This trial was designed to assess and compare the clinical and radiographic effects of using Psidium guajava leaf powder together with injectable platelet-rich fibrin (iPRF) against demineralized freeze-dried bone allograft (DFDBA) combined with iPRF in treating periodontal intrabony osseous defects, employing cone-beam computed tomography for radiographic evaluation. A total of 28 periodontal intrabony defects were included in this study. Defects assigned to the control arm received DFDBA plus iPRF, while those in the test arm were treated with P. guajava leaf powder plus iPRF. Measurements of the gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were taken at baseline, 3 months, and 6 months. In contrast, radiographic assessments occurred at baseline and 6 months. Both study arms achieved meaningful improvements across all clinical and radiographic parameters, with reductions noted in GI, PI, PPD, and CAL at the 3- and 6-month follow-ups. The test arm showed more pronounced CAL gain and more favorable radiographic findings compared to the control arm, though the degree of bone fill proved similar between the two arms. P. guajava leaf powder used with iPRF yielded statistically comparable outcomes to DFDBA used with iPRF, suggesting that P. guajava leaf powder is a suitable option for periodontal regeneration.
