Clinical effects of combination anorganic bovine-derived hydroxyapatite matrix(ABM)/cell binding peptide (P-15) in periodontal intrabony defects

치주 골내낭에서 anorganic bovine-derived hydroxyapatite matrix(ABM)/cell binding peptide(P-15)의 임상적효과

  • Won, Mi-Sook (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Paik, Jeong-Won (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Kim, Chang-Sung (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Cho, Kyoo-Sung (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Chai, Jung-Kiu (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Kim, Chong-Kwan (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center) ;
  • Choi, Seong-Ho (Department of Periodontology, College of Dentistry, Yonsei University Oral Science Research Center)
  • 원미숙 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 백정원 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 김창성 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 조규성 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 채중규 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 김종관 (연세대학교 치과대학 치주과학교실, 구강과학연구소) ;
  • 최성호 (연세대학교 치과대학 치주과학교실, 구강과학연구소)
  • Published : 2002.09.30

Abstract

The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic peridontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the following results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0${\pm}$0.9mm), positive control(3.0${\pm}$0.9mm), and experimental group (3.4${\pm}$1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.0${\pm}$0.6mm), and experimental group (2.2${\pm}$l.0mm) except negative control group(0.1${\pm}$0.7mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group(P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.7${\pm}$l.0mm), and experimental group (3.4${\pm}$1.3mm) except negative control(0.l${\pm}$0.9mm) (9<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). The results suggest that the use of ABM/P-15 in the treatment of periodontal intrabony defects can reduce loss of attachment and bone probing depth more than flap operation only. It suggests that ABM/P-15 may be an effective bone graft material for the regeneration of periodontal tissue in intrabony defects.

