Clinical evaluation of a biphasic calcium phosphate grafting material in the treatment of human periodontal intrabony defects

Min-Jae Lee, Byung-Ock Kim, Sang-Joun Yu, Min-Jae Lee, Byung-Ock Kim, Sang-Joun Yu

Abstract

Purpose: The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs).

Methods: The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component≥4 mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period.

Results: In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of 3.7±1.2 mm and a mean CAL gain of 3.0±1.1 mm compared to the baseline. Corresponding values for the patients treated with OFD were 2.5±0.8 mm and 1.4±1.0 mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group.

Conclusions: The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.

Keywords: Alveolar bone loss; Bone transplantation; Calcium phosphates; Chronic periodontitis; Hydroxyapatites.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Schematic drawing illustrating the anatomical landmarks and linear measurements taken from digitized radiographs. CEJ: cemento-enamel junction, BC: bone crest, BD: bottom of the defect, IBD, intrabony defect.
Figure 2
Figure 2
Treatment of an intrabony defect with biphasic calcium phosphate (BCP) on the distal aspect of an lower left first molar. (A) Preoperative clinical view. (B) Intraoperative view of the debrided intrabony defect. (C) Defect filled with the BCP biomaterial. (D) Sutures immediately after flap closure. (E) Clinical view of healing result after 6 months.
Figure 3
Figure 3
Radiographic evaluation. (A) Baseline radiograph showing intrabony periodontal defect (IBD)=5.0 mm with linear measurement. (B) Radiograph after 6 months showing IBD=2.0 mm with linear measurement.

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