Clinical outcomes with bioactive agents alone or in combination with grafting or guided tissue regeneration

J Clin Periodontol. 2008 Sep;35(8 Suppl):117-35. doi: 10.1111/j.1600-051X.2008.01265.x.

Abstract

Aim: The purpose of the present review was to determine the clinical effect of the use of bioactive agents (BAs) for the treatment of intra-osseous and furcation defects.

Material and methods: The effectiveness of the BAs was evaluated when used in addition to open flap debridement either alone or in association with grafts and/or guided tissue regeneration (GTR). Among the included agents, recombinant human platelet-derived growth factor-BB (rhPDGF-BB), platelet-rich plasma (PRP), commercially available enamel matrix derivative (cEMD) and peptide P-15 (P-15) have been clinically tested for treating periodontal defects.

Results and conclusions: The results of the present review indicate that: (1) cEMD either alone or in combination with grafts can be effectively used to treat intra-osseous defects and the clinical results appear to be stable long term; (2) the additional use of a graft seems to enhance the clinical outcome of cEMD; (3) the combined use of rhPDGF-BB and P-15 with a graft biomaterial has shown beneficial effects in intra-osseous defects; (4) contrasting results were reported for PRP and graft combinations; and (5) limited evidence supports the use of BAs either alone or in association with graft/GTR for the treatment of furcation defects.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alveolar Bone Loss / surgery*
  • Becaplermin
  • Biocompatible Materials / therapeutic use*
  • Biological Factors / therapeutic use
  • Bone Substitutes / therapeutic use*
  • Bone Transplantation*
  • Collagen / therapeutic use
  • Dental Enamel Proteins / therapeutic use
  • Furcation Defects / surgery
  • Guided Tissue Regeneration, Periodontal / methods*
  • Humans
  • Peptide Fragments / therapeutic use
  • Platelet-Derived Growth Factor / therapeutic use
  • Proto-Oncogene Proteins c-sis
  • Recombinant Proteins
  • Treatment Outcome

Substances

  • Biocompatible Materials
  • Biological Factors
  • Bone Substitutes
  • Dental Enamel Proteins
  • Peptide Fragments
  • Platelet-Derived Growth Factor
  • Proto-Oncogene Proteins c-sis
  • Recombinant Proteins
  • cell-binding peptide P-15
  • enamel matrix proteins
  • Becaplermin
  • Collagen