Periodontology 432 Winter 2024

Synthetic Hydroxyapatites, Ceramic Materials, and Bioactive Glass in the

Management of Osseous Defects

Possible Questions for Seminar:

1. What types of synthetic bone graft materials have been suggested for treating
periodontal osseous defects? What are they composed of? Which ones are resorbable?

2. Are any of the synthetic bone graft materials osteoinductive? Which ones are
primarily osteoconductive? How do they work?

3. Which of the available synthetic bone graft materials appear to have the most promise
in the treatment of osseous defects in humans?

4. Can synthetic bone graft materials be used as effective carriers of bone-inducing

growth factors?

5. When compared to other methods/materials used for periodontal regeneration, how

efficacious are the commercially available synthetic bone substitutes?

Suggested Articles

1. Bartold PM, Xiao Y, Lyngstaadas SP, Paine ML, Snead ML. Principles and
applications of cell delivery systems for periodontal regeneration. Periodontol 2000
2006;41:123-135.

2. De Leonardis D, Paolantonio M. Enamel matrix derivative, alone or associated with

synthetic bone substitute, in the treatment of 1- to 2-wall periodontal defects. J
Periodontol 2013;84:444-455.

3. Emerton KB, Drapeau, SJ, Prasad H, Rohrer M, Roffe P, Hopper K, Schoolfield J,

Jones A, Cochran DL. Regeneration of periodontal tissues in non-human primates with
rhGDF-5 and beta-tricalcium phosphate. J Dent Res 2011;90:1416-1421.

4. Jayakumar A, Rajababu P, Rohini S, Butchibabu K, Naveen A, Reddy PK,

Vidyasagar S, Satyanarayana D, Pavan Kumar S. Multi-centre, randomized clinical trial
on the efficacy and safety of recombinant human platelet-derived growth factor with -
tricalcium phosphate in human intra-osseous periodontal defects. J Clin Periodontol
2011;38:163-172.

5. Mazor Z, Mamidwar S, Ricci JL, Tovar NM. Bone repair in periodontal defects using
a composite of allograft and calcium sulfate (DentoGen) and a calcium sulfate barrier. J
Oral Implantol 2011;37:287-292.

1
6. Meyle J, Hoffmann T, Topoll H, Heinz B, Al-Machot E, Jervøe-Storm PM, Meiss C,
Eickholz P, Jepsen S. A multi-centre randomized controlled clinical trial on the treatment
of intra-bony defects with enamel matrix derivatives/synthetic bone graft or enamel
matrix derivatives alone: results after 12 months. J Clin Periodontol 2011;38:652-660.

7. Peres MF, Ribeiro ED, Casarin RC, Ruiz KG, Junior FH, Sallum EA, Casati MZ.
Hydroxyapatite/-tricalcium phosphate and enamel matrix derivative for treatment of
proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol
2013;40:252-259.

8. Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL, Gunsolley JC. The efficacy
of bone replacement grafts in the treatment of periodontal osseous defects. Ann
Periodontol 2003;8:227-265.

9. Schmitt JM, Buck DC, Joh S-P, Lynch SE, Hollinger JO. Comparison of porous bone
mineral and biologically active glass in critical-sized defects. J Periodontol
1997;68:1043-1053.

10. Sohrabi K, Saraiya V, Laage TA, Harris M, Blieden M, Karimbux N. An evaluation

of bioactive glass in the treatment of periodontal defects: A meta-analysis of randomized
controlled clinical trials. J Periodontol 2012;83:453-464.

Reviews

1. Bartold PM, Xiao Y, Lyngstaadas SP, Paine ML, Snead ML. Principles and
applications of cell delivery systems for periodontal regeneration. Periodontol 2000
2006;41:123-135.

2. Iviglia G, Kargozar S, Baino F. Biomaterials. Current strategies, and novel nano-

technological approaches for periodontal regeneration. J Funct Biomater. 2019
Mar; 10(1): 3. Published online 2019 Jan 2. doi: 10.3390/jfb10010003

3. Mancini L, Romandini M, Fratini A, Americo LM, Panda S, Marchetti E.

Biomaterials for periodontal and peri-implant regeneration. Materials (Basel) 2021
Jun; 14(12): 3319. Published online 2021 Jun 15. doi: 10.3390/ma14123319

4. Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL, Gunsolley JC. The efficacy
of bone replavcement grafts in the treatment of periodontal osseous defects. Ann
Periodontol 2003;8:227-265.

