Furcation Defects, Open Flap Debridement, Periodontal Diseases
Conditions
Brief summary
The reduced rate of success experienced in the treatment of Furcation involvement (FI) seems to result from the incomplete removal of subgingival plaque and calculus in the interradicular area owing to the peculiar anatomy of the furcation space. Regarding the therapeutic approach, although FI treated with a conservative approach may not yield the same satisfactory results as single rooted teeth; it has been shown that teeth with FI have a remarkable survival rate following conservative treatment in patients demonstrating a satisfactory plaque control. Minimally invasive techniques aim to retain the preoperative gingival architecture, create a minimal wound and gently handle soft and hard tissues. It becomes imperative to see the differences in clinical, and patient centered outcomes of minimally invasive non- surgical versus surgical technique in the management of furcation involvement in mandibulae molar.
Detailed description
Patients will be recruited from outpatient clinic of Department of Periodontics, PGIDS, Rohtak after screening based on given inclusion and exclusion criteria. after initial session of scaling and root planing patient will be re -elevated at the and of 6 to 8 weeks those having grade 2 furcation involvement in any mandibular molar and meeting other eligibility criteria will be randomly allocated to test group and control group Test group -Experimental sites designated to receive non-surgical treatment will be submitted to careful subgingival debridement using curettes and ultrasonic device using 3.5 x magnification. control group-Surgical technique will be followed with minimally flap reflection and incisions will be performed with papilla preservation techniques. vertical- releasing incisions will not be made, and the full-thickness flap will be minimally elevated. The granulation soft tissue will be dissected with a blade and carefully removed with curettes. The visible calculus will be carefully removed with curettes and an ultrasonic device. The flaps will be re-positioned and sutured and patient follow up 3 to 6 months .
Interventions
PROCEDUREminimally invasive non- surgical therapy
hand and ultrasonic instrumentation will be done
PROCEDUREopen flap debridement
flap surgery will be done
Sponsors
Postgraduate Institute of Dental Sciences Rohtak
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Systemically healthy patients with diagnosis of generalized stage 3 periodontitis (Grade A or B) with at least one mandibular molar with FI (Degree 1 or 2-according to Hamp, 1975 and Subclass A or B- according to Tarnow and Fletcher, 1984), interproximal bone coronal to the furcation fornix and root trunk length ≤ cervical two thirds of the root length as measured on a periapical radiograph. * Full mouth plaque score \< 30% after initial therapy * Full mouth bleeding score \< 30% after initial therapy * Having undergone a course of subgingival instrumentation in the past three months
Exclusion criteria
* Pregnant or lactating females * Requiring antibiotic premedication * Received antibiotic treatment in the previous 3 months * Previous periodontal surgery in the last 1 year * Smokers * Pulpal or periapical pathology * Third molar * Non restorable tooth * Trauma from occlusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in horizontal clinical attachment level (HCAL) | 3 months | change in horizontal clinical attachment level (HCAL) of the furcation as assessed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| changes in vertical probing depth of the furcation | 3 months | vertical probing depth will be assessed using UNC 15probe |
| change in changes vertical clinical attachment level of furcation | 3 months | change clinical vertical attachment will be assessed using UNC 15 probe |
| change in vertical clinical attachment level of furcation | 6 months | change in vertical clinical attachment level of furcation will be assessed using UNC 15 probe |
| probing pocket depth (PPD)reduction | 3 months | probing pocket depth (PPD)reduction will be calculated around the molar at 6 sites |
Countries
India
Contacts
Primary ContactDR. RITIKA ARORA, MDS
Outcome results
None listed