Clinical and Radiographic Evaluation of Bioresorbable Collagen Membrane alone or in combination with Nano-Crystalline Hydroxyapatite Bone Graft in management of Intraosseous Periodontal Defects

Abstract

One of the biggest challenges remaining in dentistry is to predictably regenerate the attachment apparatus destroyed by periodontitis. To regenerate the periodontium subsequent to its destruction has been the goal of periodontal therapy. Conventional surgery as well as bone grafts and GTR had been developed in an attempt to achieve this goal. The present investigation was conducted to evaluate densitometric changes by direct digital radiography (Digora system) after treatment of intraosseous periodontal defects by bioresorbable collagen membrane alone or in combination with nano-crystalline hydroxyapatite bone graft. Furthermore, the effect of these two treatment modalities on the clinical parameters was assessed. The study was performed on twenty angular defects in patients with age ranging from 30-50 years. Clinical parameters including plaque index, gingival index, probing depth and clinical attachment level were recorded before surgery. Moreover, radiometric measurements were performed by the Digora system presurgically.Vertical bone defects were exposed by full thickness mucoperiosteal flap following sulcular incision and thorough debridement was performed. Ten defects received bioresorbable collagen membrane alone while the other ten defects received bioresorbable collagen membrane combined with nano-crystalline hydroxyapatite bone graft. The same initial clinical parameters were recorded three and six months postsurgically, while radiographic measurements were recorded after six months. The results of the present investigation showed that in groupI, there was a slight increase in mean PI after three months. This increase was statistically insignificant. There was no change in the mean between three and six months .On the other hand, group II demonstrated a statistically significant increase in mean PI throughout the study period .In addition, there was statistically significant increase in mean GI throughout the study period. By comparing the two treatment modalities, at base line as well as after three months, group I showed statistically significantly lower mean PD than group II. On the other hand, by comparing the two groups at six months, there was no statistically significant difference between them regarding PD. The mean reduction in PD in group I was 0.9 mm at the end of the study, while the mean reduction in PD in group II was 2.0 mm. On the other hand, the current investigation exhibited a percentage decrease in CAL in group I 15.94%, while for group II it was 19.75%.This difference was statistically significant. The radiographic examinationfoundthat the current investigation exhibited a percentage increase in defect fill in group I 9.95%, while for group II it was 17.05%.This difference