5. Shetty V, Han TJ. Alloplastic materials in reconstructive periodontal surgery. Dent

Clin N Am 1991;35:521-530.

6. Sohrabi K, Saraiya V, Laage TA, Harris M, Blieden M, Karimbux N. An evaluation

of bioactive glass in the treatment of periodontal defects: A meta-analysis of randomized
controlled clinical trials. J Periodontol 2012;83:453-464.

2
7. Trombelli L, Heitz-Mayfield LJ, Needleman I, Moles D, Scabbia A. A systematic
review of graft materials and biological agents for periodontal intraosseous defects. J
Clin Periodontol 2002;29(Suppl 3):117-135; discussion 160-162.

8. Yukna RA. Synthetic bone grafts in periodontics. Periodontol 2000 1993;1:92-99.

9. Yukna RA. Synthetic grafts and regeneration. In, Periodontal Regeneration. Current
Status and Directions. Polson AM (ed), Chicago: Quintessence Pub Co., 1994:103-112.

-tricalcium Phosphate (TCP; Synthograft®); Biphasic Calcium Phosphate (BCP)

1. Baldock WT, Hutchens LH Jr, McFall WT Jr, Simpson DM. An evaluation of

tricalcium phosphate implants in human periodontal osseous defects of two patients. J
Periodontol 1985;56:1-7.

2. Barney VC, Levin MP, Adams DF. Bioceramic implants in surgical periodontal
defects. A comparison study. J Periodontol 1986;57:764-770.

3. Bhaskar SN, Brady JM, Getter L, Grower MF, Driskell T. Biodegradable ceramic
implants in bone. Electron and light microscopic analysis. Oral Surg Oral Med Oral
Pathol 1971;32:336-346.

4. Bowers GM, Vargo JW, Levy B, Emerson JR, Berquist JJ. Histologic observations
following the placement of tricalcium phosphate implants in human intrabony defects. J
Periodontol 1986;57:286-287.

5. Bye FL, Krause ME, Regezi JA, Caffesse RG. Histologic evaluation of periodontal
implants in a biologically “closed” model. J Periodontol 1987;58:110-118.

6. Choi H, Park NJ, Jamiyandorj O, Hong MH, Oh S, Park YB, Kim S. Improvement of
osteogenic potential of biphasic calcium phosphate bone substitute coated with synthetic
cell binding peptide sequences. J Periodontal Implant Sci 2012;42:166-172.

7. Daculsi G, LeGeros RZ, Mitre D. Crystal dissolution of biological and ceramic

apatites. Calcif Tiss Internat 1989;45:95-103.

8. Daculsi G, LeGeros RZ, Nery E, Lynch K, Kerebel B. Transformation of biphasic

calcium phosphate ceramics in vivo: ultrastructural and physicochemical characterization.
J Biomed Mater Res 1989;23:883-894.

9. De Leonardis D, Paolantonio M. Enamel matrix derivative, alone or associated with

synthetic bone substitute, in the treatment of 1- to 2-wall periodontal defects. J
Periodontol 2013;84:444-455.

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10. Ellinger RF, Nery EB, Lynch KL. Histological assessment of periodontal osseous
defects following implantation of hydroxyapatite and biphasic calcium phosphate
ceramics: A case report. Int J Periodontics Restorative Dent 1986;6(3):23-33.

11. Emerton KB, Drapeau, SJ, Prasad H, Rohrer M, Roffe P, Hopper K, Schoolfield J,
Jones A, Cochran DL. Regeneration of periodontal tissues in non-human primates with
rhGDF-5 and beta-tricalcium phosphate. J Dent Res 2011;90:1416-1421.

12. Froum S, Stahl SS. Human intraosseous healing responses to the placement of
tricalcium phosphate ceramic implants. II. 13 to 18 months. J Periodontol 1987;58:103-
109.

13. Jayakumar A, Rajababu P, Rohini S, Butchibabu K, Naveen A, Reddy PK,

Vidyasagar S, Satyanarayana D, Pavan Kumar S. Multi-centre, randomized clinical trial
on the efficacy and safety of recombinant human platelet-derived growth factor with -
tricalcium phosphate in human intra-osseous periodontal defects. J Clin Periodontol
2011;38:163-172.

