Regeneration of Intrabony Defects with Nano Hydroxyapatite Graft, Derived from Eggshell along with Periosteum as Barrier Membrane under Magnification—An Interventional Study

Abstract

Intrabony defects can be treated by various approaches. Use of GTR along with bone grafts is said to enhance the outcome. The periosteum has been claimed to increase the regeneration. The egg-shell-derived nano hydroxyapatite (EnHA) has shown a scope as alloplastic graft. Thus, the following study was undertaken to combine the periosteal pedicle along with EnHA for the treatment of intrabony defects under magnification to achieve optimal bone regeneration. A total of 21 patients, having intrabony defects with ≥6 mm probing depth (PD) and two or three wall defects as detected on CBCT, satisfying inclusion criteria were enrolled. The sites were randomly allocated as Group A, B and C (n = 7). The following parameters, defect density and defect fill in CBCT (at baseline and 6 months), PPD, RAL, Plaque index (PI), Gingival index (GI) and Gingival Bleeding Index (GBI) were recorded at baseline, 1, 3 and 6 months. p < 0.05 is considered as statistically significant. Bone density and bone fill values were found to be much higher in pedicle with EnHA and EnHA alone group and the values showed statistically significant results. The current clinical research showed that periosteal pedicle along with EnHA and EnHA as stand-alone therapy gave superior results compared to OFD alone, which is an innovative and feasible treatment option.

Cell-Friendly Chitosan-Xanthan Gum Membranes Incorporating Hydroxyapatite Designed for Periodontal Tissue Regeneration

“…These biomaterials act as local bone substitutes or biological barriers intended to direct bone, epithelial, and connective tissue growth to restore the affected tissues and their functions, as well as aesthetic aspects [ 5 , 6 ]. Thin membranes made of collagen, gelatin, and polycaprolactone or their combination with bone grafts are among the most effective biomaterials for GTR, acting as a biological barrier and preventing the formation of fibrotic or scar tissue [ 7 , 8 , 9 ]. In addition to these combinations of materials and GTR techniques, several bioactive agents can be loaded into the biomaterial to prevent bacterial colonization and growth (e.g., doxycycline), immunomodulatory products (such as medicines or proteins), and stem cells [ 1 , 7 ].…”

Sericin as Bone Grafts

“…However, they carry risks of immunogenicity, disease transmission, and may lack the osteoinductive properties found in autografts. Synthetic substitutes, on the other hand, such as hydroxyapatite, bioactive glasses, and polymers, can be manufactured in large quantities and tailored to specific needs [10,11]. Nonetheless, these substitutes may not fully replicate the biological properties of natural bone, potentially affecting graft success.…”

“…bioactive glasses, and polymers, can be manufactured in large quantities and tailored to specific needs [10,11]. Nonetheless, these substitutes may not fully replicate the biological properties of natural bone, potentially affecting graft success.…”