Hydroxyapatite Bone Graft Research Articles

Comprehensive clinical and histological evaluation of bovine hydroxyapatite bone graft with polypropylene membrane versus leukocyte- and platelet-rich fibrin for alveolar preservation after tooth extraction.

Osseointegrated implant placement in the ideal prosthetic position necessitates a sufficient residual alveolar ridge. Tooth extraction and the subsequent healing process often lead to bony deformities, characterized by a reduction in alveolar ridge height and width, resulting in unfavorable ridge architecture for dental implant placement. Several materials, including allografts, alloplastics, xenografts, and autogenous bone, are commonly used to address these concerns. In this context, leucocyte- and platelet-rich fibrin (L-PRF) emerges as a promising solution. This case report aims to compare the clinical and histological efficacy of bovine hydroxyapatite bone graft covered with polypropylene membrane (BHAG-PM) and leucocyte- and platelet-rich fibrin (L-PRF) in preserving dental alveoli following tooth extraction. Extraction, graft placement in the alveoli, and the anterior border between extracted elements were performed for both treatment groups. Up to 24 months of follow-up revealed satisfactory and comparable clinical and histological outcomes. These results suggest that both BHAG-PM and L-PRF effectively promote alveolar preservation, paving the way for ideal implant placement. In general, bone-substitute materials are effective in reducing alveolar changes after tooth extraction. Xenograft materials should be considered as among the best of the available grafting materials for alveolar preservation after tooth extraction. Both techniques effectively preserve the alveolar bone and facilitate the placement of osseointegrated implants in ideal positions, paving the way for successful oral rehabilitation.

Management of type III Dens Invaginatus with a periapical lesion in a maxillary lateral incisor: A case report

Dens Invaginatus (DI) is a developmental abnormality, usually affecting the maxillary incisor teeth, particularly lateral incisors. These cases usually present technical difficulties concerning their management owing to their aberrant canal morphology. Conventional root canal therapy, periapical surgery, and extraction have been reported as treatment modalities for such anomalies. The following case report depicts surgical endodontic management of an Oehler’s Type III DI involving a maxillary lateral incisor associated with periapical lesion aided by cone beam computed tomography (CBCT) and with the use of mineral trioxide aggregate (MTA), hydroxyapatite bone graft and platelet-rich fibrin (PRF) membrane. At 12 months post-treatment, the patient did not report any eventful episodes, and the size of the periapical lesion was markedly reduced.

Comparison of Nanocrystalline Hydroxyapatite Bone Graft with Empty Defects in Long Bone Fractures: A Retrospective Case-Control Study.

BACKGROUND The regeneration of bone defects is indicated to restore lost tissue mass and functionality. Ostim®, an absorbable nanocrystalline hydroxyapatite (NCHA) paste, is indicated to enhance bone regeneration in bone defects due to trauma or surgery. This retrospective study of 110 patients with long-bone fracture defects presenting at a single trauma center between 2010 and 2012 aimed to compare outcomes with and without the use of Ostim® absorbable nanocrystalline hydroxyapatite paste. MATERIAL AND METHODS The study encompassed fractures in 110 patients - 55 patients received any defect augmentation (ED) and 55 patients were treated with NCHA augmentation. Fractures were located at the distal radius (66.4%, n=73), proximal humerus (5.5%, n=6), and proximal tibia (28.2%, n=31). Evaluating the clinical follow-up, the study encompassed post-surgery complications (eg, non-unions, infection). Bone healing was evaluated by conventional radiographs. RESULTS Postoperative complications occurred in 45.5% of patients regardless of the treatment (P=1.0). The non-union rate in both groups was 5.5% (n=8, P=1.0), and the risk for infection was lower in the NCHA group (3.6%, ED: n=3, NCHA: n=1, p=0.62). Patients suffered open fractures were treated in the NCHA group (100%, n=7, P=0.003). Radiological assessment demonstrated comparable healing of the fracture border, fracture gap, and articular surface (P>0.05). CONCLUSIONS The findings from this retrospective study support previous studies that have shown Ostim® absorbable nanocrystalline hydroxyapatite paste enhances outcomes and reduces the risk of complications when used to repair bone defects in long-bone fractures in trauma patients. NCHA paste augmentation is suitable for use in traumatic long-bone fractures.

