Mehmet Taşpınar, Bülend İnanç, Ahu Dikilitaş

Mine Matriks Protein Türevlerinin Periodontal Defektlerde Klinik Ataşman Kazancı ve İn Vitro Ortamda Periodontal Ligament Fibroblastlarının Çoğalması ve Farklılaşması Üzerine Olan Etkilerinin Değerlendirilmesi: Bir Çift Kör Çalışma

Amaç: Bu çalışmanın amacı, mine matriks protein (MMP) türevlerinin in vitro ortamda periodontal ligament (PDL) fibroblastları üzerindeki etkisini ve kemik içi defektlerin tedavisinde yönlendirilmiş doku rejenerasyonuna (YDR) olası katkısını değerlendirmektir. Gereç ve Yöntemler: Kırk bir kemik içi defekt rastgele MMP + YDR (22) ya da sadece YDR (19) ile tedavi edilmiştir. PDL fibroblastlarının osteojenik farklılaşması enzime-bağlı immünosorbent yöntemi ile değerlendirilmiştir. Bulgular: MMP’nin in vitro ortamda PDL fibroblastlarının canlılığını, proliferasyon oranını, osteojenik farklılaşmasını ve mineralizasyonunu artırdığı bulunmuştur. Sonuç: MMP’nin in vitro ortamda PDL fibroblastlarının çoğalması ve farklılaşması üzerinde endüktif etkileri vardır, ancak klinikte YDR ile birleştirildiğinde periodontal ataşman kazanımına olası katkısı istatistiksel olarak klinik tespit seviyenin altında kalmıştır

Evaluation of the Effects of Enamel Matrix Protein Derivatives on Clinical Attachment Gain in Periodontal Defects and on Proliferation and Differentiation of Periodontal Ligament Fibroblasts In Vitro: A Double-blind Study

Objective: This work assesss the effect of enamel matrix protein derivatives (EMD) on the periodontal ligament (PDL) fibroblasts in vitro, and its possible contribution to guided tissue regeneration (GTR) in the therapy of intrabony defects. Materials and Methods: Forty-one intrabony defects were cured randomly with either EMD or GTR (22) or only with GTR (19). Osteogenic differentiation of PDL fibroblasts was measured usage enzyme-linked immunosorbent method. Results: EMD have been demonstrate to increase the proliferation rate, osteogenic differentiation and mineralization of PDL fibroblasts in vitro. Conclusion: EMD has inductive impacts on PDL fibroblasts proliferation and differentiation in vitro, although it’s possible contribution to periodontal attachment gain remains below a statistically significant level of clinical detection when combined with GTR.

