Clinical and radiographic evaluation of citric acid-based nano hydroxyapatite composite graft in the regeneration of intrabony defects - A randomized controlled trial

Abstract

Background:Conventional periodontal therapy with various bone grafts has limited scope and the results are not predictable. To improve their utility, the hybridization of bioceramics and biodegradable polymers has been widely adopted to reform the mechanical properties of bone grafts. One such biodegradable polymer is POC (Poly 1,8 octanediol). Secondly, citric acid is considered as the key material in bone mineralization, which is related to the overall stability, strength and fracture resistance of bone. Hence citric acid is incorporated in a polymer and Nano hydroxyapatite to form a composite graft, for periodontal bone regeneration. This study attempts to evaluate the efficacy of citric acid based Nano-hydroxyapatite composite graft for the treatment of intrabony defects in chronic periodontitis patients over 12 months.Methods:A split mouth study, which consists of 10 systemically healthy patients, were randomly treated with Citric acid based Nano hydroxyapatite composite graft (test sites, n=18) or with Nano hydroxyapatite alone (control sites, n=15). Plaque index, gingival index, gingival bleeding index, probing pocket depth (PPD), clinical attachment level (CAL), bone probing depth (BPD) and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed over a period of 12 months. Statistical analysis used was student's t-test and One-Way ANOVA.Results:Both test and control sites demonstrated statistically significant reduction of PD, BPD, gain in CAL and radiographic bone fill. Nevertheless the test sites showed Statistically significant improvements in all the parameters as compared to control sites at 12 months.Conclusion:Citric acid based Nano hydroxyapatite composite graft can be considered as a newer material for periodontal regeneration.

Mesoporous Hydroxyapatite/Chitosan Loaded With Recombinant-Human Amelogenin Could Enhance Antibacterial Effect and Promote Periodontal Regeneration

“…Compared with the traditional HA, nanohydroxyapatite (nHA) has a larger surface area and better bioactivity and loading capacity. There were sufficient preclinical and clinical findings to support the osteogenic effect of nHA in tissue engineering (Shirmohammadi et al, 2014;Kamboj et al, 2016;Dayashankar et al, 2017;Sadeghi et al, 2017). Chitosan has been used for periodontal treatments in many studies.…”

Implant Stability Parameters & Bone Density Values of Different Graft Materials with Immediately Placed Dental Implants

“…(25) The biological compatibility of this material along with its osteoconductive property advocated researchers to use it in bone regeneration and implant dentistry. (26)(27)(28)(29) Although the primary stability and bone regeneration achieved using different grafting materials around immediate implants are important factors influencing the long term success, the correlation between them is not well evaluated. The aim of the current study is to evaluate the effect of varying grafting materials utilized with immediate implants on implant stability & bone regeneration.…”

Various treatment modalities in aggressive periodontitis

“…showed significant improvement in clinical and radiographic parameters in the treatment of periodontal intrabony defects using indigenously prepared citic acid-nano hydroxyapatite composite graft in chronic periodontitis patients. [ 14 ]…”