ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Patients with Chronic Periodontal Disease, The Use of Biomimetic Ceramics for Intraosseous Defects was More Effective Than Open Flap Debridement in Improving Attachment Levels
Clinical Question In a patient with chronic periodontal disease, would the use of biomimetic ceramics for intraosseous defects improve clinical periodontal parameters compared to open flap debridement?
Clinical Bottom Line In patients with chronic periodontal disease, the use of biomimetic ceramics for intraosseous defects was more effective than open flap debridement in improving attachment levels. The review evaluated multiple biomimetic materials that showed different levels of effectiveness. Biomimetic ceramic appears to be an effective option for bone grafting but may benefit from additional studies with biologic agents.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25558455Rai/2014660 adult patients in 26 included studiesSystematic review of randomized trials
Key resultsThe review included studies selected on the basis of title, abstract, publications fulfilling inclusion criteria, and RCTs excluded for inappropriate data presentation. The results indicated that the biomaterials were more effective than the gold standard of open flap debridement in improving attachment levels for defects. The clinical attachment level gains varied from 1.2mm to 5.88mm based on different biomimetic materials used compared to results seen for open flap debridement which ranged between 1.36mm to 2.8mm.
Evidence Search ("biomimetics"[MeSH Terms] OR "biomimetics"[All Fields] OR "biomimetic"[All Fields]) AND periodontal[All Fields]
Comments on
The Evidence
Validity: The systematic review of 26 studies showed low bias as it declared no source of support or conflict of interest. The studies in this review ranged in duration and included studies with split mouth and parallel groups designs. All studies compared to open bone debridement therapy. The majority of the biomimetic materials showed better results in clinical attachment level gain. Perspective: The review showed that the biomaterials studied showed a significant clinical attachment level change, which is significant clinically and statistically, compared to open flap debridement with regenerative material. The article states that meta-analysis was not done because of the heterogeneity in the results between studies. This would indicate that a more concentrated approach should be studied for these new biomimetic materials.
Applicability Biomimetic ceramics overall were more effective than open flap debridement, but the study does not consider allogeneic or autogenous bone grafts as comparisons. The results seem variable based on the specific material used.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords open flap debridement, biomimetic, periodontal, regenerative, ceramic, intraosseous defects
ID# 2901
Date of submission: 04/15/2015spacer
E-mail dangtp@livemail.uthscsa.edu
Author Peter Dang
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Thomas Oates, DMD, PhD
Faculty mentor/Co-author e-mail OATES@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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