Clinical and Radiographic Evaluation of Papilla Preservation Flap with or without Nanocrystalline Hydroxyapatite Bone Graft for Management of Periodontal Intrabony Defects: A Randomized Controlled Clinical Trial

This study assessed clinically and radiographically nanocrystalline hydroxyapatite bone graft substitute (n-HA) with papilla preservation flap (PPF) versus PPF alone in treatment of periodontal intrabony defects. Thirty patients with periodontitis were randomly allocated to receive either PPF+n-HA (intervention group) or PPF (control group). Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone defect area (BDA) were recorded at baseline, 3 and 6 months postoperatively. Both groups showed a significant improvement (P≤0.05) in all parameters 6 months postoperatively without significant difference (P≥0.05) between them. After 6 months, PPF+n-HA demonstrated 3.67 (±1.07)mmPPD reduction and 3.33 (±0.89)mm CAL gain, while PPF showed PPD reduction of 3.58 (±1.31)mm and 2.67 (±1.3) mm CAL gain. The BDA reduced by 3.61(±2.46) mm2 in PPF+n-HA and 2.02 (±1.76)mm2 in PPF group.Both PPF+n-HA and PPF groups improved clinical and radiographic outcomes and were effective in managing intrabony defects.