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1. Iwata T, Yamato M, Ishikawa I, Ando T, Okano T. Tissue engineering in periodontal tissue. The Anatomical Record 2014; 297: 16-25.
2. Kao RT, Nares S, Reynolds MA. Periodontal regeneration – intrabony defects: a systematic review from the aap regeneration workshop. J Periodontol 2015; 5: 77-104.
3. Stavropoulos A, Chiantella G, Costa D, Steigmann M, Windisch P, Sculean A. Clinical and histologic evaluation of a granular bovine bone biomaterial used as an adjunct to GTR with a bioresorbable bovine pericardium collagen membrane in the treatment of intrabony defects. J Periodontol 2011; 82: 462-70.
4. Iorio-Siciliano V, Andreuccetti G, Blasi A, Matarasso M, Sculean A, Salvi GE. Clinical outcomes following regenerative therapy of non-contained ıntrabony defects using a deproteinized bovine bone mineral combined with either enamel matrix derivative or collagen membrane. J Periodontol 2014; 85: 1342-50.
5. Lindhe J. Clinical Periodontology and Implant Dentistry 5nd ed. Chapter 25, Concepts in periodontal tissue regeneration. Lang NP, Karring T, editors. Oxford: Blackwell Publishing, 2008: 541-69.
6. Cortellini P, Buti J, Pini Prato G, Tonetti MS. Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial: Tooth retention, periodontitis recurrence and costs. J Clin Periodontol 2017; 44: 58-66.
7. Hammarström L. Enamel matrix, cementum development and regeneration. J Clin Periodontol 1997; 24: 658-68.
8. Siciliano VI, Andreuccetti G, Siciliano AI, Blasi A, Sculean A, Salvi GE. Clinical outcomes after treatment of non-contained intrabony defects with enamel matrix derivative or guided tissue regeneration: a 12-month randomized controlled clinical trial. J Periodontol 2011; 82: 62-71.
9. Mitani A, Takasu H, Horibe T, Furuta H, Nagasaka T, Aino M, et al. Five-year clinical results for treatment of intrabony defects with EMD, guided tissue regeneration and open-flap debridement: a case series. J Periodontal Res 2015; 50: 123-30.
10. Ogihara S, Tarnow D. Efficacy of enamel matrix derivative with freeze-dried bone allograft or demineralized freeze-dried bone allograft in intrabony defects: a randomized trial. J Periodontol 2014; 85: 1351-60.
11. Loe H, Sillness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-51.
12. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22: 121-35.
13. Mühlemann HR, Son S. Gingival sulcus bleeding: A leading symptom in initial gingivitis. Helv Odontol Acta 1971; 15: 107-13.
14. Somerman MJ, Archer SY, Imm GR, Foster RA. A comparative study of human periodontal ligament cells and gingival fibroblasts in vitro. J Dent Res 1988; 67: 66-70.
15. Simonelli A, Minenna L, Trombelli L, Farina R. Single flap approach with or without enamel matrix derivative in the treatment of severe supraosseous defects: a retrospective study. Clin Oral Invest 2021; 25: 6385-92.
16. Fickl S, Thalmair T, Kebchull M, Böhm S, Wachtel H. Microsurgical Access flap in conjunction with enamel matrix derivative for the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol 2009; 36: 784-90.
17. Iorio-Siciliano VI, Blasi A, Stratul SI, Ramaglia L, Octavia V, Salvi GE, et al. Healing of periodontal suprabony defects following treatment with open flap debridement with or without an enamel matrix derivative: A randomize controlled clinical study. Clin Oral Investig 2020; 25: 1019-27.
18. Kulakauskiene R, Aukstakalnis R, Sadzeviciene R. Enamel matrix derivate induces periodontal regeneration by activating growth factors: A review. Stomatologija 2020; 22: 49-53.
19. Rodrigues TLS, Marchesan JT, Coletta RD, Novaes AB Jr, Grisi MF, Souza SL, et al. Effects of enamel matrix derivative and transforming growth factor-β1 on human periodontal ligament fibroblasts. J Clin Periodontol 2007; 34: 514-22.
20. Cattaneo V, Rota C, Silvestri M, Piacentini C, Forlino A, Gallanti A, et al. Effect of enamel matrix derivative on human periodontal fibroblasts: proliferation, morphology and root surface colonization. An in vitro study. J Periodontal Res 2003; 38: 568- 74.
21. Wang Z, Feng Z, Wu G, Bai S, Dong Y, Zahao Y. In vitro studies on human periodontal ligament stem cell sheets enhanced by enamel matrix derivative. Colloids Surf B Biointerfaces 2016; 141: 102-11.
22. Kato H, Katayama N, Taguchi Y, Tominaga K, Umeda M, Tanaka A. A synthetic oligopeptide derived from enamel matrix derivative promotes the differentiation of human periodontal ligament stem cells into osteoblast- like cells with increased mineralization. J Periodontol 2013; 84: 1476-83.
23. Li G, Hu J, Chen H, Chen L, Zhang N, Zhao L, et al. Enamel matrix derivative enhances the proliferation and osteogenic differentiation of human periodontal ligament stem cells on the titanium implant surface. Organogenesis 2017; 13: 3103-13