Clinical outcomes with bioactive agents alone or in combination with grafting or guided tissue regeneration.
OBJECTIVE
The purpose of the present review was to determine the clinical effect of the use of bioactive agents (BAs) for the treatment of intra-osseous and furcation defects.


METHODS
The effectiveness of the BAs was evaluated when used in addition to open flap debridement either alone or in association with grafts and/or guided tissue regeneration (GTR). Among the included agents, recombinant human platelet-derived growth factor-BB (rhPDGF-BB), platelet-rich plasma (PRP), commercially available enamel matrix derivative (cEMD) and peptide P-15 (P-15) have been clinically tested for treating periodontal defects.


CONCLUSIONS
The results of the present review indicate that: (1) cEMD either alone or in combination with grafts can be effectively used to treat intra-osseous defects and the clinical results appear to be stable long term; (2) the additional use of a graft seems to enhance the clinical outcome of cEMD; (3) the combined use of rhPDGF-BB and P-15 with a graft biomaterial has shown beneficial effects in intra-osseous defects; (4) contrasting results were reported for PRP and graft combinations; and (5) limited evidence supports the use of BAs either alone or in association with graft/GTR for the treatment of furcation defects.
Trombelli
Leonardo
L
Research Centre for the Study of Periodontal Diseases, University of Ferrara, Ferrara, Italy. leonardo.trombelli@unife.it
Farina
Roberto
R
D016301:Alveolar Bone Loss / Q000601:surgery*; D000077214:Becaplermin; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001685:Biological Factors / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D003094:Collagen / Q000627:therapeutic use; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D017823:Furcation Defects / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D010446:Peptide Fragments / Q000627:therapeutic use; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D016896:Treatment Outcome
D001672:Biocompatible Materials; D001685:Biological Factors; D018786:Bone Substitutes; D003746:Dental Enamel Proteins; D010446:Peptide Fragments; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; C407062:cell-binding peptide P-15; C109069:enamel matrix proteins; D000077214:Becaplermin; D003094:Collagen