14. Levin MP, Getter L, Adrian J, Cutright DE. Healing of periodontal defects with
ceramic implants. J Clin Periodontol 1974;1:197-205.

15. Levin MP, Getter L, Cutright DE, Bhaskar SN. Biodegradable ceramic in
periodontal defects. Oral Surg Oral Med Oral Pathol 1974;38:344-351.

16. Levin MP, Getter L, Cutright DE, Bhaskar SN. A comparison of iliac marrow and
biodegradable ceramic in periodontal defects. J Biomed Mater Res 1975;9:183-195.

17. Nery EB, Lynch KL, Hirthe WM, Mueller KH. Bioceramic implants in surgically
produced infrabony defects. J Periodontol 1975;46:328-347.

18. Nery EB, Eslami A, Van Swol RL. Biphasic calcium phosphate ceramic combined
with fibrillar collagen with and without citric acid conditioning in the treatment of
periodontal osseous defects. J Periodontol 1990;61:166-172.

19. Nery EB, Lee KK, Czajkowski S, Dooner JJ, Duggan M, Ellinger RF, Henkin JM,
Hines R, Miller M, Olson JW, Rafferty M, Sullivan T, Walters P, Welch D, Williams A.
A Veterans Administration cooperative study of biphasic calcium phosphate ceramic in
periodontal osseous defects. J Periodontol 1990;61:737-744.

20. Nery EB, LeGeros RZ, Lynch KL, Lee K. Tissue response to biphasic calcium
phosphate ceramic with different ratios of HA/TCP in periodontal osseous defects. J
Periodontol 1992;63:729-735.

21. Ogilvie A, Frank RM, Benqué EP, Gineste M, Heughebaert M, Hemmerle J. The
biocompatibility of hydroxyapatite implanted in the human periodontium. J Periodontal
Res 1987;22:270-283.

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22. Pepelassi EM, Bissada NF, Greenwell H, Farah CF. Doxycycline-tricalcium
phosphate composite graft facilitates osseous healing in advanced periodontal furcation
defects. J Periodontol 1991;62:106-115.

23. Peres MF, Ribeiro ED, Casarin RC, Ruiz KG, Junior FH, Sallum EA, Casati MZ.
Hydroxyapatite/-tricalcium phosphate and enamel matrix derivative for treatment of
proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol
2013;40:252-259.

24. Snyder AJ, Levin MP, Cutright DE. Alloplastic implants of tricalcium phosphate
ceramic in human periodontal osseous defects. J Periodontol 1984;55:273-277.

25. Stahl SS, Froum S. Histological evaluation of human intraosseoushealing responses

to the placement of tricalcium phosphate ceramic implants. I. Three to eight months. J
Periodontol 1986;57:211-217.

26. Strub JR, Gaberthüel TW, Firestone AR. Comparison of tricalcium phosphate and
frozen allogenic bone implants in man. J Periodontol 1979;50:624629.

27. Sugaya A, Minabe M, Hori T, Tatsumi J, Watanabe Y, Ikeda K, Numabe Y, Hayashi

H, Kamoi K. Effects on wound healing of tricalcium phosphate-collagen complex
implants in periodontal osseous defects in the dog. J Periodontal Res 1990;25:60-63.

28. Wada T, Hara K, Ozawa H. Ultrastructural and histochemical study of -tricalcium

phosphate resorbing cells in periodontium of dogs. J Periodontal Res 1989;24:391-401.

29. Zafirapoulos GG, Hoffmann O, Kasaj A, Willershausen B, Weiss O, Van Dyke TE.
Treatment of intrabony defects using guided tissue regeneration and autogenous
spongiosa alone or combined with hydroxyapatite/beta-tricalcium phosphate bone
substitute or bovine-derived xenograft. J Periodontol 2007;78:2216-2225.

Synthetic Hydroxyapatites (Durapaptite; Periograf®; HA 500®; Calcitite; Interpore

200®; Bioapatite®) and Calcium Carbonate (Biocoral 450®)

1. Barnett JD, Mellonig JT, Gray JL, Towle HJ. Comparison of freeze-dried bone
allograft and porous hydroxylapatite in human periodontal defects. J Periodontol
1989;60:231-237.