The effect of green mussel ( Perna viridis) shells' hydroxyapatite application on alkaline phosphatase levels in rabbit femur bone defect.

Non-union fractures can be prevented with bone grafts, such as hydroxyapatite made from green mussel shells. Green mussel shells contain a high percentage of HA, making them a promising alternative for bone healing. This research aims to reveal the effectiveness of green mussel shell HA as a bone substitute material and to provide knowledge for further research. This research was conducted for four months using a true experimental research method with a post-test-only control group design. This study used 36 New Zealand rabbits ( Oryctolagus cuniculus) which were divided into 9 groups: positive control, negative control, and intervention at weeks 2, 4 and 6 after the intervention. All groups were subjected to three general procedures: pre-surgery, surgery, and post-surgery. This study utilized histological evaluation and biochemical assessment, specifically measuring serum alkaline phosphatase (ALP) levels, to investigate the effects of hydroxyapatite (HA) from green mussel shells on bone healing in rabbits. The findings demonstrated that green mussel shell HA hashad efficacy in accelerating bone healing, better than HA bovine HA i.e. green mussel shell hydroxyapatite showed superior efficacy compared to bovine hydroxyapatite in accelerating and maximizing fracture healing, as compared to the 6-week negative control group and demonstrated a significant difference ( p < 0.05). Green mussel hydroxyapatite is proven to be able to fasten and maximize the bone healing process as fast as bovine HA, and even has higher efficacy than bovine HA.

Injectable platelet-rich fibrin polymerized with hydroxyapatite bone graft for the treatment of three-wall intrabony defects: A randomized control clinical trial.

The study was aimed to compare and evaluate the clinical and radiographic outcomes of injectable platelet-rich fibrin (i-PRF) polymerized with hydroxyapatite (HA) bone graft and HA bone graft alone for treating three-wall intrabony defects (IBDs). The trial was planned as a randomized, prospective clinico-radiographic study with inclusion of 34 three-wall IBDs in patients with stage III periodontitis. IBDs were assigned randomly to one of the groups, i.e., Group I - experimental (i-PRF + HA) and Group II - control (HA alone). At baseline and 6 and 9-month intervals, both the clinical and radiographic measurements were taken and baseline and 9-month data were tabulated and imported into SPSS 22 software. Student unpaired and paired t- tests were used to find significant differences (p<0.05). Both the groups showed substantial changes in all clinical and radiographic measures on comparison from baseline values. On intergroup comparison, the i-PRF + HA group reported significantly higher original defect resolution and original defect fill as compared to the HA group. i-PRF polymerized with HA graft has shown better results as compared to HA graft alone in three-wall IBDs and therefore can be used as a better possible alternative for the treatment of three-wall IBDs.

Comparative evaluation of nanocrystalline hydroxyapatite bone graft with and without autologous platelet-rich fibrin in the treatment of intrabony defectss

Introduction: Periodontal disease leads to the destruction of the supporting periodontal structures. Treatment of the disease would include regeneration of the lost apparatus, and various materials such as non-crystalline hydroxyapatite have been researched for the same. This study aims to evaluate the efficacy of nanocrystalline hydroxyapatite (nano-HA) as a grafting material with and without platelet-rich fibrin (PRF) in treating intrabony defects (IBDs). Materials and Methods: A total of 30 sites with IBDs were included in the study according to the inclusion and exclusion criteria. Fifteen sites were allotted in the control group (nano-HA alone) and the other 15 were allotted to the test group (nano-HA + PRF). Clinical parameters, including gingival margin (GM), probing depth (PD) and relative attachment levels (RAL), were recorded at baseline, 3 months and 6 months. The radiographic analysis included the percentage of bone fill from baseline to 6 months. Results: The intragroup analysis showed that both groups showed statistically significant results in PD reduction and RALs from baseline to 3 months and baseline to 6 months and percentage of bone fill from baseline to 6 months. No statistical significance was observed for GM. Intergroup analysis showed that the test group (nano-HA + PRF) showed statistically significant results for PD and RAL. GM and radiographic analysis did not show statistical significance. Conclusion: PRF with nano-HA gives additive effects in the regeneration of the IBD.

Fabrication of bioresorbable hydroxyapatite bone grafts through the setting reaction of calcium phosphate cement.

