What is the role of Intramarrow penetration in managing intrabony defects-A Systematic Review

Intramarrow Penetration (IMP) has recently gained attention for its potential to enhance periodontal healing with regenerative approaches for osseous deformities such as intrabony defects. This systematic review was conducted to evaluate the effect of IMP in enhancing periodontal regeneration of intrabony defects when used in conjunction with or without the use of biomaterials. A comprehensive search was performed across databases including PubMed, Scopus, Cochrane, Lilacs, and Google Scholar. Studies were selected based on the inclusion of clinical outcomes such as probing pocket depth (PPD), clinical attachment level (CAL), and bone fill following the application of IMP with Open Flap debridement (OFD) with or without biomaterials. Studies were assessed for risk of bias using the Cochrane RoB 2 tool. The quality of evidence was assessed using the GRADE approach. Initial search yielded 194 studies which eventually resulting in five eligible studies for inclusion in the review. Four of the five included studies reported that IMP significantly improved clinical and radiographic outcomes, including reduced PPD, increased CAL, and enhanced bone fill. IMP can be a potential adjunct to OFD for periodontal regeneration in intrabony defects, offering advantages such as improved healing and enhanced bone regeneration. However, as the quality of evidence is very low a definitive clinical recommendation cannot be made. Further well-designed multicentre studies are necessary to validate these findings.