Efficacy of a Combination of b-Tricalcium Phosphate with Hyaluronic Acid in the Management of Intrabony Periodontal Defects: A Prospective Clinical Study
Correspondence Address :
Dr. Lakshmi Ramachandran,
Bharathi Salai, Rama Puram, Chennai, Tamil Nadu, India.
E-mail: drlak.84@gmail.com
Introduction: Numerous bioactive grafts have been studied for periodontal defect regeneration of which, b-Tricalcium Phospate (β-TCP) is a very promising bone graft. Hyaluronic Acid (HA), an essential component of periodontal ligament matrix plays a pivotal role in tissue growth, repair and remodeling.
Aim: To evaluate the efficacy of 0.8% HA as an adjunct to β-TCP in the treatment of isolated human intrabony defects.
Materials and Methods: This prospective clinical study was conducted at the Department of Periodontics, SRM Dental College, Chennai, Tamil Nadu, India, from January 2017 and December 2017 (followed-up to June 2018). The study included 30 intrabony defects from 16 chronic periodontitis patients, 15 of each were randomly assigned into either test/control groups and were reviewed till six months. After phase I therapy regenerative osseous surgery was performed at all the sites. Control sites received β-TCP bone graft alone and test group received β-TCP with 0.8% HA. Postsurgical clinical evaluation of Probing Pocket depth (PPD) and Clinical Attachment level (CAL) was done at three and six months, radiographs were repeated at six months to assess the bone fill. Statistical analysis using Statistical Package for the Social Sciences (SPSS) version 22.0 was done, Mann-Whitney U test and Wilcoxon-Signed Rank test were used to compare the intergroup and intragroup values respectively.
Results: The mean age of the control and test groups were 45.7 and 48.5 years respectively. The PPD was reduced, CAL and bone fill were increased in both groups from baseline, indicating clinical effectiveness. From baseline to six months, the PPD reduction and gain in CAL in the test and control groups were 3.27±0.18 mm, 3.20±0.18 mm and 3.07±0.03 mm, 3.07±0.08 mm, respectively, which was statistically significant (p-value <0.001). However, intergroup comparison revealed no statistical significance (p>0.05) in both clinical and radiographic parameters.
Conclusion: Hyaluronic acid as an adjunct to β-TCP demonstrated only comparable outcomes despite obtaining substantial bone fill and attachment gain.
Bone fill, Bone grafts, Hyaluronan, Periodontitis, Regeneration
DOI: 10.7860/JCDR/2021/51879.15791
Date of Submission: Aug 11, 2021
Date of Peer Review: Sep 24, 2021
Date of Acceptance: Nov 17, 2021
Date of Publishing: Dec 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• Plagiarism X-checker: Aug 16, 2021
• Manual Googling: Nov 03, 2021
• iThenticate Software: Nov 28, 2021 (12%)
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