Evaluation of Radiographic and Clinical Outcomes in the Use of Bone Substitutes in Periapical Surgery and Periodontal Regeneration.

Background: Periapical surgery and periodontal regeneration are essential dental procedures aimed at restoring the integrity of the tooth and surrounding tissues. Bone substitutes, including synthetic materials, xenografts, allografts, and autografts, play a pivotal role in enhancing healing and promoting tissue regeneration. This study evaluates the clinical and radiographic outcomes associated with the use of these bone substitutes. Methods: The study involved 60 patients aged 18-60 years who were randomly assigned to three groups: synthetic bone substitute, autograft, and xenograft (20 patients each). Clinical outcomes such as Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), and pain scores were evaluated at baseline, 6, and 12 months post-surgery. Radiographic outcomes included bone defect fill, bone density, and graft resorption, assessed using digital radiographs and Cone-Beam Computed Tomography (CBCT). Results: The autograft group demonstrated the highest clinical and radiographic outcomes, showing superior improvements in PPD, CAL, bone defect fill, and bone density at both 6 and 12 months. The synthetic bone substitute group showed positive results, though slightly less favorable than autografts. The xenograft group exhibited moderate improvements but experienced higher graft resorption, especially at 12 months. Conclusion: Autografts are the most effective bone substitute for promoting bone regeneration and periodontal healing. Synthetic bone substitutes offer fewer complications but show somewhat slower bone regeneration. Xenografts, though effective, may have lower long-term efficacy due to higher resorption rates.