Comparative Clinical, Radiographical and Biochemical Evaluation of Autogenous Bone Graft in Periodontal Infrabony Defects: A Randomized Clinical Trial

Corresponding author: Sanjeet Gill, Department of Periodontology and Implantology, BRS Dental College and Hospital, Panchkula, India, E-mail: sanjeetgill31@gmail.com Introduction Periodontal disease is one of the most prevalent dental afflictions worldwide. Periodontitis leads to loss of the toothsupporting tissues, eventually resulting in loss of teeth. Ideal treatment should involve not only the prevention of further attachment loss, but the regeneration of lost supporting tissues, comprising new alveolar bone and a new periodontal ligament [1]. Various attempts to stimulate periodontal regeneration in the past have focused on filling the defect with some type of material, providing a space or adding growth factors to induce the host cells to form bone [2]. Over the last decades different modalities of regenerative treatment have been developed and applied clinically [3]. Among all the graft materials only autografts and Demineralized Freeze-Dried Bone Allografts (DFDBA) have demonstrated a potential to achieve periodontal regeneration [3]. Historically, autografts were the first bone replacement grafts to be reported for periodontal applications. Autogenous grafts, which are harvested from the patients’ own body, are considered the gold standard among graft materials because they are superior at retaining cell viability. These grafts contain live osteoblasts and osteoprogenitor stem cells and heal by osteogenesis. It avoids any risk of rejection or disease transmission. Autogenous bone has osteoconductive, osteoinductive and osteogenic properties [4]. The choice of an autogenous donor site is often based on the amount of bone needed. Extra-oral bone grafts are usually taken from iliac crest, the tibia, or the skull and are used when large amounts of bone are needed. These procedures result in significant morbidity and discomfort to the patient. Conversely, when smaller amount of bone is required, intraoral sites for procuring the graft has several advantages, including reduced operating time & hospitalization as well as lower morbidity and avoidance of cutaneous scarring. But, a second surgical site is still needed. However, the need for second surgical site can be avoided with the use of bone scraper, back action chisel, rongeurs or a bone mill to obtain bone during the surgical procedure [2]. Among all these, bone scraper combines the benefits of both viability and easy procurement over trephines, bone mills or roungers. This hand held instrument (bone scraper) cuts and collects thin shavings of bone from cortical surfaces. The scraperderived matrix of ribbon like bone shavings and blood has a mortal like consistency and can be easily adapted to the alveolar deficiency to reshape the alveolar crest profile [5]. This controlled clinical study, has focused on the efficacy of autogenous bone graft collected with the help of bone scraper over open flap debridement in treatment of human periodontal infrabony defects. When placed into healthy bleeding bone, the negativecharged surface of autogenous bone graft accelerated the bone-growth cascade. The separation in charge between the solid phase of bone and extracellular matrix creates a potential difference between the solid and the liquid called the zeta potential, which influences the type and nature of proteins and cells harnessed by the surface [6].