Comparison of injectable calcium phosphate bone cement grafting and open flap debridement in periodontal intrabony defects: a randomized clinical trial.
BACKGROUND
Regeneration of lost periodontium is the ultimate goal of periodontal therapy. Bone grafts, guided tissue regeneration, and application of growth factors are used for periodontal regeneration. This study aimed to evaluate the clinical efficacy of a new, injectable calcium phosphate bone cement (CPC) in human periodontal intrabony defects.


METHODS
Thirty subjects (mean age, 53.4 +/- 9.1 years) with periodontitis and narrow intrabony defects were enrolled in the study. Subjects were classified randomly into the CPC graft group (N = 15) or the open flap debridement (OFD) alone group (N = 15). Clinical measurements were performed at baseline and at 3, 6, 9, and 12 months; radiographs were taken at baseline, 2 weeks, and 6 and 12 months after surgery. The Student t test was used for statistical analysis.


RESULTS
In the CPC group, six cases showed exposure or loss of the CPC within 12 months, whereas the remaining nine cases (CPC-R group) showed no adverse reaction, including infection or suppuration. Overall, CPC-R and OFD treatment groups exhibited a significant reduction in probing depth and a significant gain in clinical attachment level at 3, 6, 9, and 12 months compared to baseline values. However, there were no significant differences in any of the clinical parameters between the groups. In the CPC-R group, radiographic bone level gain appeared to be greater than in the OFD group.


CONCLUSIONS
The present study failed to demonstrate any superior clinical outcomes for the CPC group compared to the OFD group; however, radiographs revealed more favorable results in the CPC-R group. The filling volume and stiffness of CPC may compromise the clinical outcomes for periodontal intrabony defects.
Shirakata
Yoshinori
Y
Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. syoshi@denta.hal.kagoshima-u.ac.jp
Setoguchi
Takashi
T
Machigashira
Miho
M
Matsuyama
Takashi
T
Furuichi
Yasushi
Y
Hasegawa
Kozue
K
Yoshimoto
Takehiko
T
Izumi
Yuichi
Y
D020341:Absorbable Implants; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D001843:Bone Cements / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000008:administration & dosage / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000008:administration & dosage / Q000627:therapeutic use*; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007267:Injections; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010518:Periodontitis / Q000601:surgery; D011859:Radiography; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology; D016896:Treatment Outcome
D001843:Bone Cements; D018786:Bone Substitutes; D002130:Calcium Phosphates; C020243:calcium phosphate