Tissue-engineered cultured periosteum used with platelet-rich plasma and hydroxyapatite in treating human osseous defects.
BACKGROUND
The aim of the present controlled clinical study was to compare the clinical response of human cultured periosteum (HCP) sheets in combination with platelet-rich plasma (PRP) and porous hydroxyapatite (HA) granules to a mixture of PRP and HA in the treatment of human infrabony periodontal defects.


METHODS
Thirty interproximal infrabony osseous defects in 30 healthy, non-smoking subjects diagnosed with chronic periodontitis were included in this study. The subjects were randomly assigned to the test group (HCP sheets combined with PRP and HA) or the control group (PRP with HA). Clinical and radiographic measurements were made at baseline and the 12-month post-surgical evaluation.


RESULTS
Compared to baseline, the 12-month results indicated that both treatment modalities resulted in statistically significant changes (P <0.01) in the gingival index, bleeding on probing, probing depth, clinical attachment level, and radiographic infrabony defect depth. Compared to the control group, the test group exhibited a statistically significantly more favorable change in clinical attachment gain (3.9 +/- 1.6 mm versus 2.7 +/- 1.3 mm; P <0.05), vertical relative attachment gain (83.5% +/- 31.7% versus 55.0% +/- 21.9%; P <0.05), and radiographic infrabony defect fill (4.9 +/- 1.2 mm versus 3.2 +/- 1.1 mm; P <0.01).


CONCLUSIONS
Compared to PRP with HA, treatment with a combination of HCP sheets, PRP, and HA led to a significantly more favorable clinical improvement in infrabony periodontal defects. A factor likely contributing to these favorable clinical results is the presence of osteogenic cells in the HCP sheets, which provided greater regeneration potential.
Yamamiya
Kanoko
K
Division of Periodontology, Department of Oral Biological Science, Course for Oral Life Science, Institute of Medicine and Dentistry, Niigata University, 52374 Chuo-ku, Gakkocho-dori 2-bancho, Niigata, Japan.
Okuda
Kazuhiro
K
Kawase
Tomoyuki
T
Hata
Ken-Ichiro
K
Wolff
Larry F
LF
Yoshie
Hiromasa
H
D020341:Absorbable Implants; D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications / Q000601:surgery*; D001861:Bone Regeneration / Q000187:drug effects*; D018786:Bone Substitutes / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications / Q000601:surgery; D010521:Periosteum; D053657:Platelet-Rich Plasma; D023822:Tissue Engineering / Q000379:methods; D016896:Treatment Outcome
D018786:Bone Substitutes; D017886:Durapatite