Periodontal regeneration in horizontal osseous defect

Horizontal bone loss represents the most frequently encountered pattern of bone destruction in periodontitis and remains a significant therapeutic challenge due to limited regenerative possibilities. It is characterized by a reduction in bone height with the absence of contained bony walls, thereby restricting the predictability of regenerative outcomes. Despite its high prevalence, effective management of horizontal bone defects remains an area requiring further exploration. Intramarrow penetration (IMP) promotes bone healing by exposing cancellous bone, inducing bleeding, and facilitating the migration of progenitor cells and vascular elements into the grafted region. Low-level laser therapy (LLLT) enhances mesenchymal stem cell proliferation and stimulates the release of growth factors, thereby supporting bone regeneration without causing thermal damage to surrounding tissues. Sticky bone, a grafting material enriched with autologous fibrin, acts as a biological scaffold that supports cellular migration, enhances angiogenesis, and accelerates tissue repair. This case series investigates the clinical benefits of combining IMP, LLLT, and sticky bone in the management of horizontal bone loss in periodontitis patients. The objective of the study was to evaluate the regenerative potential of this multimodal approach in improving bone regeneration outcomes.