الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The present study evaluated clinically, radiographically, and histologically in Egyptian Baladi dogs, the efficacy of gelatin sponge loaded with beta-tricalcium phosphate with or without concentrated growth factor (CGF), versus collagen with concentrated growth factor, in the treatment of Miller class II recession defects. Twenty-one buccal defects in 11 patients, (3 males and 8 females) with class II recession were selected. Inclusion criteria comprised class II recession defects between 3- 5 mm , the thickness and width of the papillae should not be smaller than the recession defect according to Tinti and Parma- Benfananti (254) and absence of relevant medical conditions that contraindicate periodontal surgery. Their ages ranged between 25 to 50 years old. All subjects received initial therapy including scaling & root planing as well as comprehensive oral hygiene instructions. Re-evaluation was conducted after one month to evaluate tissue response and compliance to plaque control measures for their inclusion in the study. The defects were randomly allocated into three groups (7 in each) as follows: group I: Laterally advanced flap (LAF) + biodegradable gelatin sponge with ß tri-calcium phosphate. group II: LAF+ collagen membrane +concentrated growth factor (CGF). group III: LAF+ biodegradable gelatin sponge with ß tri-calcium phosphate+ (CGF) Comparison between the groups was assessed by the following parameters: 1- Clinical parameters: This included probing pocket depth (PD), clinical attachment level (CAL), recession depth (RD), recession width (RW), height of keratinized tissue (HKT), gingival thickness (GT), percentage of root coverage (RC), and digital measurement at baseline, 3, 6 and 12months post-operatively except PD and CAL which were assessed at 6 and 12 months. The level of clinical significance questionnaire was answered 2 weeks after surgery. 2- Radiographical assessment: CBCT was taken at baseline & 12 months post-surgery Labial bone thickness in millimeters was measured from sagittal view. While labial bone volume was assessed through height, width, and depth in cubic millimeters from the sagittal and coronal views in relation to position of the tooth using simplant software. 3-Histopathological assessment Eight defects in 4 quadrants of 3 Egyptian Baladi dogs (13-15 kg) with a total 24 sites were selected for this study, and Miller class II gingival recessions were surgically created at the buccal surfaces of canines. The three treatment modalities were represented in each dog separately, with a total of eighteen sites while the remaining six sites served as control. The animals were euthanized at 12 weeks postoperatively and tissue specimens which consist of bone segments were decalcified in 10 % ethylene-diamine tetraacetic acid (EDTA) solution and were stained with Hematoxylin & Eosin stain following the routine technique. Histomorphometric analysis was carried out using free software image procedure to evaluate histopathological results. The collected data was statistically analyzed at the different follow up periods. The statistician was blinded of the treatment allocated to any of the clinical and experimental groups to prevent bias. Clinical results: The results of the present study showed significant reduction of PD, CAL, RD, RW and significant increase in HKT, GT and RC in all study groups along different study periods with no significant difference between groups II and III, while a significant difference was noted when group I was compared to groups II and III in favor of the latter. However, it was observed that, group II showed the most favorable clinical results as compared to all the study groups. Radiographic results: The results of the present study showed a significant increase in labial bone thickness and bone volume observed by CBCT in all study groups at 12 months postoperatively, with no significant difference between the three treatment groups. However, the 3D volume assessment using CBCT showed that group III was the most favorable among the study groups. Histopathological results Experimental defects of all groups showed different types of new attachment with variable degree of regeneration and repair of new cementum, bone, and periodontal fibers. The control group exhibited attachment with a long junctional epithelium. In group I, four defects showed new attachment with periodontal ligament (pdl)- like tissue whereas two defects healed with long junctional epithelium. Five defects in group II displayed new attachment with Pdl- like tissue whereas the last defect demonstrated attachment with long junctional epithelium. While in group III, all defects showed new attachment with Pdl- like tissues.