Chronic Periodontitis
Conditions
Keywords
Chronic Periodontitis, Clinical Parameters, Furcation defects, Radiographic bone fill
Brief summary
Background: Furcation is the bifurcation or trifurcation of a multirooted tooth. It is an area of complex anatomic morphology difficult to debride by routine periodontal instrumentation. Multiple approaches have been used in an effort to treat the furcation Choukroun's platelet-rich fibrin (PRF), a second generation platelet concentrate has biochemical components which have well known synergetic effects on healing processes. The present study was conducted to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) in the treatment of mandibular molar Grade 2 furcation defects in comparison to allograft and guided tissue regeneration (GTR) membrane.
Detailed description
ABSTRACT Background: Furcation is the bifurcation or trifurcation of a multirooted tooth. It is an area of complex anatomic morphology difficult to debride by routine periodontal instrumentation. Multiple approaches have been used in an effort to treat the furcation Choukroun's platelet-rich fibrin (PRF), a second generation platelet concentrate has biochemical components which have well known synergetic effects on healing processes. The present study was conducted to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) in the treatment of mandibular molar Grade 2 furcation defects in comparison to allograft and guided tissue regeneration (GTR) membrane. MATERIALS AND METHODS: The study was designed as a randomized, prospective, parallel-arm, interventional clinical trial wherein 30 patients with periodontitis and grade II Mandibular furcation defects attending the Out Patient wing of the Department of Periodontics of a tertiary referral care hospital were equally divided into group A and group B. Patients in.Group A, were treated by the placement of PRF as a Graft and as a membrane at the surgical site , while in Group B, the defects were treated by the placement of Allograft and Healiguide collagen membrane. Plaque Index, Probing depth, Vertical clinical attachment level, Horizontal clinical attachment level, Gingival marginal level, and amount of bonefill using Radiovisiography were recorded at baseline and 9 months. Intra-group comparison of Mean scores between Group A and Group B was done using Paired t test and Inter-group comparison using independent sample t test. CONCLUSION Further studies evaluating the efficacy of PRF using a larger sample size should be performed to evaluate its true beneficial effects on long term basis in patients with mandibular molar Grade 2 furcation defects.
Interventions
PROCEDUREFurcation Treatment with Allograft and GTR
Allograft and GTR placed into furcation after flap elevation and debridement
DEVICEallograft and guided tissue regeneration (GTR) membrane (DFDBM and Healiguide)
PROCEDUREFurcation treatment with PRF
PRF Placed into the furcation after flap elevation and debridement
Sponsors
Dr.Syed Asimuddin
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Masking description
The eligible samples were screened and randomly assigned by lottery method by investigator KRR into PRF (Group A) and GTR + Allograft (Group B). The treatment was performed by investigator SA who was blinded to the randomization process
Intervention model description
Prospective, randomized, parallel arm, interventional trial
Eligibility
Sex/Gender
ALL
Age
30 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* One or more sites showing grade II furcation involvement in mandibular molars, with Probing pocket depth ≥ 5mm * Vertical attachment level and horizontal level ≥3mm were considered. * Patients who were systemically healthy, with no history of endodontic and periodontal treatment for the last 6 months, and no antibiotic usage for the last 6 months were included in the study. Care was taken to ascertain that the samples taken for the study were not allergic to any drugs nor to the graft materials used.
Exclusion criteria
* Patients with a history of diabetes, hypertension, on anticoagulant or steroid therapy (which could alter the effects of PRF), cardiac diseases, insufficient platelet counts and immunocompromised individuals were excluded from the study. * Care was taken to exclude pregnant women and lactating mothers, smokers, patients with previous history of graft placement in the experimental site, and importantly those patients who were unable to maintain good oral hygiene (PI Score ≥ 1.5). * If Grade II mobility was observed after phase I therapy in the experimental teeth, they were excluded
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Vertical clinical attacment level | 9 months Post treatment | The Vertical clinical attachment level was assessed preoperatively and 9 months after surgery |
| Horizontal clinical attachment level | 9 months Post treatment | The horizontal clinical attachment level was assessed preoperatively and 9 months after surgery. |
| Bone fill | 9 months Post treatment | Bone fill was assessed radiographically and 9 months after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Plaque Index | 9 Months Post treatment | Plaque index was assessed preoperatively and 9 months after surgery |
| Probing depth | 9 Months Post treatment | Probing depth was assessed preoperatively and 9 months after surgery |
| Gingival marginal level | 9 months post treatment | Gingival marginal level was assessed preoperatively and 9 months after surgery |
Outcome results
None listed