Management of Intrabony Defects using Hydroxyapatite/β-Tricalcium Phosphate Bone Substitute Alone or Combined with a Collagen Barrier: A Pilot Split-mouth Randomized Clinical Trial

Abstract

Aim: To determine the clinical efficacy of biphasic hydroxyapatite+β-tricalcium phosphate (HA/β-TCP) alone or in the presence of collagen membrane (CM) in the management of intrabony defects. Materials and methods: Nineteen bilateral intrabony defects with an intrabony component ≥4 mm were selected and randomly allocated in a double-blind, split-mouth design to receive either HA/β-TCP+CM (test) or HA/β-TCP (control). Analytical parameters measured at baseline and 1 year after surgery included plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), gingival recession (R), radiographic defect depth (RDD), and radiographic percentage bone fill (PBF). Results: One year after therapy, the test treatment resulted in statistically higher PD reductions (p < 0.001) and CAL gains (p < 0.001) than the control one. In the test group, all sites (100%) gained at least 3 mm of CAL, whereas in the control group only 10 sites (53%) gained CAL of ≥3 mm. The mean radiographic PBF calculated at the end of 1 year was found to be 41.3 ± 20.6% for the test group and 30 ± 20.5% for the control group, with a significant (p = 0.016) improvement in the PBF for the former. Conclusion: The present data appear to indicate that treatment with HA/β-TCP in combination with collagen barrier may result in higher clinical improvements than that achieved with HA/β-TCP alone.