2. Barney VC, Levin MP, Adams DF. Bioceramic implants in surgical periodontal
defects. A comparison study. J Periodontol 1986;57:764-770.

3. Boetto J, Freeman E. Histological evaluation of durapatite in experimental

periodontal defects. J Can Dent Assoc 1984;50:239-244.

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4. Bowen JA, Mellonig JT, Gray JL, Towle HT. Comparison of decalcified freeze-dried
bone allograft and porous particulate hydroxyapatite in human periodontal osseous
defects. J Periodontol 1989;60:647-654.

5. Brown GD, Mealey BL, Nummikoski PV, Bifano SL, Waldrop TC. Hydroxyapatite
cement implant for regeneration of periodontal osseous defects in humans. J Periodontol
1998;69:146-157.

6. Bye FL, Krause ME, Regezi JA, Caffesse RG. Histologic evaluation of periodontal
implants in a biologically “closed” model. J Periodontol 1987;58:110-118.

7. Carranza FA Jr, Kenney EB, Lekovic V, Talamante E, Valencia J, Dimitrijevic B.

Histologic study of healing of human periodontal defects after placement of porous
hydroxylapatite implants. J Periodontol 1987;58:682-695.

8. Doll BA, Towle HJ, Hollinger JO, Reddi AH, Mellonig JT. The osteogenic potential
of two composite graft systems using osteogenin. J Periodontol 1990;61:745-750.

9. Ettel RG, Schaffer EM, Holpuch RC, Bandt CL. Porous hydroxyapatite grafts in
chronic subcrestal periodontal defects in rhesus monkeys: A histological investigation. J
Periodontol 1989;60:342-351.

10. Frank RM, Klewansky P, Hemmerle J, Tenenbaum H. Ultrastructural demonstration

of the importance of crystal size of bioceramic powders implanted into human
periodontal lesions. J Clin Periodontol 1991;18:669-680.

11. Froum SJ, Kushner L, Scopp IW, Stahl SS. Human clinical and histologic responses
to Durapatite implants in intraosseous lesions. J Periodontol 1982;53:719-725.

12. Galgut PN, Verrier J, Waite IM, Linney A, Cornick DER. Computerized
densitometric analysis of interproximal bone levels in a controlled clinical study into the
treatment of periodontal bone defects with ceramic hydroxyapatite implant material. J
Periodontol 1991;62:44-50.

13. Galgut PN, Waite IM, Brookshaw JD, Kingston CP. A 4-year controlled clinical
study into the use of a ceramic hydroxylapatite implant material for the treatment of
periodontal bone defects. J Clin Periodontol 1992;19:570-577.

14. Ganeles J, Listgarten MA, Evian CI. Ultrastructure of durapaptite-periodontal tissue

interface in human intrabony defects. J Periodontol 1986;57:133-140.

15. Kenney EB, Lekovic V, Han T, Carranza FA Jr, Dimitrijevic B. The use of a porous
hydroxylapatite implant in periodontal defects. I. Clinical results after six months. J
Periodontol 1985;56:82-88.

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16. Kenney EB, Lekovic V, Sa Ferreira JC, Han T, Dimitrijevic B, Carranza FA Jr.
Bone formation within porous hydroxylapatite implants in human periodontal defects. J
Periodontol 1986;57:76-83.

17. Kenney EB, Lekovic V, Elbaz JJ, Kovacvic K, Carranza FA Jr, Takei HH. The use
of a porous hydroxylapatite implant in periodontal defects. II. Treatment of class II
furcation lesions in lower molars. J Periodontol 1988;59:67-72.

18. Kim C-K, Choi E-J, Cho K-S, Chai J-K, Wikesjö UME. Periodontal repair in
intrabony defects treated with a calcium carbonate implant and guided tissue
regeneration. J Periodontol 1996;67:1301-1306.

19. Kim C-S, Choi S-H, Cho K-S, Chai J-K, Wikesjö UME, Kim C-K. Periodontal
healing in one-wall intra-bony defects in dogs following implantation of autogenous
bone or a coral-derived biomaterial. J Clin Periodontol 2005;32:583-589.

20. Krejci CB, Bissada NF, Farah C, Greenwell H. Clinical evaluation of porous and
nonporous hydroxyapatite in the treatment of human periodontal bony defects. J
Periodontol 1987;58:521-528.

