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

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.