title: Gingival crevicular fluid vascular endothelial cell growth factor and platelet-derived growth factor-BB release profile following the use of perforated barrier membranes during treatment of intrabony defects: a randomized clinical trial.
abstract: OBJECTIVE
  Perforated barrier membranes open channels between the suprabony and intrabony compartments of the defect, which could allow for more physiologic cellular interactions between different components of the periodontium during guided tissue regeneration surgery. To test this assumption, this study was designed to evaluate levels of vascular endothelial cell growth factor (VEGF) and platelet-derived growth factor (PDGF)-BB in gingival crevicular fluid during the early stages of healing of localized intrabony defects treated with perforated membranes (PMs) or non-PMs, as compared with open flap debridement.
  
  
  METHODS
  Thirty non-smoking patients with severe chronic periodontitis participated in this prospective, randomized and single blinded trial. Each patient contributed one interproximal defect that was randomly assigned to the PM group (n = 10), occlusive membrane (OM) group (n = 10) or open flap debridement (OFD) group (n = 10). Plaque index, gingival index, probing depth, clinical attachment level and the intrabony depth of the defect were measured at baseline and reassessed at 6 and 9 mo after therapy. Gingival crevicular fluid samples were collected on days 1, 3, 7, 14, 21 and 30 d after therapy for the changes in VEGF and PDGF-BB levels.
  
  
  RESULTS
  During the early stages of healing (1, 3 and 7 d), the mean VEGF and PDGF-BB concentrations at sites treated with PMs and OFD peaked with a statistically significant difference as compared with the OM-treated group. VEGF and PDGF-BB levels at sites treated with PMs and OFD were not statistically different. Growth factor levels decreased sharply in the samples obtained at days 21 and 30 with non-significant differences between the three groups. Nine months after therapy, the PM-treated group showed a statistically significant improvement in probing depth, clinical attachment level and intrabony defect compared to the OM and OFD groups.
  
  
  CONCLUSIONS
  Within the limits of the present study, one can conclude that PM coverage of periodontal defects is associated with initial gingival crevicular fluid growth factor upregulation that could improve the clinical outcomes of guided tissue regeneration surgery.
authors.affiliation: Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: A Y
authors.initials: AY
authors.lastname: Gamal
authors.affiliation: Department of Periodontology, Faculty of Dental Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: K A
authors.initials: KA
authors.lastname: Abdel-Ghaffar
authors.affiliation: Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: V J
authors.initials: VJ
authors.lastname: Iacono
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000473:pathology / Q000601:surgery*; D000539:Alveolar Process / Q000473:pathology; D000077214:Becaplermin; D055113:Chronic Periodontitis / Q000378:metabolism / Q000601:surgery; D003646:Debridement / Q000379:methods; D003774:Dental Plaque Index; D004534:Egypt; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000473:pathology; D010512:Periodontal Index; D010513:Periodontal Ligament; D010514:Periodontal Pocket / Q000145:classification / Q000473:pathology; D011446:Prospective Studies; D020574:Proto-Oncogene Proteins c-sis / Q000032:analysis*; D016037:Single-Blind Method; D013524:Surgical Flaps / Q000601:surgery; D042442:Vascular Endothelial Growth Factors / Q000032:analysis*; D014945:Wound Healing / Q000502:physiology
chemical_list: D008567:Membranes, Artificial; D020574:Proto-Oncogene Proteins c-sis; D042442:Vascular Endothelial Growth Factors; D000077214:Becaplermin
keywords: bone morphogenetic proteins; growth factors; guided tissue membranes; periodontal intrabony defects; periodontal pockets; periodontal regeneration