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Platelet‐Derived Growth Factor Promotes Periodontal Regeneration in Localized Osseous Defects: 36‐Month Extension Results From a Randomized,Controlled, Double‐Masked Clinical Trial
Authors:Myron Nevins  Richard T. Kao  Michael K. McGuire  Pamela K. McClain  James E. Hinrichs  Bradley S. McAllister  Michael S. Reddy  Marc L. Nevins  Robert J. Genco  Samuel E. Lynch  William V. Giannobile
Affiliation:1. Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA.;2. Private practice, Cupertino, CA.;3. Private practice, Houston, TX.;4. Private practice, Aurora, CO.;5. School of Dentistry, University of Minnesota, Minneapolis, MN.;6. Private practice, Tigard, OR.;7. Department of Periodontology, University of Alabama, Birmingham, AL.;8. University at Buffalo, Buffalo, NY.;9. Biomimetic Therapeutics, Franklin, TN.;10. Michigan Center for Oral Health Research and Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI.
Abstract:
Background: Recombinant human platelet‐derived growth factor (rhPDGF) is safe and effective for the treatment of periodontal defects in short‐term studies up to 6 months in duration. We now provide results from a 36‐month extension study of a multicenter, randomized, controlled clinical trial evaluating the effect and long‐term stability of PDGF‐BB treatment in patients with localized severe periodontal osseous defects. Methods: A total of 135 participants were enrolled from six clinical centers for an extension trial. Eighty‐three individuals completed the study at 36 months and were included in the analysis. The study investigated the local application of β‐tricalcium phosphate scaffold matrix with or without two different dose levels of PDGF (0.3 or 1.0 mg/mL PDGF‐BB) in patients possessing one localized periodontal osseous defect. Composite analysis for clinical and radiographic evidence of treatment success was defined as percentage of cases with clinical attachment level (CAL) ≥2.7 mm and linear bone growth (LBG) ≥1.1 mm. Results: The participants exceeding this composite outcome benchmark in the 0.3 mg/mL rhPDGF‐BB group went from 62.2% at 12 months, 75.9% at 24 months, to 87.0% at 36 months compared with 39.5%, 48.3%, and 53.8%, respectively, in the scaffold control group at these same time points (P <0.05). Although there were no significant increases in CAL and LBG at 36 months among all groups, there were continued increases in CAL gain, LBG, and percentage bone fill over time, suggesting overall stability of the regenerative response. Conclusion: PDGF‐BB in a synthetic scaffold matrix promotes long‐term stable clinical and radiographic improvements as measured by composite outcomes for CAL gain and LBG for patients possessing localized periodontal defects ( ClinicalTrials.gov no. CT01530126).
Keywords:Bone regeneration  periodontics  platelet‐derived growth factor  randomized controlled trial  regenerative medicine  tissue engineering
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