Rationale and comparative clinical evaluation of a personalized guided tissue and bone regeneration protocol using different bone grafting materials in patients with generalized periodontitis

Chronic generalized periodontitis remains a widespread condition and continues to pose challenges in achieving predictable long‑term stabilization. Conventional therapeutic approaches, which are mainly focused on reducing the microbial component of inflammation, do not always provide sufficient restoration of periodontal structures or ensure a stable remission. For this reason, personalized treatment strategies that integrate guided tissue and bone regeneration techniques together with biologically active adjuncts, such as platelet‑enriched preparations, are receiving increasing scientific and clinical attention. The aim of this study was to justify and compare the clinical effectiveness of a personalized protocol for guided periodontal tissue and bone regeneration in patients with chronic generalized periodontitis, using different bone‑substitute materials in combination with platelet‑rich preparations. After a 12‑month follow‑up, patients in the main group demonstrated a steady improvement in the majority of periodontal parameters. Probing depth decreased from 5.8 ± 1.2 mm to 2.9 ± 0.7 mm (p<0.001), while clinical attachment levels improved by an average of 2.8 ± 0.6 mm. Bleeding on probing showed a marked reduction, and the width of keratinized tissue increased substantially over the observation period. CBCT examination confirmed the positive clinical dynamics, with an average of 72 ± 12% of bone defect fill, which was noticeably higher than in the control group. The identified correlation between probing depth and the width of keratinized tissue (r = –0.72) suggests that these parameters are closely interrelated in the progression and stabilization of periodontal disease. Overall, the findings indicate that the combination of PRF therapy with the bioactive Augma bone graft within a personalized regenerative protocol contributes to more pronounced clinical improvements and enhanced bone regeneration. Integrating biological, surgical, and functional components in a single treatment approach may offer a reliable option for achieving sustained remission in patients with chronic generalized periodontitis.