Keywords

References

  1. C.K Kim et al : Periodontal repair in intrabony defects treated with a calcium carbonate implant and guided tissue regeneration., J. Periodontol., 67: 1301, 1996 https://doi.org/10.1902/jop.1996.67.12.1301
  2. C.K. Kim., KS. Cho., S.H. Choi., Annamarie Prewett. : Periodontal repair in dog : Effect of allogenic freeze-dried demineralized bone matrix I implants on alveolar bone and cementum regeneration.,J. Periodontol., 69 : 26-33, 1998 https://doi.org/10.1902/jop.1998.69.1.26
  3. Feingold J.P. and Chasens et al : Preserved scleral allografts in periodontal defects in man. I. Histological evaluation., J, Periodontol., 48 : 1, 1977 https://doi.org/10.1902/jop.1977.48.1.1
  4. Ellegaard B., Karring T. and Loe H. : Retardation of epithelial migration in new attachment attempts in intrabony defects in monkeys., J. Clin, Periodontol., 3: 23, 1976 https://doi.org/10.1111/j.1600-051X.1976.tb01848.x
  5. Feingold J.P. et al : Preserved scleral allografts in periodontal defects in man. II. Histological evaluation., J. Periodontol., 48 : 4, 1977 https://doi.org/10.1902/jop.1977.48.1.4
  6. Mellonig J. T. : Decalcified freeze-dried bone allografts as an implant material in human periodontal defects,. Int. J. Periodont, Ter, Dent., 4(6) : 41, 1984
  7. Mellonig J.T. and Bowe G.M. : Regenerating bone in clinical periodontics., J. Am . Dent. Assoc., 121 : 497, 1990 https://doi.org/10.14219/jada.archive.1990.0199
  8. Mellonig J. T. : Freeze-dried bone allografts in periodontal reconstructive surgery., Dent. Clin, North Am., 35 : 505, 1991
  9. Schllohorn R G. : Postoperative problems associated with iliac transplants., J. Periodontol., 43 : 3, 1972 https://doi.org/10.1902/jop.1972.43.1.03
  10. Schallorn R G. : Osseous grafts in the treatment of periodontal osseous defects in periodontal surgery, Edited by S.S. Sthal, Springfield, Illonosis Charles C. Thomas. 1976
  11. Schllohorn R.G. and McClain P.K : Combined osseous composite grafting, root conditioning and guided tissue regeneration., Int. J. Perio. and Rest. Dent., 8 : 9, 1998
  12. Barnett J.D. et al : Comparison of freeze-dried bone allograft and porous hydroxyapatite in human periodontal defects., J. Periodontol., 60 : 231, 1989 https://doi.org/10.1902/jop.1989.60.5.231
  13. Peason G.E., Rosen S., Deporter D.A. : Preliminary observations in the usefulness of a decalcified freeze-dried cancellous bone allograft material in periodontal surgery., J. Periodont., 52 : 55, 1981 https://doi.org/10.1902/jop.1981.52.2.55
  14. Seyedin S.M. Osteoinduction : A report on the discovery and research of unique protein growth factors mediating bone development., Oral Surg, Oral Med, Oral Pathol., 68 : 527, 1989 https://doi.org/10.1016/0030-4220(89)90232-6
  15. Lynch S.E., Wiliams R C., Polson A.M., Howell T.H., Reddy M.S., Zapa U.E. : A combination of platelet derived and insulin-like growth factors enhances periodontal regeneration., J. Clin, Periodontol., 16 : 545-548, 1989 https://doi.org/10.1111/j.1600-051X.1989.tb02334.x
  16. Joyce M.E., Robert A.B., Spom M.B., Bolander M.E. : Transforming growth factor-$\beta$and the initiation of chondrogenesis and osteogenesis in the rat femur., J. Cell Biol., 110 : 2195-2207, 1990 https://doi.org/10.1083/jcb.110.6.2195
  17. Bhatnagar R.S., Qian J.J., Gough C.A. : The role in cell binding of a beta-bend within the triple helical region in collagen al(I)chain : structural and biological evidence for conformational tautomerism on fiber surface., J Biomolecular Structure Dynamics., 14: 547, 1997 https://doi.org/10.1080/07391102.1997.10508155
  18. Yukna R.A., Callan D.P., Krauser J.T. : Multicenter clinical evaluation of combination anorganic bovine-derived hydroxyapatite matrix(ABM)lcell binding peptide(P-15) as a bone replacement graft material in human periodontal osseous defects. 6-month results., J. Periodontol.,69 : 655, 1998
  19. Qian J.J. and Bhatnagar R.S. : Acollagen related synthetic peptide promotes osteogenic differentiation in dermal fibroblasts to anorganic bone mineral., J. Dent. Res., 72: 390, 1993
  20. Yukna R.A., Krauser J.T., Callan D.P. et al, : Three year results with ABM/P-15 grafts in human periodontal defects., J. Dent. Res., IADR abstracts.,79: 2059, 2000