We prepared hydroxyapatite (HAp) bone grafts by the setting reaction of calcium phosphate cement, and investigated the effects of the porosity and crystallinity on the osteoconductivity and bioresorbability. We examined the effect of the water-mixing ratio, pressure, and post-heat treatment temperature during preparation on the crystallite size and porosity of the HAp blocks. The quantity of protein adsorption increased with increasing porosity and specific surface area (SSA) of the HAp blocks, whereas the initial cell attachment was similar despite the different porosities and crystallinities. In in vitro dissolution tests with a pH 5.5 buffer, which mimics an osteoclast-created Howship's lacuna, both the porosity and SSA of the HAp blocks affected the solubility; most likely due to the increased contact area with the buffer. Thus, HAp blocks prepared by the setting reaction of calcium phosphate cement could be applicable for bioresorbable HAp bone grafts because of the high porosity and SSA.

Ceramic bone graft substitute (Mg-HA) in spinal fusion: A prospective pilot study.

Background: Iliac crest bone graft (ICBG) is considered the gold standard for spine surgical procedures to achieve a successful fusion due to its known osteoinductive and osteoconductive properties. However, complications related to harvesting procedure and donor site morbidity have been largely reported in the literature, favoring the development of a wide range of alternative products to be used as bone graft extenders or substitutes for spine fusion. Among all, ceramic-based biomaterials have been widely studied and employed in the last years as bone graft substitutes. Methods: We report here the results of a prospective pilot study aimed to evaluating the grade of ossification obtained by the use of an Mg-doped hydroxyapatite (HA) product to achieve postero-lateral fusion in degenerative spine diseases. Results: Results show a successful degree of fusion of about 62% at the 12-month follow-up and an improvement of quality of life and health status following surgery, as evaluated by clinical scores (ODI, VAS, and EQ-5L). No adverse events related to the material were reported. Conclusion: The present pilot study shows the effectiveness and the safety profile of an Mg-doped HA bone graft substitute used to achieve postero-lateral fusion in the treatment of degenerative spine diseases, laying down the basis for further larger clinical investigations.

Evaluation of the efficacy and safety of Escherichia coli-derived recombinant human bone morphogenetic protein-2 in transforaminal lumbar interbody fusion to treat degenerative spinal disease: a protocol of prospective, randomized controlled, assessor-blinded, open-label, multicenter trial

BackgroundRecombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used as an alternative bone graft in spine fusion surgery. However, clinical outcome such as effects and complications has not yet been revealed for transforaminal lumbar interbody fusion (TLIF). Although previous studies have reported some results, the evidence is weak. Therefore, the purpose of this trial is to evaluate the effectiveness and safety of Escherichia coli-derived rhBMP-2 combined with hydroxyapatite (HA) in TLIF.MethodsThis trial is designed as a prospective, assessor-blinded, open-label, multicenter, randomized controlled study. Participants will be recruited from six tertiary teaching hospitals. All randomized participants will be undergoing one- or two-level TLIF with rhBMP-2 (77 participants) as the active experimental group or with an auto-iliac bone graft (77 participants) as the control group. The primary interbody fusion rate outcome will be evaluated using computed tomography (CT) 12 months after surgery. The secondary outcomes will be as follows: clinical outcomes (visual analog scale score, EuroQol-5-dimensions-5-level score, Oswestry Disability Index score, and some surgery-related variables) and adverse effects (radiculitis, heterotrophic ossification, endplate resorption, and osteolysis). Radiological outcomes will be evaluated using simple radiography or CT. All outcomes will be measured, collected, and evaluated before surgery and at 12, 24, and 52 weeks postoperatively.DiscussionThis study will be the primary of its kind to evaluate the effectiveness and safety of E. coli-derived rhBMP-2 with HA in one- or two-level TLIF. It is designed to evaluate the equivalence of the results between rhBMP-2 with HA and auto-iliac bone graft using an appropriate sample size, assessor-blinded analyses, and prospective registration to avoid bias. This study will set up clear conclusions for using E. coli-derived rhBMP-2 with HA in TLIF.Trial registration: This study protocol was registered at Korea Clinical Research Information Service (https://cris.nih.go.kr; number identifier: KCT0005610) on 19 November 2020. And protocol version is v1.1, January 2022.

