Early wound healing at 1 week postoperatively in periodontal tissue regeneration therapy: enamel matrix derivative versus recombinant human fibroblast growth factor
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Purpose: Recombinant human fibroblast growth factor-2 (rhFGF-2) has demonstrated positive effects on wound healing at 2 weeks after periodontal surgery relative to enamel matrix derivative (EMD). However, the effects at earlier postoperative stages have not been reported. This retrospective study compared the early wound healing outcomes 1 week after surgery using the modified papilla preservation technique (mPPT) with either EMD or rhFGF-2 therapy. Methods: We compiled a list of all mPPT sites treated with EMD or rhFGF-2 during the survey period (September 2011 to March 2022). Early wound healing was assessed using the early wound healing score (EHS) and the modified early wound healing index (mEHI). Inter-rater reliability for the EHS and mEHI was established using intraclass correlation coefficients. Factors influencing mPPT were identified by analyzing the correlation coefficients between the EHS items, mEHI items, and potential influencing factors. After adjusting for factors impacting EHS, mEHI, and mPPT, we compared the EHS and mEHI between EMD and rhFGF-2 groups. Results: In total, 72 sites were evaluated. The scores for incision line, step, and dehiscence were significantly higher in those receiving rhFGF-2 (n=42) compared to those treated with EMD (n=30). The EHS item scores did not differ significantly between groups. Among patients aged ≥50 years, but not those <50 years, significantly higher step and dehiscence scores were found in the rhFGF-2 group than the EMD group (P<0.01). Additionally, for patients exhibiting a clinical attachment level (CAL) ≥8 mm, the step score was significantly higher in the rhFGF-2 group than in the EMD group (P<0.05), but this trend was not reflected in those with a CAL <8 mm. Conclusions: In this study, early wound closure at mPPT sites was more effectively achieved with rhFGF-2 than with EMD. Nevertheless, biochemical assessments are required to compare the re-epithelialization effects of these therapies.
Abstract
Purpose: Recombinant human fibroblast growth factor-2 (rhFGF-2) has demonstrated positive effects on wound healing at 2 weeks after periodontal surgery relative to enamel matrix derivative (EMD). However, the effects at earlier postoperative stages have not been reported. This retrospective study compared the early wound healing outcomes 1 week after surgery using the modified papilla preservation technique (mPPT) with either EMD or rhFGF-2 therapy. Methods: We compiled a list of all mPPT sites treated with EMD or rhFGF-2 during the survey period (September 2011 to March 2022). Early wound healing was assessed using the early wound healing score (EHS) and the modified early wound healing index (mEHI). Inter-rater reliability for the EHS and mEHI was established using intraclass correlation coefficients. Factors influencing mPPT were identified by analyzing the correlation coefficients between the EHS items, mEHI items, and potential influencing factors. After adjusting for factors impacting EHS, mEHI, and mPPT, we compared the EHS and mEHI between EMD and rhFGF-2 groups. Results: In total, 72 sites were evaluated. The scores for incision line, step, and dehiscence were significantly higher in those receiving rhFGF-2 (n=42) compared to those treated with EMD (n=30). The EHS item scores did not differ significantly between groups. Among patients aged ≥50 years, but not those <50 years, significantly higher step and dehiscence scores were found in the rhFGF-2 group than the EMD group (P<0.01). Additionally, for patients exhibiting a clinical attachment level (CAL) ≥8 mm, the step score was significantly higher in the rhFGF-2 group than in the EMD group (P<0.05), but this trend was not reflected in those with a CAL <8 mm. Conclusions: In this study, early wound closure at mPPT sites was more effectively achieved with rhFGF-2 than with EMD. Nevertheless, biochemical assessments are required to compare the re-epithelialization effects of these therapies.
