Bioactive ceramic filler in the treatment of severe osseous defects: 12-month results

Background: Bioactive ceramic fillers are synthetic materials for medical use with the potential to enhance bone formation. The purpose of this study was to evaluate the clinical effectiveness of a bioactive ceramic filler in the treatment of teeth with poor prognosis because of deep osseous defects and increased tooth mobility. Methods: Nineteen patients, 35 to 75 years of age, who presented with one proximal intrabony periodontal defect with vertical radiographic bone loss 3 mm were included. After initial therapy, defects were assigned randomly to a test (12 defects) or control (seven defects) procedure. Following flap reflection and root planing, test defects were filled with a bioactive ceramic filler. Mucoperiosteal flaps were replaced and sutured, and a periodontal dressing was applied. All patients received postoperative analgesics, rinsed twice daily with chlorhexidine, and were seen 2 weeks postoperatively for suture removal. Postoperative deplaquing and reinstruction in home care were performed at weekly intervals during the first month, and at 3, 6, and 12 months. At baseline and at 6 and 12 months, dental plaque, bleeding on probing (BOP), probing depth (PD), and probing attachment level (PAL) were assessed, and standardized radiographs were taken. Results: The test and control groups showed similar periodontal status at baseline, with no significant differences in clinical or radiographic parameters. Plaque and BOP showed a non-significant deterioration over time. PD was reduced significantly in experimental and control sites following treatment (P < 0.001), but there was no significant between-group difference (P = 0.793). For PAL and radiographic bone levels, no overall within- or between-group differences were detected. Conclusion: The use of bioactive ceramic filler in combination with open debridement provided no significant beneficial effect over open debridement alone in the treatment of teeth with deep intraosseous defects, severe bone loss, and hypermobility.