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العنوان
The Use of Simvastatin Gel with Perforated Resorbable Membranes in the Treatment of Intrabony Defects in chronic Periodontitis Patients :
المؤلف
Issa, Dalia Mohammed Rasheed Mohammed Fathy.
هيئة الاعداد
باحث / داليا محمد رشيد محمد فتحى عيسى
مشرف / أحمد يوسف جمال
مشرف / محمد عبد الرحيم الشحات
مشرف / أحمد عبد العزيز حسن
تاريخ النشر
2018.
عدد الصفحات
275 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
Periodontics
تاريخ الإجازة
6/3/2018
مكان الإجازة
جامعة عين شمس - كلية طب الأسنان - طب الفم وأمراض اللثة والتشخيص
الفهرس
Only 14 pages are availabe for public view

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Abstract

The hopeful goal of periodontal therapy is regeneration of the lost part of the periodontium on a previously diseased root surface. Currently, the major progress is being made to achieve this goal by utilizing various regenerative procedures such as bone grafting, guided tissue regeneration techniques and combination therapy.
The present investigation was conducted to evaluate the clinical and radiographic outcome and simvastatin gingival crevicular fluid levels availability for 30 days following the use of simvastatin gel combined with a modified perforated resorbable membrane compared with simvastatin gel combined with a traditional cell occlusive resorbable membrane in cases with and without EDTA root surface etching for improving bone regeneration in intrabony defects in chronic periodontitis patients.
The study was performed on forty patients having chronic periodontitis aged from 30 to 50 years with 40 intrabony defects divided into four groups. group I in which 10 patients received open flap procedure and 1.2% simvastatin gel and covering the defect with resorbable collagen occlusive membrane. group II in which 10 patients received open flap procedure and 1.2% simvastatin gel and covering the defect resorbable collagen modified perforated membrane. group ΙIΙ in which 10 patients received open flap procedure, 24% EDTA root surface etching, 1.2% simvastatin gel and then coverage of the defect by resorbable collagen occlusive membrane. group ΙV in which 10 patients received open flap procedure, 24% EDTA root surface etching, 1.2% simvastatin gel and then coverage of the defect by resorbable collagen modified perforated membrane.
Clinical parameters including plaque index, gingival index, probing depth and clinical attachment level were recorded before surgery. Moreover, radiographic measurements were performed by the Digora system presurgically. Vertical bone defects were exposed by full thickness mucoperiosteal flap following sulcular incision and thorough debridement was performed. The first group received simvastatin gel and occlusive resorbable membrane. The second group received simvastatin gel and perforated membrane. The third group received EDTA root surface etching, simvastatin gel and occlusive membrane, while the fourth group received EDTA root surface etching, simvastatin gel and perforated membrane.
The same initial clinical parameters and radiographic measurements were recorded six and nine months post surgically.
The results of the present study demonstrated that at the initial, after six months, and after nine months, the four treatment modalities showed no statistically significant difference in mean gingival index and plaque index through all periods. By comparing the four groups, after six months and at the end of the study, group III and group IV showed statistically significantly lower mean probing pocket depth and lower mean clinical attachment level than group I and group II. On the other hand, there was no statistically significant difference between group II and group I.
The radiographic examination found that the current investigation exhibited that at the base line and at six months; there was no statistically significant difference between the four groups in the defect fill. While At nine months; results showed that there is no statistically significant difference between group IV, group III and group II but the three groups showed a statistically significant difference than group I.
By comparing the four treatment modalities preoperatively and at six as well as at nine months; results revealed that there was no statistically significant difference between radiodensitometric measurements between them.
Regarding simvastatin concentration, group IV showed higher mean simvastatin concentration which was followed by group III, then group II, and the least simvastatin concentration was noticed in group I.