Intrabony Periodontal Defect
Conditions
Brief summary
This study evaluates the effect of citric acid on bone surface of infrabony defects when used for 30 seconds at ph 1 and 50% concentration before the application of bovine derived xenograft to fill the defect, Bone Morphogenic protein 2 (BMP-2) marker was evaluated in 5 different days during the first month after surgery and clinical and radiographic parameters were reassessed after 6 months
Detailed description
Citric acid have been widely used to treat root surfaces of periodontally affected teeth in order to render it biologically suitable for fibroblast reattachment. however, systematic reviews showed no clinical significance when it was used as a root surface conditioner. Recently it was found in experimental studies that when citric acid was used on bone surface for a brief period, it increased bone formation and improved consolidation of grafted bone to bone bed. In this study infrabony defects were treated with citric acid PH 1 and 50% concentration for 30 seconds before washing it off and then application of bovine derived xenograft was done to fill the defect. BMP-2 marker was evaluated at days 1,3,7,14 and 30 by taking a sample using perio-paper from the gingival crevicular fluid (GCF) and clinical and radiographic parameters were taken after 6 months of follow-up
Interventions
DRUGCitric acid
Citric acid ph1, 50% concentration solution
DRUGControl Test
Control group, xenograft was used to fill infrabony defects without treating bone surface
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Both genders aged between 32-60 years. * Selected patient with a single site of: 1. Two walled or three walled infra-bony defect. 2. The bone defect should be at least 3 mm in depth from the crest of the alveolar bone to the base of the defect. 3. Pocket depth of more than or equal to 5 mm. 4. Clinical attachment loss equal or more than 3mm * Patients ready to comply with oral hygiene measures.
Exclusion criteria
* Any systemic disease that contra-indicates periodontal surgery or may affect healing. * Smokers * Pregnant females * Drug abusers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bone Morphogenic protein 2 | 1 day | The level of Bone morphogenic protein 2 was measured in the gingival crevicular fluid using a perio-paper then the marker level was determined using an Enzyme linked immunosorbent kit (ELISA kit) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gingival Index | 6 months | Estimation of the degree of gingival inflammation was done according to Loe where scores were given between 0-3 (0=no inflammation and 3=severe inflammation) |
| Plaque index | 6 months | Estimation of the amount of dental plaque according to Silness & Loe where scores were given between 0-3 (0=no plaque and 3=presence of abundant plaque) |
| Probing depth | 6 months | Estimation was done by measuring the depth from the gingival margin to the base of the periodontal pocket using a UNC-15 periodontal probe |
| Clinical attachment level | 6 months | Estimation was done by measuring the distance from the cemento-enamel junction to the base of the pocket using a UNC-15 periodontal probe |
| Radiographic bone fill | 6 months | Estimation was done by taking a linear measurement using RVG system from the baseline defect till the alveolar bone crest |
Outcome results
None listed