Clinical and radiographic evaluation of Nano-crystalline hydroxyapatite bone graft (Sybograf®) in combination with bioresorbable collagen membrane (Periocol®) in periodontal intrabony defects

Vijendra P. Singh, Dilip G. Nayak, Ashita S. Uppoor, Dipen Shah


Background: Nanosized ceramics may represent a promising class of bone graft substitutes due
to their improved osseointegrative properties. Nanocrystalline Hydroxyapatite (NcHA) bind to
bone and stimulate bone healing by stimulation of osteoblast activity. The present study aims to
explore the clinical and radiographical outcome of NcHA bonegraft (Sybograf®) with collagen
membrane (Periocol®), in comparison with open flap debridement (OFD), in the treatment of
intrabony periodontal defects.
Materials and Methods: A parallel-group, randomized, controlled clinical trial was designed to
conduct the study. Eighteen intrabony defects in 14 systemically healthy patients aged between 25
to 65 years were randomly assigned to test and control group. The plaque index, gingival index,
probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (REC) were
recorded at baseline, and were reevaluated at 6 months. In addition to this, radiographic bone fill
was assessed using digital software. At the test site, NcHA bone graft and collagen membrane was
placed, whereas at the control site, only OFD was done. Recall appointments were made at 7 days,
30 days, and then at 3 months and 6 months.
Results: The data were subjected to statistical analysis using the Mann-Whitney ‘U’ Test and
Wilcoxon signed rank sum test. In the control group, the mean reduction of PPD was 3.22±1.09 mm
(P=0.007) and CAL gain was 2.77±1.09 mm (P=0.007). In the test group, the mean PPD reduction
of 4.33±0.5 mm (P=0.006) and mean gain in CAL was 3.77±0.66 mm (P=0.006) at 6 months.
The mean increase in REC was 0.55±0.72 mm (P=0.025) in test, and 0.44±0.52 mm (P=0.046) in
control group. The mean gain in radiographic defect fill was 2.07±0.67 mm (P=0.008) in test and
0.91±0.21 mm (P=0.007) in control group.
Conclusion: The nanocrystalline hydroxyapatite bone graft in combination with collagen membrane
demonstrated clinical advantages beyond that achieved by OFD alone.
Key Words: Bone graft, collagen membrane, nanocrystalline hydroxyapatite, periodontal regeneration

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