Acellular dermal matrix allograft combined with coralline hydroxyapatite repair periapical tissue defects

doi:10.3969/j.issn.2095-4344.2014.34.006

Abstract

Abstract:

BACKGROUND: Chronic periapical periodontitis often causes periapical tissue defects and ultimately leads to the loss of teeth if the inflammation is not promptly cleared to terminate bone resorption and destruction of gingival tissue. Acellular dermal matrix allograft and coralline hydroxyapatite are the common materials to repair periodontal injury.

OBJECTIVE: To evaluate clinical efficacy of acellular dermal matrix allograft combined with coralline hydroxyapatite in repairing periapical tissue defects.

METHODS: A total of 76 patients of chronic apical periodontitis were randomly divided into two groups, with

38 cases in each group. In the experimental group, periapical tissue defects were treated with acellular dermal matrix allograft and coralline hydroxyapatite. In the control group, tissue defects were not treated. All the involved patients underwent apicectomy and retrograde filling. Clinical parameters and radiographic film were recorded at 1 week, 6 months and 3 years follow-up visits to evaluate the repairing effects.

RESULTS AND CONCLUSION: After 1 month of treatment, all acellular dermal matrix allografts survived, and the defect of gingival tissues that caused by repairing fistula had been healed. After 3 years, the repairing efficiency in the experimental group was significantly higher than that in the control group (P < 0.05). The bone defect disappeared in the experimental group at 6 months, the transmission of coralline hydroxyapatite particles was decreased, and there were some fuzzy images of compact density. This suggested that new bone was growing. The density of coralline hydroxyapatite particle got closed to normal bone tissue after 3 years, and there were transitional changes of density between coralline hydroxyapatite with normal bone. Coralline hydroxyapatite particle gradually fused with alveolar bone. Acellular dermal matrix allograft and coralline hydroxyapatite have good biological compatibility. In repairing periapical tissue defects, the application of acellular dermal matrix allograft combined with coralline hydroxyapatite is effective in clinical practice.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: hydroxyapatites, periapical periodontitis, periodontitis, periodontium

CLC Number:

R318

Xu Jun, Wang Jin-tao, Li Gang, Shi Fang-chuan, Zhong Liang-jun. Acellular dermal matrix allograft combined with coralline hydroxyapatite repair periapical tissue defects[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(34): 5441-5448.

Figures/Tables 2

Quantitative analysis of subjects All patients in both groups were included in following analysis. Clinical observation of periapical tissue defects repaired with different methods The complaints of patients, the degree of pain when percussed the crown vertically or laterally and the swelling degree of the mucous membranes was observed. The wounds were all primary healing. One week after operation, no significant discomfort was observed in patients. At 1 month, all acellular dermal matrix allografts survived, moreover, the defect of gingival tissues that caused by repairing fistula had been healed. As shown in Table 1, there was no significant difference between two groups in 3 years postoperative therapy (P > 0.05). As shown in Table 2, the rate of efficiency was 95% in the experimental group, and 79% in the control group, there was a significant difference between two groups in 3 years postoperative therapy (χ2=4.15, P < 0.05). There was no significant difference in the teeth, gender, age and style of lesions in 3 years postoperative therapy in the experimental group (Tables 3-6). Analysis of radiographic films of periapical tissue defects repaired with different methods Due to the large range of bone destruction, we shot periapical films to observe the tiny changes in periodontal tissue and compare the curative effect. As shown in radiographic films, we can see that there was a large scope of bone defect area before operation. The scope in Figure 2A was about 1.8 cm × 1.4 cm. The bone defect disappeared 6 months after operation, the transmission of coralline hydroxyapatite particles decreased, and, there were some fuzzy images of compact density. It suggested that new bone was growing. The density of coralline hydroxyapatite particle was similar to normal bone tissue after 3 years (Figure 2), and there were transitional changes of density between coralline hydroxyapatite with normal bone, which suggested that it began to combine with the alveolar bone."

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