KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Comparative Evaluation of Open Flap Debridement Alone and In Combination with Bone Graft in the Treatment of Vertical Bony Defects in Periodontitis
Subedi G, Rijal AH, Lamichhane S, Humagain M

Abstract:
Background Regeneration of lost periodontium is the ultimate goal of periodontal therapy. Regenerative periodontal therapy aims to improve the regeneration of lost periodontal tissue by using various kinds of bone grafts, membranes, growth factors or combination thereof. Objective To compare open flap debridement alone and in combination with alloplastic bone graft (Biphasic calcium phosphate) for the treatment of vertical bony defects in periodontitis. Method A total of 24 patients with vertical bony defects > 3 mm were selected for the study. The study design was randomized controlled clinical trial. The study participants were assigned into 2 groups: Group A receiving open flap debridement only (n = 12) and Group B receiving open flap debridement along with biphasic calcium phosphate (n = 12). Simple random sampling technique was employed. The primary outcome measures were changes in Probing Pocket Depth, Clinical Attachment Loss and Radiographic Defect Depth, from baseline to 3 and 6 months after surgery. Secondary clinical outcomes included Plaque Index, Gingival Index and Gingival Recession, which were also assessed at baseline, and 3 and 6 months after surgery. Result No statistically significant difference was noted between the groups in terms of clinical parameters (P-value > 0.005 for all parameters). However, there was a statistically significant increase in the radiographic defect fill in group B in 6 months, as compared to group A (P-value < 0.001 at 95% confidence intervals). Conclusion The present study failed to demonstrate any superior clinical outcomes for Group B compared to Group A in terms of clinical parameters but radiographs revealed superior results in favor of group B. Hence, biphasic calcium phosphate can be considered as a potential periodontal regenerative material for the treatment of vertical bony defects in periodontitis.
Keyword : Biphasic calcium phosphate, Periodontitis, Periodontal regeneration, Radiographic defect depth, Vertical bony defect