Egg shell derived apatite cement for the treatment of angular periodontal defects: A preliminary clinical and radiographic assessment

Abstract

Development of alloplastic grafts for the treatment of periodontal osseous defects are moving towards designing biomaterials with optimized ultrastructure and composition to trigger assured biological function upon implantation. As eggshells are composed of calcium carbonate (94\%) along with traces of biologically beneficial ions such as Mg 2+ , Sr 2+ , SiO 2-4 , F-and Na + etc., calcium phosphates derived from this natural source may mimic bone composition. Calcium phosphate cements (CPC) are considered better candidates for periodontal regeneration because they act both as a graft material and barrier membrane to promote guided bone regeneration and can also progressively resorb. Earlier, we have reported eggshell derived CPC (ECPC) for first time and shown to have superior physical and biological properties than the synthetically derived CPC due to the presence of trace ions in ECPC. In the current study, we have evaluated the clinical efficacy of ECPC in treating angular periodontal osseous defects. The reduction in probing pocket depth (PD), gain in clinical attachment level (CAL) and change in gingival position were measured in a series of 6 patients and radiographs were taken at baseline and at 6 months. Results showed relative increase in PD and CAL of 44.7 + 6.3 \% and 50.9 + 11.5 \% respectively after 6 months. Bone regeneration was identified in the radiograph through trabecular continuity in the angular defect site at the end of 6 months along with complete resorption of ECPC. The results confirm ECPC as potential biomaterial for treating angular periodontal defects.