21. Lekovic V, Kenney EB, Carranza FA Jr, Danilovic V. Treatment of class II

furcation defects using porous hydroxylapatite in conjunction with a
polytetrafluoroethylene membrane. J Periodontol 1990;61:575-578.

22. Louise F, Borghetti A, Kerebel B. Histologic case reports of coralline

hydroxyapatite grafts placed in human intraosseous lesions: Results 6 to 36 months
postimplantation. Int J Periodontics Restorative Dent 1992;12:475-485.

23. Meffert RM, Thomas JR, Hamilton KM, Brownstein CN. Hydroxylapatite as an
alloplastic graft in the treatment of human periodontal osseous defects. J Periodontol
1985;56:63-73.

24. Meffert RM, Thomas JR, Caudill RF. Hydroxyapatite implantation – Clinical and
histologic analysis of a treated lesion and speculations regarding healing phenomena. Int
J Periodontics Restorative Dent 1986;6(6):61-66.

25. Meyle J, Hoffmann T, Topoll H, Heinz B, Al-Machot E, Jervøe-Storm PM, Meiss C,

Eickholz P, Jepsen S. A multi-centre randomized controlled clinical trial on the treatment
of intra-bony defects with enamel matrix derivatives/synthetic bone graft or enamel
matrix derivatives alone: results after 12 months. J Clin Periodontol 2011;38:652-660.

26. Mora F, Ouhayoun JP. Clinical evaluation of natural coral and porous
hydroxyapatite implants in periodontal bone lesions: results of a 1-year follow-up. J Clin
Periodontol 1995;22:877-884.

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27. Moskow BS, Lubarr A. Histological assessment of human periodontal defect after
durapatite ceramic implant. Report of a case. J Periodontol 1983;54:455-462.

28. Oreamuno S, Lekovic V, Kenney EB, Carranza FA Jr, Takei HH, Prokic B.
Comparative clinical study of porous hydroxyapatite and decalcified freeze-dried bone in
human periodontal defects. J Periodontol 1990;61:399-404

29. Peres MF, Ribeiro ED, Casarin RC, Ruiz KG, Junior FH, Sallum EA, Casati MZ.
Hydroxyapatite/-tricalcium phosphate and enamel matrix derivative for treatment of
proximal class II furcation defects: a randomized clinical trial. J Clin Periodontol
2013;40:252-259.

30. Pietruska M, Skurska A, Pietruski J, Dolińska E, Arweiler N, Milewski R, Duraj E,

Sculean A. Clinical and radiographic evaluation of intrabony periodontal defect
treatment by open flap debridement alone or in combination with nanocrystalline
hydroxyapatite bone substitute. Ann Anat 2012;194:533-537.

31. Rabalais ML Jr, Yukna

RA, Mayer ET. Evaluation of durapatite ceramic as an alloplastic implant in periodontal
osseous defects. I. Initial six-month results. J Periodontol 1981;52:680-689.

32. Sapkos SW. The use of Periograf® in periodontal defects. Histologic findings. J
Periodontol 1986;57:7-13.

33. Shepard WK, Bahat O, Joseph CE, LoPiccolo P, Bernick S. Human clinical and
histological responses to a Calcitite® implant in intraosseous lesions. Int J Periodontics
Restorative Dent 1986;6(3):47-63.

34. Stahl SS, Froum SJ, Kushner L. Healing responses of human intraosseous lesions
following the use of debridement, grafting and citric acid root treatment. II. Clinical and
histologic observations: One year postsurgery. J Periodontol 1983;54:325-338.

35. Stahl SS, Froum SJ. Histologic and clinical responses to porous hydroxylapatite
implants in human periodontal defects. Three to twelve months postimplantation. J
Periodontol 1987;58:689-695.

36. Sugaya A, Minabe M, Tamura T, Hori T, Watanabe Y. Effects on wound healing of

hydroxyapatite-collagen complex implants in periodontal osseous defects in the dog. J
Periodontal Res 1989;24:284-288.

37. Trombelli L, Simonelli A, Pramstraller M, Wikesjö UM, Farina R. Single flap

approach with and without guided tissue regeneration and a hydroxyapatite biomaterial in
the management of intraosseous periodontal defects. J Periodontol 2010;81:1256-1263.

