الفهرس 
Clinical and histological outcomes
Bone substitutesOnly 14 pages are availabe for public view
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Abstract
The adult human periosteum is highly vascular and contains fibroblasts, osteoblasts and their progenitor cells and multipotent stem cells.
Material and Methods
Sixteen patients each diagnosed with moderate to severe chronic periodontitis had participated in this study.
All selected patients were randomly assigned by coin flipping to one of the 2 treatment groups:
1. group 1: 8 patients each received the sub-marginal periosteal pedicle graft as a filling material.
2. group 2: 8 patients each received open flap debridement and xenograft as a control.
Baseline data for the experimental and control defects were collected just prior to the surgical phase of treatment and included:
1. Plaque index (Pl).
2. Gingival index (GI).
3. Probing pocket depth (PD) and clinical attachment level (CAL) were recorded to the nearest millimeter at the deepest location of the selected interproximal site.
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The radiographic parameters measured were:
1. The relative intrabony component (RIBC): the distance from the cemento-enamel junction to the base of the pocket.
2. The crestal bone level (CBL) :the distance from the alveolar crest to the base of the pocket.
Follow up of the subjects were both radiographically by CBCT and clinically after 6 months.
Results
All cases were followed up both clinically and radiographically the wound healing was uneventful for all treated cases. Soft tissues healed within normal limits, and no significant visual differences were noted between the treatment groups.
The plaque index was 0 for both groups from the baseline to the follow up. The gingival index showed a statistically insignificant change in only two cases each belongs to a different group P value was 0.351 for both groups after 6 months from the baseline . These results could be attributed to the patient’s compliance to the oral hygiene instructions.
No statistically significant differences were found pre-operatively between SMPP and OFD groups with respect to clinical and radiographic measurements (p < 0.05). The defects had deep PD (SMPP, 6.38 ± 1.19mm; OFD, 7.13 ± 1.36 mm) and CAL (SMPP, 5.38 ± 1.19mm; OFD, 6.50 ± 2.33mm).
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For the RIBC (SMPP, 5.24 ± 2.31 mm; OFD, 6.23 ±3.48 mm) and CBL (SMPP, 3.17 ± 0.78 mm; OFD, 3.94 ± 1.94mm) respectively. Post-operatively each group separately have shown a statistically significant change in both clinical and radiographic parameters in 6 months after surgery. For the SMPP group, PD changed from ( 6.38 ± 1.19 mm to 4.00 ± 1.07 mm ) with a p value of <0.001 and the CAL changed from ( 5.38 ± 1.19 mm to 3.00 ± 1.07 mm ) with a p value of <0.001 and an attachment gain of 2.38mm . For the OFD group PD changed from (7.13 ± 1.36 mm to 4.63 ± 0.92 mm ) with a p value of <0.001 and the CAL changed from (6.50 ± 2.33 mm to 4.00 ± 1.51 mm ) with a p value of <0.001 and an attachment gain of 2.5 mm. For the SMPP group the RIBC changed from ( 5.24 ± 2.31 mm to 4.63 ± 1.94 mm ) with a p value of 0.010 and CBL changed from ( 3.17 ± 0.78 mm to 2.86 ± 0.75 mm) with a p value of 0.018 with a gain in ( RIBC) of 0.61 mm. For the OFD group the RIBC changed from ( 6.23 ± 3.48 mm to 5.59 ± 3.44mm ) with a p value of 0.002 and CBL changed from ( 3.94 ± 1.94 mm to 3.44 ± 2.09 mm ) with a p value of 0.045 with a gain in (RIBC) of 0.64 mm. No statistically significant differences were found between SMPP and OFD groups with respect to the percentage of change in the bone filling (p < 0.05). intrabony component RIBC (SMPP, 11.06 ± 4.40% ; OFD ,13.20 ± 13.61% ) with a p value of 0.678 and CBL (SMPP, 9.85 ± 7.15 % ; OFD ,16.46 ± 21.12 % ) with a p value of 0.416 respectively.
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No statistically significant differences were found between SMPP and OFD groups with respect to the percentage of change in (PD) and (CAL) (p < 0.05). PD (SMPP, 37.53 ± 9.22 % ; OFD , 34.67 ± 9.85 % ) with a p value of 0.559 and CAL ( SMPP, 44.88 ± 11.20 % ; OFD , 38.78 ± 9.67 % with a p value of 0.263 respectively .