Effect of Laser Bio stimulation and Bone Graft in Treatment of a Large Periapical Lesion – A CBCT Analysis

Nonsurgical endodontic treatment is a definitive predictable treatment option in most cases, but endodontic surgery may be indicated for teeth with persistent peri apical pathosis unresponsive to non-surgical approaches. This paper reports the one case of bone healing after peri apical surgery using laser biostimulation and hydroxyapatite bone graft assessed using CBCT analysis. Each case was evaluated using Pre-operative CBCT. Post treatment evaluation was done clinically, radiographically and by CBCT analysis.

Clinical and Radiographic Evaluation of Papilla Preservation Flap with or without Nanocrystalline Hydroxyapatite Bone Graft for Management of Periodontal Intrabony Defects: A Randomized Controlled Clinical Trial

Clinical and Radiographic Evaluation of Papilla Preservation Flap with or without Nanocrystalline Hydroxyapatite Bone Graft for Management of Periodontal Intrabony Defects: A Randomized Controlled Clinical Trial

English

Periapical surgery is the treatment of choice for a large periapical lesion with bone loss that occurs due to long standing untreated teeth affected by trauma, caries or in situations where there is an endodontic treatment failure. Failure of nonsurgical endodontic treatment may be due to peri radicular tissues incorporating with infections, foreign body response to filling materials, over instrumentation or over obturation which might have prevented complete periapical healing. We present here 2 case reports wherein, combination of platelet-rich fibrin (PRF) and the hydroxyapatite (HA) graft was used to achieve rapid healing of large periapical lesions, and the treatment outcome concluded that PRF and hydroxyapatite bone graft accelerated the wound healing and induced the rapid rate of bone formation, which was confirmed radiographically. Untreated non-vital teeth generally result in bone destruction in periapical region, which may occur due to the spread of infection following pulpal necrosis, trauma or failed endodontic treatment. Surgical intervention is essential when endodontic treatment has failed and retreatment is not possible. Periapical surgery, Apicoectomy or root end resection endodontic surgery is a safe and well documented treatment alternative when teeth with periapical pathosis are not responding to conventional endodontic treatment.1 Periapical surgery removes periapical pathosis resulting in optimal wound healing with regeneration of the bone and periodontal tissue.

Titanium Cage in Comparison with Nano-Hydroxyapatite Bone Graft Substitutes in Cervical Reconstruction.

Cervical spondylosis is a disease that occurs with age and affects the discs and joints in the cervical spine located in the neck. The hydroxyapatite (HA) bone graft substitutes can used as a potential bone-forming agent, however, the efficacy of using HA is challenging in cervical reconstruction. In this regard, nano-based HA was used in this study to explore its sagittal parameters and clinical potency in relative to titanium (TiO₂) cage in patient with cervical spondylosis. 50 patients suffering from cervical spondylosis were divided in two groups and were grafted with either TiO₂ cage or nano-HA. The sagittal parameters, including cervical spine lateral radiographs (C0-2Coob and C2-7Coob) were taken pre- and post-operation (3-month, one-year and two-year). The clinical potency was also done based on the JOA scores. Angle analysis indicated that the C0-2Cobb and C2-7Cobb angles were significantly changed after the operation in both TiO₂ cage and nano-HA groups, whereas no significant changes was determined in nano-HA relative to TiO₂ cage condition. Also, it was shown that JOA scores were significantly higher after the operation than pre-operation, indicating a potential cervical reconstruction after surgery in both groups which slightly were higher for nano-HA groups.

Clinical evaluation of 3D printed nano-porous hydroxyapatite bone graft for alveolar ridge preservation: A randomized controlled trial