38. West TL, Brustein DD. Freeze-dried bone and coralline implants compared in the
dog. J Periodontol 1985;56:348-351.

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39. Yukna RA, Mayer ET, Brite DV. Longitudinal evaluation of durapaptite ceramic as
an alloplastic implant in periodontal osseous defects after 3 years. J Periodontol
1984;55:633-637.

40. Yukna RA, Harrison BG, Caudill RF, Evans GH, Mayer ET, Miller S. Evaluation
of durapatite ceramic as an alloplastic implant in periodontal osseous defects. II. Twelve
month reentry results. J Periodontol 1985;56:540-547.

41. Yukna RA, Cassingham RJ, Caudill RF, Mayer ET, Evans GH, Miller S, Simon JF.
Six month evaluation of Calcitite® (hydroxylapatite ceramic) in periodontal osseous
defects. Int J Periodontics Restorative Dent 1986;6(3):35-45.

42. Yukna RA, Mayer ET, Amos SM. 5-year evaluation of durapatite ceramic
alloplastic implants in periodontal osseous defects. J Periodontol 1989;60:544-551.

43. Yukna RA. Osseous defect responses to hydroxylapatite grafting versus open flap
debridement. J Clin Periodontol 1989;16:398-402.

44. Yukna RA. Clinical evaluation of coralline calcium carbonate as a bone replacement
graft material in human periodontal osseous defects. J Periodontol 1994;65:177-185.

45. Yukna RA, Yukna CN. A 5-year follow-up of 16 patients treated with coralline
calcium carbonate (Biocoral™) bone replacement grafts in infrabony defects. J Clin
Periodontol 1998;25:1036-1040.

Bioplant HTR® Synthetic Bone (Composite of PMMA [poly-methyl-methacrylate],

PHEMA [poly-hydroxy-ethyl-methacrylate], Calcium Hydroxide)

1. Froum SJ. Human histologic evaluation of HTR polymer and freeze-dried bone
allograft. A case report. J Clin Periodontol 1996;23:615-620.

2. Shahmiri S, Singh IJ, Stahl SS. Clinical response to the use of the HTR polymer
implant in human intrabony lesions. Int J Periodontics Restorative Dent 1992;12:295-
299.

3. Stahl SS, Froum SJ, Tarnow D. Human clinical and histologic responses to the
placement of HTR polymer particles in 11 intrabony lesions. J Periodontol
1990;61:269-274.

4. Yukna RA. HTR polymer grafts in human periodontal osseous defects. I. 6-month
clinical results. J Periodontol 1990;61:633-642.

5. Yukna RA, Greer RO Jr. Human gingival tissue response to HTR polymer. J Biomed
Mater Res 1992;26:517-527.

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6. Yukna RA. Clinical evaluation of HTR polymer bone replacement grafts in human
mandibular class II molar furcations. J Periodontol 1994;65:342-349.

7. Yukna RA, Yukna CN. Six-year clinical evaluation of HTR synthetic bone grafts in
human grade II molar furcations. J Periodontal Res 1997;32:627-633.

Bioactive Glass (PerioGlas®, Bioglass™)

1. Anderegg CR, Alexander DC, Freidman M. A bioactive glass particulate in the

treatment of molar furcation invasions. J Periodontol 1999;70:384-387.

2. Demir B, Sengün D, Berberoglu A. Clinical evaluation of platelet-rich plasma and

bioactive glass in the treatment of intra-bony defects. J Clin Periodontol 2007;34:709-
715.

3. Dybvik T, Leknes KN, Boe OE, Skavland RJ, Albandar JM. Bioactive ceramic filler
in the treatment of severe osseous defects: 12-month results. J Periodontol 2007;78:403-
410.

4. Fetner AE, Hartigan MS, Low SB. Periodontal repair using PerioGlas® in nonhuman
primates: Clinical and histologic observations. Compend Contin Educ Dent
1994;15:932-939.

5. Froum SJ, Weinberg MA, Tarnow D. Comparison of bioactive glass synthetic bone
graft particles and open deberidement in the treatment of human periodontal defects. A
clinical study. J Periodontol 1998;69:698-709.

6. Furusawa T, Mizunuma K. Osteoconductive properties and efficacy of resorbable

bioactive glass as a bone-grafting material. Implant Dent 1997;6:93-101.

