Introduction: Regeneration of periodontium is always difficult to achieve regardless of all advancement. In an attempt to refine, various materials have been tried and tested. The present study was carried out to evaluate regenerative potential of easy-graft CRYSTAL in intrabony defects, clinically, and radiographically.
Methods: This randomised split-mouth study was conducted at Rungta College of Dental Sciences and Research from 2015 October to 2016 October. Intrabony pockets more than 5 mm and radiographic evidence of vertical bone loss were selected from 15 patients having two sites each. The chosen sites were randomly divided into test sites: open flap debridement (OFD) with easy-graft CRYSTAL and control sites (OFD). The clinical parameters evaluated were Plaque Index, Gingival Index, Probing Pocket Depth, Relative Attachment Level, and Gingival Recession at baseline, three months, and six months postoperatively. Radiographic parameters recorded were Defect Fill and Percentage of Defect Fill at baseline, three months, and six months. Data were analysed in SPSS v.20.
Results: At six months, improved clinical and radiographic values were obtained compared to baseline. The plaque and gingival index showed statistically significant reduction. Both groups showed statistically significant reduction in mean probing pocket depth and gain in relative attachment level. Mean gingival recession score was increased in both the group but was not significant. There was significant increase in Defect Fill and Percentage of Defect fill in both groups with better bone fill in test group.
Conclusion: Easy-graft CRYSTAL is a potential regenerative material for the treatment of periodontal intrabony defects.
Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple I, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182-216.
Becker W, Becker BE. Periodontal regeneration: A contemporary re-evaluation. Periodontol 2000. 1999;19:104-14.
American Academy of Periodontology. Glossary of periodontal terms. 3rd ed. Chicago, IL: American Academy of Periodontology, 1992.
Bartold PM, Xiao Y, Lyngstaadas SP, Paine ML, Snead ML. Principles and applications of cell delivery systems for periodontal regeneration. Periodontol 2000. 2006;41:123-35.
Nasr HF, Reidy MEA, Yukna RA. Bone and bone substitutes. Periodontol 2000. 1999;19:74-86.
Debnath T, Chakraborty A, Pal TK. A clinical study on the efficacy of hydroxyapatite - bioactive glass composite granules in the management of periodontal bony defects. J Indian Soc Periodontol. 2014;18:593-600.
Chung SM, Jung IK, Yoon BH, Cho BR, Kim DM, Jang JS. Evaluation of different combinations of biphasic calcium phosphate and growth factors for bone formation in calvarial defects in a rabbit model. Int J Periodontics Restorative Dent. 2016;36:49-59.
Farina NM, Guzon FM, Pena ML, Cantalapiedra AG. In vivo behaviour of two different biphasic ceramic implanted in mandibular bone of dogs. J Mater Sci Mater Med. 2008;19:1565-73.
Armitage GC. Periodontal diagnoses and classification of periodontal diseases. Periodontol 2000. 2004;34:9-21.
Hujoel PP and Loesche WJ. Efficiency of split-mouth designs. J Clin Periodontol. 1990;17:722-8.
Troedhan A, Schlichting I, Kurrek A, Wainwright M. Primary implant stability in augmented sinus lift-sites after completed bone regeneration: a randomised controlled clinical study comparing four subantrally inserted biomaterials. Sci Rep. 2014;5877:1-8.
Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol. 1967;38:610-6.
Gowda VS, Chava V, Kumara AE. An evaluation of a resorbable (semirigid) gtr membrane in human periodontal intraosseous defects: a clinicoradiological re-entry study. J Indian Soc Periodontol. 2011;15:393-7.
Singhal R, Nandlal, Kumar A, Rastogi P. Role of space provision in regeneration of localised two-wall intrabony defects using periosteal pedicle graft as an autogenous guided tissue membrane. J Periodontol. 2013;84:316-24.
Tonetti MS, Pini-Prato G, Cortellini P. Periodontal regeneration of human intrabony defects. iv. determinants of healing response. J Periodontol. 1993;64:934-40.
Eickholz P, Horr H, Klein P, Hassfeld S, Kim T. Radiographic parameters for prognosis of periodontal healing of intrabony defects: two different definitions of defect depth. J Periodontol. 2004;75:399-407.
Nery EB, Lee KK, Czajkowski S, Dooner JJ, Duqqan M, Ellinger RF, et al. A veteran administration cooperative study of biphasic calcium phosphate ceramic in periodontal osseous defects. J Periodontol. 1990;61:737-44.
Bansal R, Patil S, Chaubey KK, Thakur RK, Goyel P. 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;18:610-7.
Yip I, Ma L, Matthoes N, Dard M, Lang NP. Defect healing with various bone substitutes. Clin Oral Implants Res. 2015;26:606-14.
Leventis MD, Fairbairn P, Horowitz RA. Extraction site preservation using an in-situ hardening alloplastic bone graft substitute. Compendium. 2014;35:11-3.
Jurisic M, Manojlovic-Stojanoski M, Andric M, Kokovic V, Danilovic V, Jurisic T, et al. Histological and morphometric aspects of ridge preservation with a moldable, in situ hardening bone graft substitute. Arch Biol Sci. 2013;65:429-37.
Leventis MD, Fairbairn P, Kakar A, Leventis AD, Margaritis V, Luckerath W et al. Minimally invasive alveolar ridge preservation utilising an in situ hardening β-tricalcium phosphate bone substitute: A multicentre case series. Int J Dent. 2016;2016:1-11.
Dudek D, Sołtykiewicz K, Helewski K, Wyrobiec G, Slowinska MH, Kowalczyk-Ziomek G. Treatment of a mandibular cyst with synthetic bone graft substitute. Implants. 2013;1:34-6.
Schmidlin PR, Nicholls F, Kruse A, Zwahlen RA, Weber FE. Evaluation of moldable, in situ hardening calcium phosphate bone graft substitutes. Clin Oral Implants Res. 2013;24:149-57.
Kumar PG, Kumar JA, Anumala N, Reddy KP, Avula H, Hussain SN. Volumetric analysis of intrabony defects in aggressive periodontitis patients following use of a novel composite alloplast: A pilot study. Quintessence Int. 2011;42:375-84.
Shirakata Y, Setoguchi T, Machigashira M, Matsuyama T, Furuichi Y, Hasegawa K, et al. Comparison of injectable calcium phosphate bone cement grafting and open flap debridement in periodontal intrabony defects: A randomised clinical trial. J Periodontol. 2008;79:25-32.
Yukna RA. Clinical evaluation of coralline calcium carbonate as a bone replacement graft material in human periodontal osseous defects. J Periodontol. 1994;65:177-85.
Kaushick BT, Jayakumar ND, Padmalatha O, Varghese S. Treatment of human periodontal intrabony defects with hydroxyapatite+β tricalcium phosphate bone graft alone and in combination with platelet rich plasma: A randomised clinical trial. Indian J Dent Res. 2011;22:505-10.