title: Clinical and Radiologic Evaluation of Regenerative Potential of NHA Paste and DBM in the Treatment of Periodontal Intra-bony Defects -A Randomized Control Trial.
abstract: BACKGROUND
  Previous studies have shown that Hydroxyapatite (HA) has shown good results in the treatment of intra-osseous periodontal defects. A newer variety of HA has been designed over a period of research which has nano-sized particles and is availed in a paste consistency called Nanocrystalline Hydroxyapatite paste (NHA paste). This variation in size and surface area of NHA paste can provide better results when used in intra-bony defects.
  
  
  OBJECTIVE
  The purpose of this study was to compare the clinical and radiographic outcomes obtained with usage of NHA paste to those obtained with Demineralized Bone Matrix (DBM) in the treatment of periodontal intra-bony defects.
  
  
  METHODS
  A clinical trial was carried out for a period of 12 months. A total of 26 intra-bony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with NHA paste. The control sites were debrided and grafted with DBM-Xenograft. Probing Depth, Clinical Attachment Level (DCAL) and Gingival Margin (GM) position were recorded at baseline 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls. The results were averaged (mean± standard deviation) for each parameter and Student t-test was used to determine intra-group statistical difference and One way analyses of variance (ANOVA) to test the difference between groups using Excel and SPSS (SPSS Inc, Chicago) software packages.
  
  
  RESULTS
  On completion of 12 months, the mean percentage of PD reduction achieved in the experimental and control sites was 67.45% and 69.03% respectively (p<0.05). The mean percentage of gain achieved in CAL was 63.58% and 61.42% in the experimental and control sites respectively (p<0.05). Gingival recession was seen to be non-significant in the experimental and control sites. The mean percentage of bone fill in the control group obtained was 48.16% where as the percentage of bone fill obtained in the experimental group was 48.64% (p<0.05).
  
  
  CONCLUSIONS
  Overall, both therapies led to significant improvements of the investigated parameters. The NHA paste was as effective in terms of improving clinical and radiographic parameters as DBM-Xenograft, which is an already established bone graft. There is a need for further long term controlled studies evaluating the adjunctive benefits of usage of NHA paste in the treatment of periodontal intra-bony defects.
authors: Private Practioner, England.
authors: Deepti
authors: D
authors: Jain
authors: Senior Resident, Department of Periodontology, Uttar Pradesh Medical University , Saifai, Uttar Pradesh, India .
authors: Anshul
authors: A
authors: Sawhney
authors: Senior Lecturer, Department of Periodontology, MGM Dental College , Mumbai, Maharashtra, India .
authors: Bharat
authors: B
authors: Gupta
authors: Senior Lecturer, Department of Orthodontics, Maitri Dental College , District Durg, Chhattisgarh, India .
authors: Saurabh
authors: S
authors: Sharma
authors: Senior Lecturer, Department of Oral Pathology, ITS Dental College , Ghaziabad, Uttar Pradesh, India .
authors: Saurabh
authors: S
authors: Juneja
authors: Senior Lecturer, Department of Oral Medicine and Radiology, Sharda University , Greater Noida, Uttar Pradesh, India .
authors: Manjushree
authors: M
authors: Juneja
authors: Senior Lecturer, Department of Oral and Maxillofacial Surgery, Maitri Dental College , District Durg, Chhattisgarh, India .
authors: Shruti
authors: S
authors: Sharma
authors: Senior Lecturer, Department of Oral Medicine and Radiology, MGM Dental College , Mumbai, Maharashtra, India .
authors: Neha
authors: N
authors: Patil
keywords: Bone fill; Debrided; Nano- sized particles; Probing depth