Objectives: The aim of the present study was to evaluate periodontal regeneration/ alveolar bone fill with the use of autologous bone marrow concentrate alone and with a combination of demineralized freeze dried allograft in the treatment of intrabony defects (IBDs). The evaluation was based on histological, immunohistochemical and radiographic analysis.
Materials and Methods: Forty adult male albino rats with experimentally induced periodontitis were included in the present study and divided as follows, group I involved 10 rats and served as positive controls, group II involved 10 rats were treated with demineralized freeze dried allograft (DFDBA) only, group III involved 10 rats were treated with autologous bone marrow concentrate (BMSCs) only and group IV involved 10 rats were treated with combined demineralized freeze dried allograft and autologous bone marrow concentrate. Five rats of each group were sacrificed two weeks after the beginning of the experiment and the other 5 rats were sacrificed six weeks after the beginning of the experiment. Harvested jaw specimens were fixed in formalin, then embedded in paraffin wax, and serially sectioned at 4µm for histological, immunohistochemical assessment using of TGF-β1. Furthermore radiographic assessment was done at the end of study period.
Results: The histological examination of control positive rats revealed degeneration of the collagen fibers associated with alveolar bone resorption. In group II DFDB allograft treated rats showed signs of PDL regeneration associated with increase in the thickness of bone trabeculae. BMSCs treated rats (group III) showed formation of new bundles of collagen fibers of PDL with increase in alveolar bone thickness. In group IV rats treated with combined DFDBA and BMSCs showed the best regenerative features in the PDL fibers and cells with more increase in the thickness of alveolar bone. Immunohistochemical results of TGF-β1 of group I showed negatively to weakly positive TGF-β1 reaction. While, PDL of group II presented moderately positive TGF-β1staining. PDL of group III revealed weakly to moderately positive TGF-β1 stain. However, group IV presented strongly positiveTGF-β1 staining.
Radiographic analysis: showed a statistical significant difference between the three treated groups compared to the positive control group at 2 and 6 weeks respectively indicating that the bone density increased gradually in the three treated groups with the best radiographic evidence of increased bone density in group IV (treated with combined DFDBA and BMSCs).
Conclusion: The present investigation revealed that all the treatment modalities showed favorable regeneration of the intrabony defect. The combination of DFDBA with BMSCs may positively influence the treatment of a periodontal attachment gain with enhancing resolution of osseous defects compared with other treatment modalities. Regenerative combination (DFDBA with BMSCs) emerging as a promising option in the treatment of periodontal osseous defects.