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Management of a One-wall Intrabony Osseous Defect with Combination of Platelet Rich Plasma and Demineralized Bone Matrix- a Two-year Follow up Case Report.

Thakkalapati P, R Chandran C, Ranganathan AT, Jain AR, Prabhakar P, Padmanaban S - J Dent (Shiraz) (2015)

Bottom Line: The 6-month follow- up results showed significant improvement in clinical parameters.Radiographic evidence of bone formation was observed as early as 3 months with almost complete fill by 6 months post-operatively.The results were maintained over a period of 2 years.

View Article: PubMed Central - PubMed

Affiliation: Dept. of Periodontics, Tagore Dental College and Hospitals, Chennai, India.

ABSTRACT
Periodontal regeneration in a one-wall intrabony defect is a challenging and complex phenomenon. The combination therapy of commercially available bone grafts with the innovative tissue engineering strategy, the platelet rich plasma, has emerged as a promising grafting modality for two and three walled intrabony osseous defects. The application of this combination approach was attempted in a most challenging one-wall intrabony defect. Open flap debridement and placement of combination of autologous platelet rich plasma(PRP) and demineralized bone matrix was done in one-wall intrabony defect in relation to tooth #21 in a 30 year old female patient. The 6-month follow- up results showed significant improvement in clinical parameters. Radiographic evidence of bone formation was observed as early as 3 months with almost complete fill by 6 months post-operatively. The results were maintained over a period of 2 years.

No MeSH data available.


a: Following elevation of f  ull thickness flap and degranulation of interproximal area, one-wall intrabony defect mesial to tooth # 21 is revealed.  b: Freshly-prepared platelet rich plasma.
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Figure 2: a: Following elevation of f  ull thickness flap and degranulation of interproximal area, one-wall intrabony defect mesial to tooth # 21 is revealed.  b: Freshly-prepared platelet rich plasma.

Mentions: The surgical procedure was performed by local anesthesia. Mucoperiosteal flaps were reflected using papilla preservation flap technique involving the region of teeth #11, 21. A one-wall intrabony defect was exposed mesial to tooth # 21 (Figure 2a) and surgically 4.5 mm infrabony defect was evaluated. The area was thoroughly debrided and root planning was performed. Briefly, prior to surgery, PRP was prepared following the protocol described by Marx and Garg in 2005.[12] 10ml intravenous blood collected through a venipuncture in the antecubital vein was transferred to a test tube containing 1 ml of 10% trisodium citrate anticoagulant solution and centrifuged at 1200 rpm for 20 minutes, which resulted in two fractions. The plasma along with the top 2ml of red blood cells was again centrifuged at 2000 rpm for 15 minutes to get three basic fractions, platelet-poor plasma (PPP) at the top of the preparation (supernatant), platelet rich plasma (PRP) in the middle and the red blood cell fraction at the bottom. The top 80% fraction corresponding to PPP was aspirated with a pipette, leaving the residual (0.5-2ml) platelet concentrate (Figure 2b). Then the coagulation of platelet rich plasma was obtained by adding 1ml Batroxobin (Pentapharm) and 1ml of 10% calcium gluconate (Medicos pharma). Within a few seconds, a sticky gel consistency was obtained to be mixed with the bone graft and applied to the surgical site (Figure 3a).


Management of a One-wall Intrabony Osseous Defect with Combination of Platelet Rich Plasma and Demineralized Bone Matrix- a Two-year Follow up Case Report.

Thakkalapati P, R Chandran C, Ranganathan AT, Jain AR, Prabhakar P, Padmanaban S - J Dent (Shiraz) (2015)

a: Following elevation of f  ull thickness flap and degranulation of interproximal area, one-wall intrabony defect mesial to tooth # 21 is revealed.  b: Freshly-prepared platelet rich plasma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554316&req=5

Figure 2: a: Following elevation of f  ull thickness flap and degranulation of interproximal area, one-wall intrabony defect mesial to tooth # 21 is revealed.  b: Freshly-prepared platelet rich plasma.
Mentions: The surgical procedure was performed by local anesthesia. Mucoperiosteal flaps were reflected using papilla preservation flap technique involving the region of teeth #11, 21. A one-wall intrabony defect was exposed mesial to tooth # 21 (Figure 2a) and surgically 4.5 mm infrabony defect was evaluated. The area was thoroughly debrided and root planning was performed. Briefly, prior to surgery, PRP was prepared following the protocol described by Marx and Garg in 2005.[12] 10ml intravenous blood collected through a venipuncture in the antecubital vein was transferred to a test tube containing 1 ml of 10% trisodium citrate anticoagulant solution and centrifuged at 1200 rpm for 20 minutes, which resulted in two fractions. The plasma along with the top 2ml of red blood cells was again centrifuged at 2000 rpm for 15 minutes to get three basic fractions, platelet-poor plasma (PPP) at the top of the preparation (supernatant), platelet rich plasma (PRP) in the middle and the red blood cell fraction at the bottom. The top 80% fraction corresponding to PPP was aspirated with a pipette, leaving the residual (0.5-2ml) platelet concentrate (Figure 2b). Then the coagulation of platelet rich plasma was obtained by adding 1ml Batroxobin (Pentapharm) and 1ml of 10% calcium gluconate (Medicos pharma). Within a few seconds, a sticky gel consistency was obtained to be mixed with the bone graft and applied to the surgical site (Figure 3a).

Bottom Line: The 6-month follow- up results showed significant improvement in clinical parameters.Radiographic evidence of bone formation was observed as early as 3 months with almost complete fill by 6 months post-operatively.The results were maintained over a period of 2 years.

View Article: PubMed Central - PubMed

Affiliation: Dept. of Periodontics, Tagore Dental College and Hospitals, Chennai, India.

ABSTRACT
Periodontal regeneration in a one-wall intrabony defect is a challenging and complex phenomenon. The combination therapy of commercially available bone grafts with the innovative tissue engineering strategy, the platelet rich plasma, has emerged as a promising grafting modality for two and three walled intrabony osseous defects. The application of this combination approach was attempted in a most challenging one-wall intrabony defect. Open flap debridement and placement of combination of autologous platelet rich plasma(PRP) and demineralized bone matrix was done in one-wall intrabony defect in relation to tooth #21 in a 30 year old female patient. The 6-month follow- up results showed significant improvement in clinical parameters. Radiographic evidence of bone formation was observed as early as 3 months with almost complete fill by 6 months post-operatively. The results were maintained over a period of 2 years.

No MeSH data available.