Sub-junctional Pinhole Technique

Pinhole Regenerative Therapy (PRT) following minimally invasive non-surgical periodontal therapy (MINST) in the treatment of intrabony defects associated with Stage III Grade B periodontitis. Eligible patients with 2- or 3-wall intrabony defects will be randomly allocated to the study groups. Clinical outcomes, including probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain, together with radiographic bone defect fill assessed by periapical radiographs and CBCT, will be evaluated over a 6-month follow-up period to determine the effectiveness of the proposed minimally invasive regenerative approacا

Inclusion Criteria * Patients aged 39-61 years. * Systemically healthy patients. * Diagnosed with Stage III periodontitis. * Presence of probing pocket depth (PPD) ≥ 6 mm. * Presence of clinical attachment loss (CAL) ≥ 4 mm. * Presence of at least one 2- or 3-wall interproximal intrabony defect with: * Defect depth ≥ 3 mm. * Angulation width ≥ 45°. * Each participant contributed one maxillary or mandibular single- or multi-rooted interproximal intrabony defect. Exclusion Criteria * Patients with any systemic condition contraindicating surgical intervention. * Pregnant or lactating females. * Smokers. * Alcoholic patients. * History of periodontal therapy within the previous 6 months. * History of antibiotic administration within the previous 6 months. * Patients with unacceptable oral hygiene after re-evaluation following Step 1 and Step 2 periodontal therapy. * Teeth with any degree of mobility.