Periodontal Bone Loss, Periodontal Diseases
Conditions
Brief summary
For patients having periodontal intrabony lesions, three treatment modalities were executed to evaluate the effect of protecting Leukocyte rich -Platelet Rich Fibrin harvests (applied in the bony defects) with resorbable collagen membranes. Clinical Outcomes recorded were the Plaque index (PI), Gingival index (GI), probing depth reduction (PD), Clinical attachment level (CAL), and radiographic defect depth changes. For the biochemical evaluation: levels of PDGF-BB and VEGF obtained from crevicular fluid by Perio-Paper strips were assessed using ELIZA.
Detailed description
* Patients having 2-3 osseous bony wall infrabony periodontal lesions are enrolled in the present study. They have to be free from any systemic disease that contraindicates periodontal surgeries. * Baseline data are obtained including the GI, PI, PD, CAL and preoperative paralleling periapical radiographs. * Full thickness mucoperiosteal flaps are elevated and thorough debridement of the periodontal bony defect is performed. * for OFD group; following debridement and saline irrigation, wound closure proceeds. * for the L-PRF group; L-PRF is prepared and applied within the defect before primary closure. * for the L-PRF + CM: similar procedure like the second group is performed but with an additional protective layer of collagen membrane on top of the defect before wound closure. * from the second day postoperative; Periopaper strips are used to obtain a crevicular fluid sample from the sulcus * At 6 months postoperative: the same baseline clinical measurements are obtained.
Interventions
a blood sample is obtained from the patient, and centrifuged to prepare a leukocyte platelet rich fibrin harvest that is applied within the derided lesion.
Full thickness flap elevation to gain access to the infrabony lesion for debridement followed by flap closure.
Xenogeneic collagen membranes that are used as barrier membranes in guided tissue regeneration of periodontal defects
Sponsors
Study design
Masking description
* The clinical data (Gingival index, Plaque index, PPD, CAL) were collected by a blinded single operator at the university outpatient clinic. * The biochemical analysis: The biochemist received the filter papers with a label for group letter and patient number. She was didn't know which intervention was carried out for any of the samples.
Eligibility
Inclusion criteria
* Minimum of one interproximal pocket probing depth of ≥6 mm and/or ≥5 mm CAL after 4 weeks from phase I execution * 2 or 3 osseous wall interproximal intrabony defects that are ≥3mm in depth
Exclusion criteria
* Systemic diseases or conditions that contraindicate periodontal surgeries and/or affect the formed elements of the blood * Patients who received antibiotic therapy and/or anti-inflammatory drug within the past 6 months * Vulnerable groups * Interdental craters and 1 wall osseous defects * Active periapical pathosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CEJ to alveolar crest | 6 months | measures the amount of crystal bone changes |
| Clinical attachment level | 6 months | measures the changes in amount of periodontal attachment |
| CEJ to base of defect | 6 months | measures the changes in bone defect depth |
| Gingival index | 6 months | measures the score of gingival inflammation. Minimum value of 0: denotes absence of inflammation. Maximum value = 3 and denotes severe inflammation |
| Plaque index | 6 months | measures the score of plaque accumulation. Minimum value of 0: denotes absence of plaque on teeth surfaces. Maximum value = 3 and denotes diffuse and abundant plaque accumulation on teeth surfaces |
| Probing depth | 6 months | measures the reduction in pocket depth |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VEGF | 31 days | Biochemical Evaluation of changes in levels of crevicular Vascular endothelial growth factor |
| PDGF | 31 days | Biochemical Evaluation of changes in levels of crevicular Platelet Derived Growth Factor -BB |
Countries
Egypt