In this clinical study we evaluated the use of hydroxyapatite ceramic (HAP) implant in conjunction with the surgical treatment of periodontal osseous defects. Fifty-five defects in 23 patients were treated and filled with HAP particles (BDHAP-101). At 6 months and 12 months after the placement of particles, the sites were evaluated by gingival margin heights, periodontal pocket depths, attachment levels, tooth mobility, the gingival index (GI), and radiographic analyses. Oral hygiene status was estimated by the plaque index (PlI). There were significant improvements with regard to probe depth, attachment level, tooth mobility, and GI. The radiographic analysis showed a similar density of the adjacent bone and the particles, suggesting excellent biocompatibility. There were no changes in PlI before or after the placement of implants.