Clinical Efficacy of Open Flap Debridement with Camel Whey Protein Hydrogel for the Treatment of Periodontal Intraosseous Defects in Stage III Periodontitis : A Randomized Controlled Clinical Trial

Abstract

Background: Periodontal intraosseous defects represent a major clinical challenge in the management of advanced periodontitis. Although open flap debridement (OFD) can arrest disease progression and improve periodontal clinical parameters, predictable regeneration of the lost periodontal supporting tissues remains challenging. Camel whey protein (CWP) possesses biological properties, including anti-inflammatory, antioxidant, and immunomodulatory effects, which may enhance periodontal healing. The present randomized controlled clinical trial evaluated the clinical efficacy of locally applied CWP hydrogel as an adjunct to OFD in the treatment of periodontal intraosseous defects. Methods: Twenty systemically healthy patients aged 18–40 years with Stage III periodontitis and periodontal intraosseous defects characterized by probing pocket depth (PPD) ≥6 mm and clinical attachment level (CAL) ≥5 mm were enrolled. Participants were randomly allocated to two groups (n = 10 each). Group 1 received OFD with application of CWP hydrogel, whereas Group 2 received OFD alone. Periodontal clinical parameters, including PPD and CAL, were recorded at baseline and at 3 and 6 months postoperatively. Results: Both treatment groups demonstrated significant improvements in PPD and CAL throughout the 6-month follow-up period. PPD in Group 1 decreased from 7.50 ± 0.53 mm at baseline to 4.50 ± 0.85 mm at 3 months and 3.60 ± 0.52 mm at 6 months. In Group 2, PPD decreased from 7.40 ± 0.52 mm to 4.90 ± 0.57 mm and 4.30 ± 0.67 mm, respectively. The groups were comparable at baseline and at 3 months; however, a statistically significant intergroup difference in PPD was observed at 6 months (mean difference = −0.70 mm, 95% CI: −1.27 to −0.13; p = 0.0179). CAL also improved significantly within both groups from baseline to 6 months. Conclusion: Within the limitations of this 6-month randomized clinical trial, both OFD alone and OFD supplemented with CWP hydrogel resulted in significant clinical improvement in periodontal parameters. The addition of CWP hydrogel was associated with greater PPD reduction at 6 months. Further adequately powered clinical trials with longer follow-up and validated regenerative outcomes are warranted to determine the potential role of CWP as an adjunctive periodontal regenerative biomaterial.