Clinical and radiographic evaluation of Nano-crystalline hydroxyapatite bone graft (Sybograf^®) in combination with bioresorbable collagen membrane (Periocol^®) in periodontal intrabony defects

Abstract

Background:Nanosized ceramics may represent a promising class of bone graft substitutes due to their improved osseointegrative properties. Nanocrystalline Hydroxyapatite (NcHA) bind to bone and stimulate bone healing by stimulation of osteoblast activity. The present study aims to explore the clinical and radiographical outcome of NcHA bonegraft (Sybograf®) with collagen membrane (Periocol®), in comparison with open flap debridement (OFD), in the treatment of intrabony periodontal defects.Materials and Methods:A parallel-group, randomized, controlled clinical trial was designed to conduct the study. Eighteen intrabony defects in 14 systemically healthy patients aged between 25 to 65 years were randomly assigned to test and control group. The plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) were recorded at baseline, and were reevaluated at 6 months. In addition to this, radiographic bone fill was assessed using digital software. At the test site, NcHA bone graft and collagen membrane was placed, whereas at the control site, only OFD was done. Recall appointments were made at 7 days, 30 days, and then at 3 months and 6 months.Results:The data were subjected to statistical analysis using the Mann-Whitney ‘U’ Test and Wilcoxon signed rank sum test. In the control group, the mean reduction of PPD was 3.22±1.09 mm (P=0.007) and CAL gain was 2.77±1.09 mm (P=0.007). In the test group, the mean PPD reduction of 4.33±0.5 mm (P=0.006) and mean gain in CAL was 3.77±0.66 mm (P=0.006) at 6 months. The mean increase in REC was 0.55±0.72 mm (P=0.025) in test, and 0.44±0.52 mm (P=0.046) in control group. The mean gain in radiographic defect fill was 2.07±0.67 mm (P=0.008) in test and 0.91±0.21 mm (P=0.007) in control group.Conclusion:The nanocrystalline hydroxyapatite bone graft in combination with collagen membrane demonstrated clinical advantages beyond that achieved by OFD alone.

Treatment of horizontal defect with and without platelet-rich fibrin matrix: A randomized comparative clinical study

“…At baseline, 6 months, and 9 months plaque index (PI),[ 10 ] GI[ 11 ] scores were evaluated. Periodontal probing depth (PPD), clinical attachment level (CAL), and radiovisiography (RVG) to measure the defect fill (DF) depth percentage (DF %)[ 12 ] were also recorded.…”

Nanoreinforced Hydrogels for Tissue Engineering: Biomaterials that are Compatible with Load‐Bearing and Electroactive Tissues

“…The corresponding studies have reported a hydroxyapatite‐mediated increase in the expression of bone markers such as osteopontin, osteocalcin, and alkaline phosphatase (ALP), as a consequence of the exceptional and native‐like osteoinductivity of hydroxyapatite . These affirming outcomes have also encouraged researchers to develop high‐performance hydroxyapatite‐based bone grafts . However, grafting procedures are invasive in practice and often result in adverse tissue reactions accompanied by post‐operative discomfort.…”

Main properties of nanocrystalline hydroxyapatite as a bone graft material in treatment of periodontal defects. A review of literature

“…Although it was not statistically significant, utilizing collagen membrane revealed superior results compared to sites treated with bone graft alone. The clinical and radiographic results of n-HA alone and in combination with bioabsorbable collagen membrane in the treatment of periodontal intra-bony defects were evaluated by Singh et al [47]. It was concluded that combination therapy was significantly greater to open flap debridement alone.…”