Effectiveness of Adjuncts with Demineralized Freeze Dried Bone Allograft in Treatment of Intrabony Defects - A systematic review

Abstract Objective: To systematically evaluate the effect of adjuncts with demineralized freeze dried bone in the treatment of intrabony defects in terms of clinical and radiological outcomes. Methods: A search was conducted for randomized controlled trials in cases of chronic periodontitis to evaluate the effect of adjuncts with demineralized freeze dried bone in the treatment of intrabony defects. The electronic databases like PUBMED and the Cochrane Central Register of Controlled Trials were used as data sources. Gain in clinical attachment level was considered as the primary outcome variable while Pocket depth reduction and Radiological bone fill were considered to be the secondary outcome variables. Results: Of all the articles screened, seven controlled human clinical trials met the eligibility criteria and provided clinical and radiological outcome data on the effectiveness of adjuncts with Demineralized Freeze Dried Bone Allograft (DFDBA) in the treatment of intrabony defects. Amongst the above mentioned seven trials, three controlled clinical trial showed significant results while four controlled clinical trials did not show significant results. From this systematic review, it can be concluded that the treatment with Autologous Platelet Concentrate (PRP) in combined with DFDBA showed significant results in probing pocket depth reduction and clinical attachment level gain. Cyclosporine A in combination with DFDBA showed significant radiological bone fill and Enamel Matrix Derivative (EMD) in combination with DFDBA with 12 months followup showed significant soft tissue and hard tissue healing. Conclusion: PRP in combination with DFDBA showed significant results in probing pocket depth reduction and clinical attachment level gain. Cyclosporine with DFDBA showed significant radiological bone fill and EMD in combination to DFDBA with 12 months follow-up showed significant soft tissue and hard tissue healing. However, long term studies are needed to clarify the effectiveness of adjuncts with DFDBA in the treatment of intrabony defect.