Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis

Muhammad Saad Shaikh; Muhammad Sohail Zafar; Ahmad Alnazzawi; Fawad Javed

doi:10.1016/j.aanat.2021.151877

Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis

Ann Anat. 2022 Feb:240:151877. doi: 10.1016/j.aanat.2021.151877. Epub 2021 Dec 2.

Authors

Muhammad Saad Shaikh¹, Muhammad Sohail Zafar², Ahmad Alnazzawi³, Fawad Javed⁴

Affiliations

¹ Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan.
² Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan. Electronic address: MZAFAR@taibahu.edu.sa.
³ Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia.
⁴ Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, New York 14620, United States.

PMID: 34864225
DOI: 10.1016/j.aanat.2021.151877

Abstract

Background: Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone.

Materials and methods: The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively.

Results: From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48).

Conclusions: The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.

Keywords: Bone grafts; Intrabony defects; Nanocrystalline hydroxyapatite; Open flap debridement; Periodontal regeneration.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Alveolar Bone Loss* / surgery
Bone Transplantation
Durapatite*
Follow-Up Studies
Guided Tissue Regeneration, Periodontal
Humans
Retrospective Studies
Treatment Outcome

Substances

Durapatite