7. Hall EE, Meffert RM, Hermann JS, Mellonig JT, Cochran DL. Comparison of
bioactive glass to demineralized freeze-dried bone allograft in the treatment of intrabony
defects around implants in the canine mandible. J Periodontol 1999;70:526-535.

8. Hench LL, Splinter RJ, Allen WC, Greenlee TK. Bonding mechanisms at the
interface of ceramic prosthetic materials. J Biomed Mater Res 1971;5(6):117-141.

9. Hench LL, Paschall HA. Direct chemical bond of bioactive glass-ceramic materials
to bone and muscle. J Biomed Mater Res 1973;7(3):25-42.

10. Hench LL, Wilson J. Surface-active biomaterials. Science 1984;226:630-636.

11. Karatzas S, Zavras A, Greenspan D, Amar S. Histologic observations of periodontal

wound healing after treatment with PerioGlas in nonhuman primates. Int J Periodontics
Restorative Dent 1999;19:489-499.

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12. Keles GC, Cetinkaya BO, Albayrak D, Koprulu H, Acikgoz G. Comparison of
platelet pellet and bioactive glass in periodontal regenerative therapy. Acta Odontol
Scand 2006;64:327-333.

13. Kirkland G, Greenwell H, Drisko C, Wittwer JW, Yancey J, Rebitski G. Hard tissue
ridge augmentation using a resorbable membrane and a particulate graft without
complete flap closure. Int J Periodontics Restorative Dent 2000;20:383-389.

14. Kuru B, Yilmaz S, Argin K, Noyan U. Enamel matrix derivative alone or in

combination with a bioactive glass in wide intrabony defects. Clin Oral Investig
2006;10:227-234.

15. Leknes KN, Andersen KM, Boe OE, Skavland RJ, Albandar JM. Enamel matrix
derivative versus bioactive ceramic filler in the treatment of intrabony defects: 12-month
results. J Periodontol 2009;80:219-227.

16. Lovelace TB, Mellonig JT, Meffert RM, Jones AA, Nummikoski PV, Cochran DL.
Clinical evaluation of bioactive glass in the treatment of periodontal osseous defects in
humans. J Periodontol 1998;69:1027-1035.

17. Low SB, King CJ, Krieger J. An evaluation of bioactive ceramic in the treatment of
periodontal osseous defects. Int J Periodont Rest Dent 1997;17:359-367.

18. Mengel R, Soffner M, Flores-de-Jacoby L. Bioabsorbable membrane and bioactive

glass in the treatment of intrabony defects in patients with generalized aggressive
periodontitis: results of a 12-month clinical and radiological study. J Periodontol
2003;74:899-908.

19. Nevins ML, Camelo M, Nevins M, King CJ, Oringer RJ, Schenk RK, Fiorellini JP.
Human histologic evaluation of bioactive ceramic in the treatment of periodontal osseous
defects. Int J Periodontics Restorative Dent 2000;20:459-467.

20. Ong MMA, Eber RM, Korsnes MI, MacNeil RL, Glickman GN, Shyr Y, Wang H-L.
valuation of a bioactive glass alloplast in treating periodontal intrabony defects. J
Periodontol 1998;69:1346-1354.

21. Park J-S, Suh J-J, Choi S-H, Moon I-K, Cho K-S, Kim C-K, Chai J-K. Effects of
pretreatment clinical parameters on bioactive glass implantation in intrabony periodontal
defects. J Periodontol 2001;72:730-740.

22. Schmitt JM, Buck DC, Joh S-P, Lynch SE, Hollinger JO. Comparison of porous
bone mineral and biologically active glass in critical-sized defects. J Periodontol
1997;68:1043-1053.

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23. Schepers EJG, Ducheyne P, Barbier L, Schepers S. Bioactive glass particles of
narrow size range: A new material for the repair of bone defects. Implant Dent
1993;2:151-156.

24. Schmitt JM, Buck DC, Joh S-P, Lynch SE, Hollinger JO. Comparison of porous
bone mineral and biologically active glass in critical-sized defects. J Periodontol
1997;68:1043-1053.

25. Sculean A, Pietruska M, Schwarz F, Willershausen B, Arweiler NB, Auschill TM.

Healing of human intrabony defects following regenerative periodontal therapy with an
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