Background/purposeRidge resorption after tooth extraction may result in inadequate bone volume and unfavorable ridge architecture for ideal implant placement. The use of bone substitutes has been advocated to fill extraction sites and to enhance primary implant stability. This study was made to evaluate the clinical efficacy of novel 3D printed nano-porous hydroxyapatite (3DP HA, test group) in comparison to nano-crystalline bone graft (NanoBone®, control group) in alveolar ridge preservation prior to implant placement.Materials and methodsThirty patients were randomized into two groups following tooth extraction. All extracted sockets were filled with 3DP HA or NanoBone® and covered with a non-resorbable membrane. After four months, cone-beam computed tomography (CBCT) and intraoral scanner were used to measure dimensional changes of bone and soft tissue surface. Bone core specimens were harvested for histological analysis during implant osteotomy. Implant stability was assessed using a modified damping capacity analysis.ResultsAt four months postoperatively, dimensional changes in soft tissue surface resorption were less in the test group than in the control group; however, alveolar bone resorption was the same in both groups. Histological analysis revealed new bone formation, residual graft and fibrous connective tissue in both groups. The average primary implant stability (IST) value for both groups was approximately 70. There was no statistically significant difference in all parameters between two groups (p > 0.05).Conclusion3DP HA could potentially be used as an alternative bone graft material for alveolar ridge preservation.

Clinical effect of simvastatin gel with bone graft in grade II furcation defects: A randomized controlled clinical trial

Aim: To evaluate the effectiveness of 1.2 mg/mL simvastatin (SMV) gel with hydroxyapatite (HA) bone graft in the surgical treatment of mandibular Grade II furcation defects compared with HA bone graft, SMV, and placebo after open-flap debridement (OFD). Materials and Methods: The present study was a single-center, triple-blind randomized controlled clinical trial wherein 23 mandibular grade II furcation defects from 15 chronic periodontitis patients were randomly assigned for treatment with either placebo gel (group 1; n = 5), HA (group 2; n = 6), SMV (group 3; n = 6), and SMV + HA (group 4; n = 6). Clinical parameters at the furcation defect site, such as horizontal and vertical probing depth (HPD and VPD), vertical clinical attachment level (VCAL), radiologic parameters, such as vertical defect depth in intraoral periapical radiograph (IOPA), vertical and horizontal defect depth, and volume of defect in cone-beam computed tomography (CBCT) were recorded at baseline, 3, and 6 months postoperatively and analyzed using SPSS software. For intragroup comparison, paired t test and Wilcoxon test were used, and for intergroup comparison, ANOVA and Kruskal-Wallis test were used. Results: SMV + HA group had improvement in all the clinical parameters when compared to baseline but were not significantly different when compared to other groups. However, statistically significant improvement in HPD was evident in SMV + HA group at 3 months (1.8 ± 1.3; P = 0.019; P < 0.05) when compared to HA group. In CBCT, SMV + HA group had significant improvement in VDD, HDD, and volume of the defect whereas in IOPA, there was no significant findings. Conclusion: Simvastatin with HA is more effective in reducing the horizontal component of grade II furcation defects.

Clinical and radiographic evaluation of open flap debridement with or without Nanocrystalline Hydroxyapatite bone graft in management of periodontal intrabony defects

Abstract: Background: Nanocrystalline hydroxyapatite (n-HA) bone graft could improve proliferation and differentiation of periodontal ligament fibroblasts. The osteoconductive and biomimetic properties incorporated into the early stage of human physiological bone turnover assumed that deposition of these molecules promoted early osteogenesis in and around Nano Bone. Methods: 20 periodontitis patients with intra-bony defects participated in this clinical trial and treated with either open flap debridement (OFD) alone as control group or OFD and n-HA bone graft as intervention group. Clinical outcomes included plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and gingival recession (GR). Bone defect area (BDA) was measured by digital periapical radiographs and linear measurements were used to calculate the radiographic bone fill. Measurements at baseline and 6-months postoperatively were subjected to statistical analysis. Results: Both OFD and OFD with n-HA bone substitute resulted in statistically significant improvement in all clinical and radiographic parameters from baseline to 6 months. But no significant difference was observed between both groups. After 6 months, OFD showed 2.4(±0.5)mm PD reduction and 1.2(±0.8)mm CAL gain, while n-HA group showed 3.2(±1.1)mm PD reduction and 2.7(±1.3)mm CAL gain. The BDA was reduced by 1.7(±1)mm2 with OFD and by 3.4(±2.2)mm2 in n-HA group. Conclusion: Both OFD and OFD with n-HA showed significant reduction in clinical and radiographic outcomes after 6 months with no statistically significant difference between them. Clinical relevance: Both treatment modalities are successful procedures for treating intrabony defects

Extracellular matrix containing nanocomposite bone graft in periodontal regeneration - A randomized controlled clinical and radiographic evaluation.

