Treatment of periodontal intrabony defects using ß-TCP alone or in combination with rhPDGF-BB: a randomized controlled clinical and radiographic study.

The need to increase the predictability of periodontal regeneration has encouraged clinicians and researchers to employ cell-stimulating proteins in combination with osteoconductive scaffolds, based on the principles of tissue engineering. The purpose of this clinical and radiographic study was to compare the regenerative potential of the combination of ß-tricalcium phosphate (ß-TCP) and recombinant human platelet-derived growth factor BB (rhPDGF-BB) in the grafting of intraosseous defects with the established technique of bone grafting with (ß-TCP alone. A total of 30 sites from 15 patients with infrabony defects in two different quadrants were selected, and the sites were randomly divided into test sites (rhPDGF + ß-TCP) and control sites (ß-TCP alone) using a split-mouth design. Clinical parameters, including probing pocket depth, clinical attachment level, and gingival recession, were recorded at baseline, 6 months, and 9 months. Radiographic evaluation was carried out to evaluate defect fill, change in alveolar crest height, and percentage of defect fill at baseline, 6 months, and 9 months. Both the experimental groups showed statistically significant reduction in probing pocket depth and gain in clinical attachment level. On intergroup comparison, sites treated with rhPDGF + ß-TCP demonstrated a significantly greater pocket depth reduction (P < .05) and greater gain in clinical attachment level (P < .01). Mean percentage defect fill was significantly greater in test sites as compared with control sites at 6 and 9 months (P < .01). rhPDGF + ß-TCP-treated sites demonstrated a significant gain in mean alveolar crest height at 6 and 9 months (P < .05), while ß-TCP-treated sites demonstrated crestal resorption. Both groups demonstrated potential in enhancing periodontal regeneration; however, on comparison between the two groups, the results obtained by rhPDGF + ß-TCP were significantly better with respect to both clinical and radiographic parameters.

Clinical and radiographic evaluation of recombinant human platelet derived growth factor with beta tricalcium phosphate in the treatment of a periodontal intrabony defect.

The need to increase the predictability of successful periodontal regeneration has led to the use of cell-stimulating proteins in combination with osteoconductive scaffolds and cells based on the principles of tissue engineering. The present case report describes the treatment of an intrabony defect with recombinant human platelet derived growth factor (rhPDGF) + ß-tricalcium phosphate (ß-TCP). A 25-year-old patient presented with a probing pocket depth of 9 mm mesial to the left maxillary molar. The radiograph revealed an intrabony defect with a depth of 4.23 mm. The defect was treated by open flap debridement and grafting with rhPDGF + ß-TCP. On 9 months follow-up, the pocket depth reduced to 3 mm and the defect was completely filled as observed in radiographs and surgical re-entry. A gain in alveolar crest height was also observed.