulate the root surface during healing. A mandibular incisor with advanced periodontal disease of long standing (the distance between the cemento-enamel junction and the alveolar bone crest was 9 mm) was subjected to periodontal surgery using a technique which during healing prevented the dentogingival epithelium and the gingival connective tissue from reaching contact with the curetted root surface. Preference was hereby given to the periodontal ligament cells to repopulate the previously diseased root surface. After 3 months of healing a block biopsy containing the incisor and surrounding tissue was sampled. The histological analysis revealed that new cementum with inserting principal fibers had formed on the previously diseased root surface. This new attachment extended in coronal direction to a level 5 mm coronal to the alveolar bone crest. This finding suggests that new attachment can be achieved by cells originating from the periodontal ligament and demonstrates that the concept that the periodontitis affected root surface is a major preventive factor for new attachment is invalid.
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              New attachment formation in the human periodontium by guided tissue regeneration. Case reports.

              The aim of the present study was to evaluate whether a regenerative surgical procedure, based on guided tissue regeneration, could predictably result in the formation of a new attachment in human teeth. The material included 12 teeth in 10 patients with advanced periodontal disease. Following flap elevation, scaling, root planing and removal of granulation tissue, a teflon membrane was placed over the denuded root surface in such a way that the epithelium and the gingival connective tissue were prevented from reaching contact with the root during healing. The flap was replaced on the outer surface of the membrane and secured with interdental sutures. This design of wound preparation gives preference to the cells originating from the periodontal ligament (PDL-cells) to repopulate the wound area adjacent to the root. Histologic analysis of the result of treatment was made in 5 of the 12 teeth scheduled for extraction. In the remaining 7 teeth, the result was evaluated using clinical measurements. The result of healing disclosed that in all teeth treated, substantial amounts of new attachment had formed. This suggests that predictable restitution of the attachment apparatus can be accomplished by using a method of treatment which is based on the principle of guided tissue regeneration.
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                Author and article information

                Journal
                J Indian Soc Periodontol
                J Indian Soc Periodontol
                JISP
                Journal of Indian Society of Periodontology
                Medknow Publications & Media Pvt Ltd (India )
                0972-124X
                0975-1580
                May-Jun 2014
                : 18
                : 3
                : 331-335
                Affiliations
                [1] Department of Periodontics, Carrier Postgraduate Institute of Dental Sciences and Hospital, Ghaila, Sitapur-Hardoi Bypass, IIM Road, Lucknow, Uttar Pradesh, India
                [1 ] Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
                [2 ] Department of Periodontics, Faculty of Dental Sciences, C. S. M. Medical University, Lucknow, Uttar Pradesh, India
                Author notes
                Address for correspondence: Dr. Anju Gautam, Department of Periodontics, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. E-mail: dranjugautam@ 123456gmail.com
                Article
                JISP-18-331
                10.4103/0972-124X.134571
                4095626
                25024547
                b1737e51-ad6f-4b6a-98b9-de22b9220387
                Copyright: © Journal of Indian Society of Periodontology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 April 2012
                : 21 November 2013
                Categories
                Original Article

                Dentistry
                barrier membranes,guided tissue regeneration,intrabony defects,periosteum
                Dentistry
                barrier membranes, guided tissue regeneration, intrabony defects, periosteum

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