Background:The study aims to evaluate the effect of adding extracellular matrix (ECM) component – natural collagen to nanocrystalline hydroxyapatite (nHA) bone graft in the treatment of intrabony defect in chronic periodontitis patients.Materials and Methods:Forty chronic periodontitis patients having at least one intrabony defect were treated surgically by open flap debridement and the defect grafted (Group A: 20 sites grafted with nHA with natural collagen and Group B: 20 sites grafted with nHA). Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and radiographic defect depth (RDD) were evaluated.Results:The mean PPD reduced from 7.6 ± 0.88 at baseline to 4.45 ± 0.69 and 2.60 ± 0.6 at 3 and 6 months, respectively, in Group A. In Group B, the mean PPD reduced from 7.5 ± 0.89 at baseline to 4.95 ± 0.60 and 2.65 ± 0.59 at 3 and 6 months, respectively. The mean CAL reduced from 7.75 ± 0.85 at baseline to 5.05 ± 0.76 and 3.6 ± 0.68 at 3 and 6 months, respectively, in Group A. In Group B, the mean CAL reduced from 7.70 ± 0.86 at baseline to 5.8 ± 0.7 and 3.75 ± 0.64 at 3 and 6 months, respectively. The mean RDD reduced from 8.13 ± 0.78 and 8.12 ± 0.83 at baseline to 4.27 ± 0.66 and 3.94 ± 0.5 after 6 months in Groups A and B, respectively. After 3 months, a statistically significant reduction in mean PPD and CAL values was noted in Group A while the results were comparable after 6 months.Conclusion:The effectiveness of nHA composite during initial healing phase (3 months) can be attributed to the presence of ECM-collagen in bone graft matrix.

Coralline Hydroxyapatite Bone Graft in Non-Contained Defects: Case Report

Coralline Hydroxyapatite Bone Graft in Non-Contained Defects: Case Report

Clinicoradiographic evaluation of hyaluronan-nano hydroxyapatite composite graft in the management of periodontal infrabony defects.

Background:Hyaluronan is a naturally occurring polysaccharide in the extracellular matrix of the connective tissue. It imparts antibacterial and osteogenic properties to the nano hydroxyapatite bone graft (NHA).Aim:This study aims to evaluate the efficacy of hyaluronan-NHA (H-NHA) composite in the treatment of infrabony defects in chronic periodontitis patients.Materials and Methods:Eight systemically healthy chronic periodontitis patients with 32 graftable sites were included in the study. After flap reflection and debridement, the defect sites in the test quadrant were filled with H-NHA graft and those in the control quadrant were filled with NHA graft alone. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline and 3, 6, 9, and 12 months; bone probing depth (BPD) and radiographic parameters such as amount and percentage of defect depth reduction (DDR, PDDR) and change in alveolar crest level (ALR) were assessed at baseline and 6 and 12 months.Statistical Analysis Used:Descriptive statistics, one-way analysis of variance, and Student's t-test were used for statistical analysis.Results:At the end of 12 months, H-NHA group showed a greater reduction in PPD (5.06 ± 0.582 mm), BPD (4.22 ± 0.371 mm), and gain in CAL (4.00 ± 0.421 mm) as compared to the NHA group (3.21 ± 0.648 mm, 3.21 ± 0.047 mm, and 2.86 ± 0.127 mm, respectively). In addition, DDR, PDDR, and ALR were better in H-NHA group (1.92 ± 0.647 mm 48.22 ± 31.561 mm, and 1.22 ± 0.808 mm, respectively) as compared to the NHA group (1.14 ± 0.602 mm, 20.14 ± 25.349 mm, and 0.89 ± 0.626 mm, respectively). Statistically significant improvements in all the parameters were seen in the test sites when compared to control sites at 12 months.Conclusion:H-NHA composite graft can be considered a promising periodontal regenerative material.

Clinical and radiographic diagnostic study of strontium ranelate and metal-substituted hydroxyapatite bone graft materials in diabetes mellitus with chronic periodontitis

Background The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients. Methods A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis. After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups. Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel. Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel. Clinical parameters were assessed at baseline and 3- and 6-month intervals. Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain. Results The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value. Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2. Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group. Conclusion Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases.