Comparative clinical and radiographic evaluation of autogenous dentin graft versus xenograft in periodontal intrabony defects – A nonrandomized controlled trial

Background: Periodontal regeneration aims to restore the natural structure of the periodontium, therefore improving the long-term stability and function of the affected teeth. Traditional bone graft materials such as allografts, autografts, xenografts, and alloplasts serve as a scaffold for new bone formation and are employed for the regeneration of osseous defects. Autogenous dentin graft (ADG), which is characterized by both osteoinductive and osteoconductive properties, is a biomaterial that mimics the mineral and organic composition of alveolar bone, whereas anorganic deproteinized bovine graft, a xenograft, is renowned for its osteoconductive properties. The current study investigates the comparative clinical and radiographic effectiveness of ADG versus xenograft in intrabony defects. Aim: The present study aims to compare the clinical and radiographic effectiveness of ADG and xenograft in managing periodontal defects. Materials and Methods: Patients with Stage III and Stage IV periodontitis were selected, and Phase I therapy was performed. After Phase I (nonsurgical periodontal therapy), re-evaluation was carried out, and patients with probing pocket depth (PPD) ≥5 mm and an intrabony defect (two-walled or three-walled) were selected for the study. 24 surgical sites were selected for the study and were divided into two groups of 12 sites each (test group – ADG and control group – xenograft). The sites were assessed for radiographic parameters (bone fill [BF], bone crest change [BCC], defect resolution [DR], and relative bone mineral density indicator [RBMD]) using cone beam computed tomography at Visit-1 (screening) and at 6 months (6-month follow-up). The sites were assessed for clinical parameters (gingival bleeding index [GBI], probing pocket depth [PPD] and clinical attachment level [CAL]) at baseline (day of the surgery) and at 6 months (6-month follow-up). Results: On evaluation, clinical parameters (PPD and CAL) showed significant results from baseline to 6 months on intragroup comparison. However, no significant difference was seen on intergroup comparison. In intergroup comparison, radiographic evaluation showed a higher BF in the ADG group (test group), while no difference was seen in BCC, DR, and RBMD parameters. Conclusion: Within the limitations of this study, ADG can be a promising alternative to xenograft in periodontal intrabony defects. However, larger randomized controlled trials with longer follow-up are necessary to validate these findings.