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VOLUME 24 , ISSUE 12 ( December, 2023 ) > List of Articles


Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial

Moitri Ojha, Deepika Pawar Chandrashekara Rao, Vishakante Gowda

Keywords : Bone regeneration, Calcium phosphate cement, Chronic Periodontitis, Composite bone graft, Intrabony defects, Poly(lactide-co-glycolide) microspheres

Citation Information : Ojha M, Rao DP, Gowda V. Clinical and Radiographic Evaluation of Calcium Phosphate-Poly(lactide-co-glycolide) Graft in Regeneration of Intrabony Defects: Randomized Control Trial. J Contemp Dent Pract 2023; 24 (12):921-927.

DOI: 10.5005/jp-journals-10024-3605

License: CC BY-NC 4.0

Published Online: 31-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: This study aims to evaluate the efficacy of calcium phosphate-poly(lactide-co-glycolide) composite graft in the regeneration of intrabony defects in chronic periodontitis patients over a period of 12 months. Materials and methods: A total of 11 systemically healthy chronic periodontitis patients with 22 graftable sites were treated with calcium phosphate cement (CPC) bone graft (control group) and CPC-poly(lactic-co-glycolic acid)(PLGA) composite (test group) after flap reflection and debridement. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 3, 6, 9, and 12 months. Bone probing depth (BPD) and radiographic parameters such as defect depth (DD), changes in alveolar crest level (ALR), defect depth reduction (DDR), and percentage in defect depth reduction (PDDR) were calculated at baseline, and 6 and 12 months. The data were recorded and statistically analyzed. Results: On intragroup comparison, there was a significant improvement in all the parameters over a period of 1 year (clinically and radiographically). However, there was no statistically significant difference between the two groups in any of the parameters though there was a slightly higher bone fill noted in the test group. Conclusion: Even though the CPC-PLGA composite bone graft showed a slight improvement in clinical and radiographic parameters as compared to the CPC graft, it was not statistically significant. Clinical significance: A major drawback of Calcium Phosphate cements as bone grafts is their poor degradability. The PLGA microspheres degrade to expose macropores and interconnected pores in the graft substrate which in turn would promote the ingrowth of osteoblasts. Also, this composite graft is mouldable, and resorbable and has been shown to snugly fit into the defects making them a suitable scaffold material.

  1. Meyle J, Chapple I. Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000;2005;69(1):7–17. DOI: 10.1111/prd.12104.
  2. Hienz SA, Paliwal S, Ivanovski S. Mechanisms of bone resorption in periodontitis. J Immunol Res 2015;2015:615486. DOI: 10.1155/2015/615486.
  3. Chandra GNRB, Vandana KL. Periodontal osseous defects: A review. CODS J Dent 2017;9(1):22–29. DOI: 10.5005/jp-journals-10063-0028.
  4. Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J 2020;71(6):462–476. DOI: 10.1111/idj.12630.
  5. Abhishek K, Jigyasa B, Sunny MB. Bone graft in periodontal surgery. A Review. J Dent Herald 2014;1:30–32.
  6. Zhang X, Cresswell M. Calcium phosphate materials for controlled release systems. In: Inorganic Controlled Released Technology, Butterworth-Heinemann Ltd.; 2016, pp. 161–187.
  7. Link DP, van den Dolder J, Jurgens WJFM, et al. Mechanical evaluation of implanted calcium phosphate cement incorporated with PLGA microparticles. Biomaterials 2006;27(28):4941–4947. DOI: 10.1016/j.biomaterials.2006.05.022.
  8. Makadia HK, Siegel SJ. Poly lactic-co-glycolic acid (PLGA) as biodegradable controlled drug delivery carrier. Polymers (Basel) 2011;3(3):1377–1397. DOI: 10.3390/polym3031377.
  9. Ying–Ying H, Min QI, Meng Z, et al. Degradation mechanisms of poly (lactic-co-glycolic acid) films in vitro under static and dynamic environment. Trans Nonferrous Met Soc China 2006;16(1):293–297. DOI:
  10. Simon CG Jr., Khatri CA, Wright SA, et al. Preliminary report on the biocompatibility of a mouldable, resorbable, composite bone graft consisting of calcium phosphate cement and poly(lactide-co-glycolide) microspheres. J Orthop Res 2002;20(3):473–482. DOI: 10.1016/S0736-0266(01)00140-1.
  11. Dhruvakumar D, Gupta C. Role of combination therapy/composite graft in periodontal regeneration: A mini review. Tanta Dent J 2017;14:169–172. DOI: 10.4103/tdj.tdj_19_1.
  12. Jeong J, Kim JH, Shim JH, et al. Bioactive calcium phosphate materials and applications in bone regeneration. Biomater Res 2019;23:4. DOI: 10.1186/s40824-018-0149-3.
  13. Pandis N, Walsh T, Polychronopoulou A, et al. Split-mouth designs in orthodontics: An overview with applications to orthodontic clinical trials. Eur J Orthod 2013;35(6):783–789. DOI: 10.1093/ejo/cjs108.
  14. Machtei EE, Dunford R, Hausmann E, et al. Longitudinal study of prognostic factors in established periodontitis patients. J Clin Periodontol 1997;24(2):102–109. DOI: 10.1111/j.1600-051x.1997.tb00474.x.
  15. Stevanović M, Biočanin V, Nedkić M, et al. Efficacy of nanocrystalline bone substitute biphasic calcium phosphate/poly-DL-lactide-co-glycolide for periodontal intrabony defects filling. Vojnosanit Pregl 2015;72(8):689–695. DOI: 10.2298/vsp140528049s.
  16. Ruhé PQ, Hedberg–Dirk EL, Padron NT, et al. Porous poly(DL-lactic-co-glycolic acid)/calcium phosphate cement composite for reconstruction of bone defects. Tissue Eng 2006;12(4):789–800. DOI: 10.1089/ten.2006.12.789.
  17. Flichy-Fernández AJ, Blaya-Tárraga JA, O'Valle F, et al. Sinus floor elevation using particulate PLGA-coated biphasic calcium phosphate bone graft substitutes: A prospective histological and radiological study. Clin Implant Dent Relat Res 2019;21(5):895–902. DOI: 10.1111/cid.12741.
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