Citation Information :
Rathod A, Jaiswal P, Bajaj P, Kale B, Masurkar D. Evaluating and Comparing the Effectiveness of Nano-HA and HA + β-TCP with A-PRF Clinically and Radiographically in the Treatment of Human Infrabony Defects. J Contemp Dent Pract 2023; 24 (7):500-506.
Aim: To evaluate and compare the effectiveness of nanocrystalline hydroxyapatite (NcHA) with advanced platelet-rich fibrin (A-PRF) and hydroxyapatite-reinforced beta tricalcium phosphate (HA + β-TCP) with A-PRF in the treatment of human infrabony defects clinically and radiographically using cone-beam computed tomography (CBCT).
Materials and methods: There were a total of 28 defects, with 14 defects in the test and control groups, respectively. There were total 28 patients were involved in the study. The test group (group A) was treated with NHA and A-PRF, while the control group (group B) was treated with HA + β-TCP and A-PRF. Bone defect fill was the primary result of the investigation. Periodontal pocket depth (PPD), R-CAL, papillary bleeding index (PBI), and PI were the secondary outcome. Clinical and radiographic measurements were recorded at baseline and 6 months postoperatively.
Results: No significant difference was observed between the two groups in terms of PPD reduction (4.64 ± 0.74 mm vs 4.07 ± 0.99 mm), clinical attachment loss (CAL) gain (4.64 ± 0.74 mm vs 3.92 ± 0.99 mm) and radiographic defect depth reduction (2.41 ± 0.32 mm vs 2.40 ± 0.27 mm) for test and control groups, respectively.
Conclusion: At 6-month post-surgery, both treatment modalities demonstrated statistically significant improvements with regard to CAL gains, PPD reduction, and reduction in radiographic defect depth.
Clinical relevance: The NcHA and HA + β-TCP with A-PRF is a novel material used in the treatment of infrabony defect for periodontal regeneration. The NcHA and HA + β-TCP with A-PRF need to consider biomaterials for bone defect fill.
Bansal R, Patil S, Chaubey KK, et al. Clinical evaluation of hydroxyapatite and β-tricalcium phosphate composite graft in the treatment of intrabony periodontal defect: a clinico-radiographic study. J Indian Soc Periodontol 2014;18(5): 610–617. DOI: 10.4103/0972-124X.142455.
Upadhyay H, Bhattacharya HS, Agarwal MC, et al. Different regenerative responses of two platelet concentrates in the treatment of human periodontal infrabony defects: a clinico-radiographic study. Contemp Clin Dent 2020;11(3):217–222. DOI: 10.4103/ccd.ccd_7_19.
Suwondo CI, Herawati D, Sudibyo S. Effect of advanced platelet-rich fibrin applications on periodontal regeneration in infrabony pocket treatment. Majalah Kedokteran Gigi Indonesia 2019;4(3):154–160. DOI: 10.22146/majkedgiind.37414.
Bodhare GH, Kolte AP, Kolte RA, et al. Clinical and radiographic evaluation and comparison of bioactive bone alloplast morsels when used alone and in combination with platelet-rich fibrin in the treatment of periodontal intrabony defects—A randomized controlled trial. J. Periodontol. 2019;90(6):584–594. DOI: 10.1002/JPER.18-0416.
Choukroun J, Adda F, Schoeffler C, et al. Une opportunité en paro-implantologie: le PRF. Implantodontie 2001;42(55):e62. Available from: https://api.semanticscholar.org/CorpusID:81142737.
Elgendy EA, Shady TEA. Clinical and radiographic evaluation of nanocrystalline hydroxyapatite with or without platelet-rich fibrin membrane in the treatment of periodontal intrabony defects. J Indian Soc Periodontol 2015;19(1):61–65. DOI: 10.4103/0972-124X.148639.
Singh VP, Nayak DG, Uppoor AS, Shah D. Clinical and radiographic evaluation of Nano-crystalline hydroxyapatite bone graft (Sybograf®) in combination with bioresorbable collagen membrane (Periocol®) in periodontal intrabony defects. Dent Res J 2012;9(1):60–67. DOI: 10.4103/1735-3327.92945.
Jain R, Kaur H, Jain S, et al. Comparison of nano-sized hydroxyapatite and β-tricalcium phosphate in the treatment of human periodontal intrabony defects. J Clin Diagn Res 2014;8(10):ZC74–78. DOI: 10.7860/JCDR/2014/9535.5047.
Verardi S, Lombardi T, Stacchi C. Clinical and radiographic evaluation of nanohydroxyapatite powder in combination with polylactic acid/polyglycolic acid copolymer as bone replacement graft in the surgical treatment of intrabony periodontal defects: A retrospective case series study. Materials. 2020;13(2):269. DOI: 10.3390/ma13020269.
Garg K, Srivastava R, Verma PK, et al. Clinical evaluation of platelet rich plasma when combined with an alloplastic bone graft material in the treatment of intrabony periodontal defects. Saudi J Oral Sci 2017;4(1):33. DOI: 10.4103/1658-6816.200139.
Khetarpal S, Pitale U, Solanki M, et al. 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. Kumar A, editor. Int J Oral Care Res 2018;6(1):38–46. 10.5005/jp-journals-10051-0147.
Kaushick BT, Jayakumar ND, Padmalatha O, et al. Treatment of human periodontal infrabony defects with hydroxyapatite + β tricalcium phosphate bone graft alone and in combination with platelet rich plasma: a randomized clinical trial. Indian J Dent Res 2011;22(4): 505–510. DOI: 10.4103/0970-9290.90278.
Thakare K, Deo V. Randomized controlled clinical study of rhPDGF-BB + β-TCP versus HA + β-TCP for the treatment of infrabony periodontal defects: clinical and radiographic results. Int J Periodontics Restorative Dent 2012;32(6):689–696. PMID: 23057058.
Schnettler R, Stahl JP, Alt V, et al. Calcium phosphate-based bone substitutes. Eur J Trauma. 2004;30(4):219–229. DOI: https://doi.org/10.1007/s00068-004-1393-x.
Pilloni A, Pompa G, Saccucci M, et al. Analysis of human alveolar osteoblast behavior on a nano-hydroxyapatite substrate: an in vitro study. BMC Oral Health 2014;14(1):1–7. DOI: https://doi.org/10.1186/1472-6831-14-22.
Schwarz F, Herten M, Ferrari D, et al. Guided bone regeneration at dehiscence-type defects using biphasic hydroxyapatite + beta tricalcium phosphate (Bone Ceramic®) or a collagen-coated natural bone mineral (BioOss Collagen®): an immunohistochemical study in dogs. Int J Oral Maxillofac Surg 2007;36(12):1198–2106. DOI: 10.1016/j.ijom.2007.07.014.
Heinz B, Kasaj A, Teich M, et al. Clinical effects of nanocrystalline hydroxyapatite paste in the treatment of intrabony periodontal defects: a randomized controlled clinical study. Clin Oral Investig 2010;14(5):525–531. DOI: 10.1007/s00784-009-0325-x.
Shrestha S, Shrestha SM, Pradhan A, et al. Platelet rich fibrin and bone graft in the treatment of intrabony defect in periodontitis patients. J Nepal Soc Periodontol Oral Implantol 2018;2(2):49–55. DOI: https://doi.org/10.3126/jnspoi.v2i2.23614.
Sun WB, Chu C, Wang J, et al. Comparison of periodontal ligament cells responses to dense and nanophase hydroxyapatite. J Mater Sci Mater Med 2007;18:677–683. DOI: 10.1007/s10856-006-0019-8.