Comparative evaluation of the relative efficacy of autogenous tooth graft and demineralized freeze-dried bone allograft in the treatment of periodontal infrabony defects - A 6-month clinico-radiographic and biochemical study.

Abstract

Context: Demineralized freeze-dried bone allograft (DFDBA) is a commonly used biomaterial in periodontal regeneration, while autogenous tooth graft (ATG) is a newer, nearly ideal biomaterial. In the literature, in vivo studies on ATG for managing periodontal infrabony defects are rare.

Aims: The aim of this study was to comparatively evaluate the efficacy of DFDBA and ATG in the management of periodontal infrabony defects clinically, radiologically, and biochemically.

Settings and design: In this randomized controlled clinical trial, 30 sites were selected based on the study criteria and randomly assigned to Group A (DFDBA) and Group B (ATG) by toss of a coin.

Materials and methods: Selected patients were evaluated 3-4 weeks after phase I therapy. Both the groups underwent open flap debridement: Group A sites were grafted with DFDBA and Group B with ATG. Clinico-radiological evaluation was performed at baseline, 3 months, and 6 months for pocket probing depth (PPD), clinical attachment level (CAL), and linear defect depth (LDD). Biochemical assessment was done using enzyme-linked immunosorbent assay for gingival crevicular fluid-alkaline phosphatase (GCF-ALP) at baseline and at 6 months.

Statistical analysis: Data obtained were subjected to parametric tests of significance (paired and unpaired t-test).

Results: In intragroup comparison, highly significant differences (P < 0.01) were observed in PPD reduction, CAL gain, LDD reduction, and GCF-ALP levels statistically from baseline to 6 months in both the groups. However, Group B showed greater PPD reduction, CAL gain, and LDD reduction as compared to Group A (3.667 > 2.933, 2.600 > 2.000, and 2.400 > 1.533 mm, respectively). Biochemically, Group B demonstrated higher GCF-ALP levels than Group A.

Conclusions: Within the limitations of the present study, highly significant changes were noticed in all the parameters statistically in both the groups, with ATG showing higher bone fill and ongoing bone healing at 6 months postoperatively in the management of periodontal infrabony defects.