A Novel Proline-rich Peptide Hydrogel for Periodontal Regeneration in Adult Periodontitis Patients

Inclusion criteria * Adults \>18 years with periodontitis (Stage III or IV) * Systemically healthy (ASA I or II) * Non-smokers or smoking \<10 cigarettes/day * Having undergone steps 1 (risk factor control, oral hygiene improvement including interdental hygiene) and 2 (subgingival instrumentation and biofilm control) of systematic periodontal therapy * Indication for step 3 periodontal therapy, i.e., sites with residual/persistent pockets (PPD \>5 mm and BoP or PPD \>6 mm) around single- or multi-rooted teeth with mobility \<grade II at re-evaluation 8-12 weeks after non-surgical instrumentation (Step 2). Further site-specific criteria include at least one site with a radiographic infrabony defect (2- or 3-walled) with a \>3 mm intrabony component, not associated with an open furcation, indicated for regenerative surgery * Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) ≤20% before surgery Exclusion criteria * Medical conditions contraindicating surgery * Pregnancy or lactation * Current use of systemic antibiotics * Smoking \>10 cigarettes/day * FMPS or FMBS \>20% * Mobility grade II or greater * Acute oral infections, active endo-perio lesions or active carious lesions on teeth associated with bone defects