참고문헌 (37)
- Takei HH, "Flap technique for periodontal bone implants. Papilla preservation technique", J Periodontol, 56, pp.204~210 (1985)
- Cortellini P, "The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures", J Periodontol, 66, pp.261~266 (1995)
- Murphy KG, "Interproximal tissue maintenance in GTR procedures : description of a surgical technique and 1-year reentry results", Int J Periodontics Restorative Dent, 16, pp.463~477 (1996)
- Ramfjord SP, "The modified Widman flap", J Periodontol, 45, pp.601~607 (1974)
- Retzepi M, "Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery : a clinical trial using laser Doppler flowmetry", J Clin Periodontol, 34, pp.903~911 (2007)
- Wachtel H, "Microsurgical access flap and enamel matrix derivative for the treatment of periodontal intrabony defects : a controlled clinical study", J Clin Periodontol, 30, pp.496~504 (2003)
- Sculean A, "Comparison of enamel matrix proteins and bioabsorbable membranes in the treatment of intrabony periodontal defects. A split-mouth study", J Periodontol, 70, pp.255~262 (1999)
- Sculean A, "Healing of human intrabony defects following treatment with enamel matrix proteins or guided tissue regeneration", J Periodontal Res, 34, pp.310~322 (1999)
- Marini L, "Early Wound Healing Score : a system to evaluate the early healing of periodontal soft tissue wounds", J Periodontal Implant Sci, 48, pp.274~283 (2018)
- Donos N, "Clinical evaluation of an enamel matrix derivative and a bioresorbable membrane in the treatment of degree III mandibular furcation involvement : a series of nine patients", Int J Periodontics Restorative Dent, 24, pp.362~369 (2004)
- Rojas MA, "Early wound healing outcomes after regenerative periodontal surgery with enamel matrix derivatives or guided tissue regeneration : a systematic review", BMC Oral Health, 19, pp.76~ (2019)
- Cortellini P, "The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures", Int J Periodontics Restorative Dent, 19, pp.589~599 (1999)
- Cortellini P, "Clinical performance of a regenerative strategy for intrabony defects : scientific evidence and clinical experience", J Periodontol, 76, pp.341~350 (2005)
- Siciliano VI, "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, 82, pp.62~71 (2011)
- Iorio-Siciliano V, "Clinical outcomes following regenerative therapy of non-contained intrabony defects using a deproteinized bovine bone mineral combined with either enamel matrix derivative or collagen membrane", J Periodontol, 85, pp.1342~1350 (2014)
- Crea A, "Treatment of intrabony defects using guided tissue regeneration or enamel matrix derivative : a 3-year prospective randomized clinical study", J Periodontol, 79, pp.2281~2289 (2008)
- Esmon CT, "The interactions between inflammation and coagulation", Br J Haematol, 131, pp.417~430 (2005)
- Esmon CT, "Crosstalk between inflammation and thrombosis", Maturitas, 61, pp.122~131 (2008)
- Luyendyk JP, "The multifaceted role of fibrinogen in tissue injury and inflammation", Blood, 133, pp.511~520 (2019)
- Silva LM, "Fibrin is a critical regulator of neutrophil effector function at the oral mucosal barrier", Science, 374, pp.eabl5450~ (2021)
- Nakayama Y, "Comparison of early wound healing using modified papilla preservation technique between enamel matrix derivative and recombinant human fibroblast growth factor", J Periodontal Implant Sci, 53, pp.e53~ (2023)
- Kitamura M, "Periodontal tissue regeneration using fibroblast growth factor-2 : randomized controlled phase II clinical trial", PLoS One, 3, pp.e2611~ (2008)
- Kitamura M, "Randomized placebo-controlled and controlled non-inferiority phase III trials comparing trafermin, a recombinant human fibroblast growth factor 2, and enamel matrix derivative in periodontal regeneration in intrabony defects", J Bone Miner Res, 31, pp.806~814 (2016)
- Heijl L, "Enamel matrix derivative(EMDOGAIN)in the treatment of intrabony periodontal defects", J Clin Periodontol, 24, pp.705~714 (1997)
- Lyngstadaas SP, "Enamel matrix proteins; old molecules for new applications", Orthod Craniofac Res, 12, pp.243~253 (2009)
- Oda Y, "Accelerating effects of basic fibroblast growth factor on wound healing of rat palatal mucosa", J Oral Maxillofac Surg, 62, pp.73~80 (2004)
- Nakayama Y, "Impact of adjunctive procedures on recombinant human fibroblast growth factor-2-mediated periodontal regeneration therapy : a retrospective study", J Periodontol, 92, pp.983~994 (2021)
- Landis JR, "The measurement of observer agreement for categorical data", Biometrics, 33, pp.159~174 (1977)
- Polimeni G, "Biology and principles of periodontal wound healing", regeneration, 2006, pp.41, 30~47
- Trombelli L, "Retrospective analysis of factors related to clinical outcome of guided tissue regeneration procedures in intrabony defects", J Clin Periodontol, 24, pp.366~371 (1997)
- Marini L, "Early wound healing score(EHS) : an intra-and inter-examiner reliability study", Dent J, 7, pp.86~ (2019)
- Fujisawa K, "Basic fibroblast growth factor and epidermal growth factor reverse impaired ulcer healing of the rabbit oral mucosa", J Oral Pathol Med, 32, pp.358~366 (2003)
- Zeldich E, "Enamel matrix derivative stimulates human gingival fibroblast proliferation via ERK", J Dent Res, 86, pp.41~46 (2007)
- Schlueter SR, "In vitro effects of enamel matrix derivative on microvascular cells", J Periodontol, 78, pp.141~151 (2007)
- Martin P, "Wound healing--aiming for perfect skin regeneration", Science, 276, pp.75~81 (1997)
- Ashcroft GS, "Ageing and wound healing", Biogerontology, 3, pp.337~345 (2002)
- Smith PC, "Gingival wound healing : an essential response disturbed by aging?", J Dent Res, 94, pp.395~402 (2015)