Flapless Periodontal Regeneration Using Hyaluronic Acid Versus Enamel Matrix Derivative

Inclusion Criteria

• •Periodontitis stage III or IV, grade A or B (Tonetti et al., 2017): attachment loss ≥ 5mm, radiographic bone loss extending to to the middle third and beyond, tooth loss ≥4 due to periodontitis, probing depth (PD) ≥ 6mm.
• •Older adults ≥ 18 years. The number per sex shall be balanced.
• •Plaque index (PI) \< 1 following initial periodontal therapy and hygiene instructions.
• •Bleeding on probing (BoP) ≤ 10%.
• •Only patients with optimal compliance, assessed during etiological therapy, will be selected.
• •At least a 2-3 wall interproximal bone defect with a radiographically moderate or deep intrabony defect (≥3mm), PD≥ 6mm using a Williams probe on uniradicular teeth or mandibular molars without furcation involvement after non-surgical periodontal treatment.
• •Vital teeth or teeth with well-performed root canal treatment.
• •Absence of caries, prosthetic restoration or periapical infection in the tooth to be regenerated.
• •Absence of systemic pathology.
• •Negative history of pregnancy.
• •Signed informed consent.
• •The participant is willing and able to comply with the necessary visits for the treatments and evaluations scheduled during the clinical study.