  21. Yukna R.A., Salinas T.M., Carr R.F, et al, : Histologic evaluation of ABM/P-15 in human periodontal defects., J. Dent. Res, IADR abstracts., 79 : 2060, 2000
  22. Souris F, et al .Coral, A new biomedical material., J. Maxillofac. Surg,, 13: 64, 1985 https://doi.org/10.1016/S0301-0503(85)80018-7
  23. Stahl S.S., Froum S.J. : Histologic and clinical responses to porous hydroxyapatite implants in human periodontal defects: three to twelve months postimplantation., J. Periodontol., 58 : 689, 1987 https://doi.org/10.1902/jop.1987.58.10.689
  24. Kent J.N. : Reconstruction of the alveolar ridge with hydroxyapatite., Dent, clin. North Am., 30 : 231, 1986
  25. Guillemin G. et al : The use of coral as a bone graft substitute., J. Biomed. Mater. Res., 21 : 557, 1987 https://doi.org/10.1002/jbm.820210503
  26. Ouhayoun J.P. et al : Influence of biomaterials on the healing pattern of bone defects miniature pig mandible., J. Dent. Res., 68(special issue):Abstraet No.1224, 1989
  27. Ellegaard B., Karring T. and Loe H. : Retardation of epithelial migration in new attachment attempts in intrabony defects in monkeys., J. Clin, Periodontol., 3 : 23, 1976 https://doi.org/10.1111/j.1600-051X.1976.tb01848.x
  28. Sogal A. and Tofe A.J. : Risk assessment of bovine spongiforrn encephalopathy transmission through bone graft material derived from bovine bone used for dental applications., J. Periodontol.,70 : 1053-1063, 1999 https://doi.org/10.1902/jop.1999.70.9.1053
  29. Nade S., Burwell R.G. : Decalcified bone as a substrate for osteogenesis., J. Bone Joint Sirg., 59-13: 189, 1977
  30. Urist M.R : Bone formation by autoinduction., Science, 150 : 893, 1965 https://doi.org/10.1126/science.150.3698.893
  31. Urist M.R., McLean F.C. : Osteogenic potential and new bone formation by induction in transplants to the anterior chamber of the eye. J. Bone Joint Surg., 34 : 443-476, 1952 https://doi.org/10.2106/00004623-195234020-00015
  32. Bowers G. M., Chardroff B., Carnevale R., Mellonig J.T., Corio R. : Histologic evaluation of human new attachment apparatus in humans, Part I., J. Periodontol., 60: 665, 1989
  33. Bowers G.M., Chadroff B., Carnevale R., Mellonig J.T., Corio R : Histologic evaluation of human new attachment apparatus in humans, Part II., J. Periodontol., 60 : 675, 1989 https://doi.org/10.1902/jop.1989.60.12.675
  34. Bowers G.M., Chadroff B., Carnevale R., MellonigJ.T., Corio R : Histologic evaluation of human new attachment apparatus in humans, Part lll., J. Periodontol, 60 : 683, 1989 https://doi.org/10.1902/jop.1989.60.12.683
  35. Salama R, Burwell R.G, Dickson IR, : Recombined grafts of bone and marrow., J. Bone Joint Surg., 55 : 402-417, 1973
  36. Burwell R.G. : The function of bone marrow in the incorporation of a bone graft., Clin Orthop., 200 : 125-141, 1985
  37. Wetfelt E. et al : Improved periodontal conditions following therapy. J. Clin, Periodontol., 12 : 283,1985 https://doi.org/10.1111/j.1600-051X.1985.tb02294.x
  38. Callan D.P., Rohrer M.D. : Use of bovinederived hydroxyapatite in the treatment of edentulous ridge defects :A human clinical and histologic case report., J. Periodontol., 64: 575, 1993 https://doi.org/10.1902/jop.1993.64.6.575
  39. Sogal A. and Tofe A.J. : Risk assessment of bovine spongiform encephalopathy transmission through bone graft material derived from bovine bone used for dental applicatlons., J. Periodontol., 70: 1053-1063, 1999 https://doi.org/10.1902/jop.1999.70.9.1053
  40. Yukna R.A.: Synthetic bone grafts in periodontics., Periodontology 2000., 1 : 92, 1993 https://doi.org/10.1111/j.1600-0757.1993.tb00210.x
  41. 김성희, 김종관, 채중규, 조규성. 골내치주낭에서 탈회냉동건조골 동 종이식시 이식효과에 대한 임상적 연구., 대한치주과학회지, 24, 3 : 618, 1994
  42. 김종관 등: 골내낭 처치시 치조골 재생에 관한 연구( I. e-PTFE차단 막의 효과)., 대한치주과학회지, 23 : 367, 1993
  43. Renvert S., Nilveus R, and Egelberg J. : Healing after treatment of periodontal intraosseous defects., J. Clin. Periodontol., 12 : 619, 1985 https://doi.org/10.1111/j.1600-051X.1985.tb00933.x
  44. 최은정, 조규성 :골내치주낭에서 expanded polytetrafluoroethylene 차단 막과 calcium carbonate 이식효과에 대한 임상적 연구., 연세치대 논문집 9권, 1994
  45. H.Y. Kim., S.W. Yi., S.H. Choi., C.K. Kim. : Bone probing measurement as a reliable evaluation of the bone level in periodontal defects., J. Periodontol., 71 : 729-735, 2000 https://doi.org/10.1902/jop.2000.71.5.729