Use of Melatonin/Decorticotomy and Autogenous Bone Graft in Induced 1-Wall Defect

Hala H Hazzaa¹, Mai S Attia², Marwa A M El Shiekh³, Mohammed E Grawish⁴, Mohamed Moawed I Ghoneim⁵, Nahed M Adly⁶, Noha S Shams⁷, Mohamed A El-Mahdy⁸, Gasser M Elewa⁹

Affiliations

¹ Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt; Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt. Electronic address: hala.hazzaa@yahoo.com.
² Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt; Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt.
³ Associate Professor of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt.
⁴ Professor of Oral Biology, Faculty of Dentistry, Mansoura University, Egypt; Professor of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt.
⁵ Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sinai University, Egypt.
⁶ Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt, Faculty of Dentistry, Al Nahda University, Benisuef, Egypt.
⁷ Lecturer of Oral pathology, Faculty of Oral and dental Medicine, Ahram Canadian University, 6th of October, Egypt.
⁸ Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry , Al Nahda University, Benisuef, Egypt.
⁹ Lecturer of Laser Applications in Dentistry, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt.

PMID: 36543730
PMCID: PMC10350604
DOI: 10.1016/j.identj.2022.11.003

Use of Melatonin/Decorticotomy and Autogenous Bone Graft in Induced 1-Wall Defect

Hala H Hazzaa et al. Int Dent J. 2023 Aug.

. 2023 Aug;73(4):524-532.

doi: 10.1016/j.identj.2022.11.003. Epub 2022 Dec 20.

Authors

Hala H Hazzaa¹, Mai S Attia², Marwa A M El Shiekh³, Mohammed E Grawish⁴, Mohamed Moawed I Ghoneim⁵, Nahed M Adly⁶, Noha S Shams⁷, Mohamed A El-Mahdy⁸, Gasser M Elewa⁹

Affiliations

¹ Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt; Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt. Electronic address: hala.hazzaa@yahoo.com.
² Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt; Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt.
³ Associate Professor of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt.
⁴ Professor of Oral Biology, Faculty of Dentistry, Mansoura University, Egypt; Professor of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt.
⁵ Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sinai University, Egypt.
⁶ Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt, Faculty of Dentistry, Al Nahda University, Benisuef, Egypt.
⁷ Lecturer of Oral pathology, Faculty of Oral and dental Medicine, Ahram Canadian University, 6th of October, Egypt.
⁸ Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry , Al Nahda University, Benisuef, Egypt.
⁹ Lecturer of Laser Applications in Dentistry, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt.

PMID: 36543730
PMCID: PMC10350604
DOI: 10.1016/j.identj.2022.11.003

Abstract

Purpose: This study was designed to investigate the effect of intramarrow penetration (IMP) and 1% melatonin (MLN) gel on the remodelling process of autogenous bone graft (ABG) in an induced 1-osseous wall defect model.

Methods: Sixty-four intrabony induced mandibular defects were created on the distal side of premolars-P1, P2, P3, and P4 (on each side)-in 8 beagle dogs. A ligature-induced periodontitis was initiated in each defect. Defects were then divided into 4 equal groups. Group I was treated with open-flap debridement (OFD) alone, group II was treated with OFD/ABG, group III was treated with OFD/IMP/ABG, and group IV was treated with OFD/ABG/IMP/1% MLN gel. The study parameters were bone fill, histologic analysis, and immunohistochemical evaluation of endothelial nitric oxide synthase (eNOS) expression at 2-week (2W) and 8-week (8W) time intervals.

Results: At 8W, significant differences were revealed amongst all groups regarding the amount of bone fill and eNOS expressions (P < .001). Bone fill percentages were 55.5%, 22.3%, 16.8%, and 0% in groups IV, III, II, and I, respectively. eNOS expressions were 1.68 ± 0.06, 8.43 ± 0.04, 16.80 ± 0.17, and 1.97 ± 0.07 in groups IV, III, II, and I, respectively. The favourable results were in line with group IV.

Conclusions: According to these preliminary results, defects treated by ABG augmented with IMP and 1% MLN gel revealed a greater amount of bone fill and reduced eNOS expression. This combination is therefore highly suggested as an adjunct to ABG.

Keywords: Autogenous bone graft; Intrabony defect; Intramarrow penetration; Melatonin.

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Conflict of interest statement

Conflict of interest None disclosed.

Figures

Fig 1 — **Fig. 1**
Photographs showing intrabony defect of 5 mm depth (A) and 5 mm mesiodistal width (B), autogenous bone harvested from the buccal plate of bone (C), intramarrow penetration (IMP) (D), combined therapy of autogenous bone graft, IMP, and melatonin gel (E), and flaps secured with interrupted sutures (F).

Fig 2 — **Fig. 2**
Photomicrograph of 4-µm decalcified sections at the areas of defects created after 2 weeks. Defects of group I showing the notch (N), granulation tissue (GT) formation and area of hemorrhage (H), and multiple inflammatory cells (ICs) (A). Group II defects show bone graft (BG) particles being resorbed by osteoclasts (OCT) impeded in more organised granulation tissue (GT) with inflammatory cell (IC) infiltration (B). The defects of group III and IV showing bone graft (BG) particles with related osteoclasts (OCT). Many medullary spaces (MS) between multiple small nonmineralised (osteoid) trabeculae (NBT) and many dilated blood vessels (BVs) (C, D). The newly formed trabeculae show multiple irregular borders and reversal lines (D) hematoxylin and eosin (H&E); scale bar = 500 µm. Photomicrograph of 4-µm decalcified sections at the areas of defects created after 8 weeks. Group I sections show granulation tissue (GT) almost filling the defect area, adjacent to newly formed blood vessels (BV), cementum (C), and areas of periodontal ligament (PDL) formation (E). Those of group II show newly formed bone (NB) intermingled with areas of granulation tissue (GT) (F). Group III sections show newly formed bone (BT) with wide medullary spaces (MS) that entirely fill the defect area interspersed by small areas of granulation tissue (GT). Newly formed bone appeared as woven bone with small, scattered, large osteocytes (OCs) (G), whilst those of group IV are entirely filled with well-organised trabeculae of newly formed bone (BT) with normal-sized and arranged osteocytes and medullary spaces (MS) surrounded with multiple resting lines (RS) (H), H&E; scale bar = 500 µmA.

Fig 3 — **Fig. 3**
Photomicrograph of 4-µm decalcified sections at the areas of defects after a 2-week period showing mild positive immunohistochemical expression of endothelial nitric oxide synthase (eNOS) in group I (A) and less stainability in group II (B), followed by group III (C) and the least in group IV (D), streptavidin biotin peroxidase, ×200. Photomicrograph of 4-µm decalcified sections at the areas of defects after an 8-week period showing mild to negative immunohistochemical expression of eNOS in group I (E) and obvious increase in stainability in groups II (F) and III (G); the least stainability was in group IV (H), streptavidin biotin peroxidase, ×200.

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References

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Use of Melatonin/Decorticotomy and Autogenous Bone Graft in Induced 1-Wall Defect

Affiliations

Use of Melatonin/Decorticotomy and Autogenous Bone Graft in Induced 1-Wall Defect

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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