Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient Selection
- Patients diagnosed with periodontitis stages III and IV, grade A/B [31].
- Age ≥ 18 years old.
- Single-rooted and multi-rooted teeth.
- Patients that did not meet the therapy targets at re-evaluation after completion of step 2 of periodontal therapy with respect to the presence of suprabony periodontal defects (i.e., defects displaying a predominantly horizontal pattern of bone loss) at a minimum of two adjacent teeth and a maximum of seven adjacent teeth in either the maxilla or the mandible, with a PPD ≥ 5 mm.
- Intrabony defect with an intraosseous component < 2 mm.
- Patients with systemic diseases.
- Prolonged antibiotic or anti-inflammatory treatment within 4 weeks before surgery.
- Pregnant or lactating.
- Tobacco smokers (≥10 cigarettes per day).
- Multi-rooted teeth with furcation involvement [34].
- Third molars or severely mispositioned teeth.
- Increased tooth mobility (grade II and III) [35].
2.3. Sample Size Calculation
Randomization
2.4. Blinding and Calibration
2.5. Clinical Measurements
2.6. Periodontal Therapy
2.7. Surgical Procedure
2.8. Postoperative Care, Follow-Up, and Re-Evaluation
2.9. Outcome Measures
2.10. Statistical Analysis
3. Results
3.1. Study Population
3.2. Changes in Clinical Attachment Level (CAL)
3.3. Changes in Pocket Probing Depth (PPD)
3.4. Changes in the Gingival Recession (GR)
3.5. Full-Mouth Plaque Score (FMPS) and Full-Mouth Bleeding Score (FMBS)
3.6. Frequency Distributions of CAL, PD, and GR Changes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Test Group (n = 30) | Control Group (n = 30) | p-Value |
---|---|---|---|
Gender (male/female) | 18 (m); 12 (f) | 16 (m); 14 (f) | 0.602 a |
Age (mean ± SD) | 49.8 ± 7.4 | 46.9 ± 8.1 | 0.153 b |
Tobacco smokers | 8 (26.7%) | 6 (20.0%) | 0.541 a |
Variable (mm) | Test Group Baseline (n = 105) | Test Group 12 Months (n = 105) | Mean Difference (p-Value) | p-Value Baseline | Control Group Baseline (n = 101) | Control Group 12 Months (n = 101) | Mean Difference (p-Value) | p-Value 12 Months |
---|---|---|---|---|---|---|---|---|
CAL (mean ± SD) | 6.31 ± 1.44 | 3.25 ± 1.50 | 3.06 ± 1.13 (<0.0001) | 0.073 | 5.92 ± 1.66 | 4.48 ± 1.42 | 1.44 ± 1.07 (<0.0001) | <0.001 a |
PPD (mean ± SD) | 5.83 ± 1.31 | 2.55 ± 0.94 | 3.28 ± 1.14 (<0.0001) | 0.699 | 5.90 ± 1.28 | 3.29 ± 1.05 | 2.61 ± 1.22 (<0.0001) | 0.032 a |
GR (mean ± SD) | 1.16 ± 1.40 | 1.08 ± 1.36 | 0.08 ± 0.76 (=0.6749) | 0.234 | 0.95 ± 1.10 | 1.69 ± 1.25 | 0.74 ± 1.03 (<0.0001) | <0.001 a |
Baseline | Baseline 95%CI | Follow-Up | Follow-Up 95%CI | Change | Change 95%CI | p-Value | |
---|---|---|---|---|---|---|---|
FMPS% (mean ± SD) | |||||||
TEST | 20.3 ± 2.0 | 19.5 to 22.2 | 19.0 ± 2.0 | 18.1 to 21.0 | 1.37 ± 1.69 | 0.5 to 1.6 | 0.014 a |
CONTROL | 20.2 ± 2.7 | 19.4 to 23.5 | 19.3 ± 2.0 | 18.5 to 21.9 | 0.93 ± 1.05 | 0.6 to 1.2 | 0.147 a |
p-value | 0.871 | 0.563 | 0.230 | ||||
FMBS% (mean ± SD) | |||||||
TEST | 18.9 ± 1.8 | 18.0 to 19.5 | 16.4 ± 2.1 | 15.2 to 18.0 | 2.50 ± 1.88 | 1.1 to 3.0 | <0.001 a |
CONTROL | 19.2 ± 2.0 | 18.2 to 21.0 | 17.7 ± 2.4 | 16.3 to 19.3 | 1.50 ± 1.42 | 0.9 to 2.2 | <0.001 a |
p-value | 0.543 | 0.029 | 0.023 |
Variable | Test Group Baseline (n = 30) | Test Group 12 Months (n = 30) | Mean Difference (p-Value) | p-Value Baseline | Control Group Baseline (n = 30) | Control Group 12 Months (n = 30) | Mean Difference (p-Value) | p-Value 12 Months |
---|---|---|---|---|---|---|---|---|
FMPS% (mean ± SD) | 20.3 ± 2.0 | 19.0 ± 2.0 | 1.37 ± 1.69 (0.014) | 0.871 | 20.2 ± 2.7 | 19.3 ± 2.0 | 0.93 ± 1.05 (0.147) | 0.563 a |
FMPS range | 0.043 | 0.116 | 0.443 b | |||||
FMBS% (mean ± SD) | 18.9 ± 1.8 | 16.4 ± 2.1 | 2.50 ± 1.88 (<0.001) | 19.2 ± 2.0 | 17.7 ± 2.4 | 1.50 ± 1.42 (0.010) | 0.029 a | |
FMBS range | 0.003 | 0.544 | 0.307 | 0.055 b |
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Vela, O.C.; Boariu, M.; Rusu, D.; Iorio-Siciliano, V.; Ramaglia, L.; Boia, S.; Radulescu, V.; Ilyes, I.; Stratul, S.-I. Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application. Medicina 2024, 60, 829. https://doi.org/10.3390/medicina60050829
Vela OC, Boariu M, Rusu D, Iorio-Siciliano V, Ramaglia L, Boia S, Radulescu V, Ilyes I, Stratul S-I. Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application. Medicina. 2024; 60(5):829. https://doi.org/10.3390/medicina60050829
Chicago/Turabian StyleVela, Octavia Carolina, Marius Boariu, Darian Rusu, Vincenzo Iorio-Siciliano, Luca Ramaglia, Simina Boia, Viorelia Radulescu, Ioana Ilyes, and Stefan-Ioan Stratul. 2024. "Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application" Medicina 60, no. 5: 829. https://doi.org/10.3390/medicina60050829