Clinical Evaluation of Nano-Hydroxyapatite as an Adjunctive to Minimally Invasive Non-Surgical Technique in the Treatment of Deep Intra-bony Defects (MINST)

May 27, 2026 updated by: Salah Eddin Sheet, Cairo University

Clinical Evaluation of Nano-Hydroxyapatite as an Adjunctive to Minimally Invasive Non-Surgical Technique in the Treatment of Deep Intra-bony Defects: A Randomized Controlled Clinical Trial

This randomized controlled clinical trial aims to evaluate the effectiveness of using nano-hydroxyapatite (nHA) gel alongside a minimally invasive non-surgical technique (MINST) to treat deep intra-bony defects in patients with Stage III periodontitis. While MINST is an effective method for cleaning deep periodontal pockets without the need for traditional surgery, the addition of nHA may further enhance soft tissue healing, improve cellular interaction, and promote bone regeneration. Participants in the study will be randomly assigned to one of two groups. The test group will receive the MINST procedure combined with the application of nHA gel directly into the periodontal pocket, while the control group will receive the MINST procedure alone. The primary goal of the study is to measure the decrease in probing pocket depth over a 6-month follow-up period to determine if the adjunctive use of nHA provides superior clinical outcomes compared to non-surgical treatment alone.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

28

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Cairo, Egypt, 11511
        • Oral Medicine and Periodontology department, Faculty of Dentistry - Cairo University.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Systemically healthy adults aged 18-65 years.
  • No history of systemic diseases affecting periodontal status or bone metabolism (e.g., uncontrolled diabetes, osteoporosis).
  • Diagnosed with Stage III periodontitis according to the 2018 classification of periodontal diseases (with interdental CAL ≥5 mm, probing depth ≥6 mm).
  • Presence of at least one deep intra-bony defect (≥3 mm defect depth) in a single-rooted or multi-rooted tooth.
  • Willingness to participate and sign informed consent.

Exclusion Criteria:

  • Immunocompromised patients, uncontrolled diabetics (HbA1c ≥ 7.0%), or individuals with autoimmune disorders.
  • History of malignancy or chemotherapy/radiation in the past year.
  • Use of bisphosphonates, corticosteroids, immunosuppressive antibiotics or anti-inflammatory agents within 6 months before periodontal therapy.
  • Smokers (≥ 10 cigarettes per day).
  • Pregnant or breastfeeding women, confirmed via medical history and/or test.
  • Receipt of periodontal surgery or nonsurgical treatment within the last 6 months.
  • Teeth with peri-apical pathology, acute abscess, or grade III mobility.
  • Multi-rooted teeth with class II and class III furcation defects.
  • Third molars.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: MINST alone
Participants receive the minimally invasive non-surgical technique (MINST) alone without adjunctive treatment
Procedure: Minimally invasive non-surgical technique (MINST)
Subgingival debridement using thin ultrasonic tips and Gracey mini-curettes under magnification, deliberately avoiding subgingival rinsing to support blood clot stabilization
Experimental: MINST + nano-hydroxyapatite
Participants receive MINST combined with the adjunctive application of nano-hydroxyapatite gel
Procedure: Minimally invasive non-surgical technique (MINST)
Subgingival debridement using thin ultrasonic tips and Gracey mini-curettes under magnification, deliberately avoiding subgingival rinsing to support blood clot stabilization
Biological: nano-hydroxyapatite
A single dose of nano-hydroxyapatite (nHA) gel applied subgingivally directly into the periodontal pocket associated with the intrabony defect immediately following debridement

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Probing Pocket Depth (PPD)
Time Frame: 6 months
Measured in millimeters (mm) using a manual periodontal probe (UNC-15)
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical Attachment Level (CAL)
Time Frame: 1, 3, and 6 months post-treatment.
Measured in millimeters (mm) using a manual periodontal probe (UNC-15).
1, 3, and 6 months post-treatment.
Gingival Recession (GR)
Time Frame: 1, 3, and 6 months post-treatment.
Measured in millimeters (mm) using a manual periodontal probe (UNC-15).
1, 3, and 6 months post-treatment.
Radiographic Defect Angle (RDA)
Time Frame: 1, 3, and 6 months post-treatment.
Measured in degrees (°) utilizing standardized periapical radiographs and measurement software.
1, 3, and 6 months post-treatment.
Patient Satisfaction
Time Frame: 1, 3, and 6 months post-treatment.
Assessed via a structured questionnaire utilizing a Likert scale. The scale ranges from 1 to 5, where 1 indicates "Very Dissatisfied" and 5 indicates "Very Satisfied," meaning higher scores represent a better outcome.
1, 3, and 6 months post-treatment.
Full-Mouth Plaque Score (FMPS)
Time Frame: 1, 3, and 6 months post-treatment.
Assessed as a percentage (%) using the Visible Plaque Index (O'Leary et al.). The index ranges from a minimum of 0% to a maximum of 100%. Higher percentages indicate a greater presence of plaque, representing a worse clinical outcome.
1, 3, and 6 months post-treatment.
Full-Mouth Bleeding Score (FMBS)
Time Frame: 1, 3, and 6 months post-treatment.
Assessed as a percentage (%) using the Gingival Bleeding Index (Ainamo & Bay). The index ranges from a minimum of 0% to a maximum of 100%. Higher percentages indicate more widespread gingival bleeding, representing a worse clinical outcome.
1, 3, and 6 months post-treatment.
Cost Effectiveness based on Clinical Attachment Level (CAL)
Time Frame: 6 months post-treatment.
Evaluated using the cost-effectiveness ratio (CER) and incremental cost-effectiveness ratio (ICER), based on the cost in USD per millimeter (mm) of CAL improvement.
6 months post-treatment.
Cost Effectiveness based on Probing Pocket Depth (PPD)
Time Frame: 6 months post-treatment.
Evaluated using the cost-effectiveness ratio (CER) and incremental cost-effectiveness ratio (ICER), based on the cost in USD per millimeter (mm) of PPD improvement.
6 months post-treatment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2025

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

August 28, 2026

Study Registration Dates

First Submitted

May 20, 2026

First Submitted That Met QC Criteria

May 20, 2026

First Posted (Actual)

May 27, 2026

Study Record Updates

Last Update Posted (Actual)

May 29, 2026

Last Update Submitted That Met QC Criteria

May 27, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PER 3 - 3 - 2

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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