Peridontal Disease, Furcation Defects
Conditions
Keywords
Periodontitis, Class II furcation defects, Platelet-rich fibrin, Emdogain, Periodontal regeneration, Mandibular molars
Brief summary
This study evaluated the regenerative potential of platelet-rich fibrin (PRF) compared with enamel matrix derivative (Emdogain®) in the surgical treatment of Class II (F2) furcation defects of mandibular molars. Twenty-one systemically healthy patients with a total of 30 mandibular molars presenting with buccal Class II furcation defects were included. The furcation defects were treated surgically with either PRF or Emdogain®. Clinical parameters, including periodontal probing depth, clinical attachment level, bleeding on probing, and furcation involvement, were assessed before treatment and during follow-up. Clinical and radiographic measurements of the furcation defects were also performed. The main follow-up evaluation was conducted 6 months after surgery. The study compared the clinical and radiographic outcomes of PRF and Emdogain® in the treatment of mandibular molars with Class II furcation defects.
Interventions
BIOLOGICALPlatelet rich fibrin
Surgical treatment of a buccal Class II furcation defect was performed under local anesthesia. Following flap elevation, complete instrumentation of the root surfaces and furcation defect was performed using hand and powered instruments (scaling and root planing). Horizontal and vertical furcation involvement were measured. For PRF preparation, peripheral venous blood was collected into two vacuum tubes using a closed butterfly system. The tubes were centrifuged using a PRF DUO centrifuge. PRF from one tube was used to fill the furcation defect, while PRF from the second tube was compressed to form a membrane covering the furcation entrance. The flap was coronally positioned and secured with sling and interrupted interdental sutures using resorbable 6-0 sutures.
BIOLOGICALEmdogain
Surgical treatment of a buccal Class II furcation defect was performed under local anesthesia. Following flap elevation, complete instrumentation of the root surfaces and furcation defect was performed using hand and powered instruments (scaling and root planing). Horizontal and vertical furcation involvement were measured. The exposed root surfaces were conditioned with 24% EDTA gel (PrefGel®, Straumann; pH 6.7) for 2 minutes, followed by thorough irrigation with sterile saline. Enamel matrix derivative (Emdogain®) was then immediately applied, starting from the most distant part of the furcation defect and covering the entire exposed root surface. The flap was coronally positioned and secured with sling and interrupted interdental sutures using resorbable 6-0 sutures.
Sponsors
Medical University of Sofia
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Systemically healthy individuals * Stage III or Stage IV periodontitis * without allergies.
Exclusion criteria
* Smoking * Inadequate plaque control * Systemic diseases that may compromise periodontal therapy, including diabetes, immunodeficiency, or viral diseases. * Immunosuppressive therapy. * Treatment with bisphosphonates. * Treatment with anticoagulants. * Treatment with antiplatelet agents. * Thrombocytopenia. * Hypofibrinogenemia. * Hemophilia. * Other coagulation disorders. * Pregnancy. * Breastfeeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Horizontal Furcation Probing Depth | Baseline to 6 months after surgery | Change in the horizontal probing depth of the furcation defect, measured at the furcation entrance before surgery and 6 months after surgery. The measurement was used to assess the horizontal component of furcation involvement and the clinical response to treatment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Probing Pocket Depth | Baseline to 6 months after surgery | Change in periodontal probing depth at the treated furcation site, measured from m.gingivalis to the bottom of the pocket. |
| Change in Clinical Attachment Level | Baseline to 6 months after surgery | Change in clinical attachment level at the treated furcation site, measured from cementoenamel junction to the bottom of the pocket. |
| Change in Vertical Bone Loss | Baseline to 6 months after surgery | Change in vertical bone loss associated with the furcation defect, measured on three-dimensional imaging. |
| Change in Horizontal Bone Loss. | Baseline to 6 months after surgery | Change in horizontal bone loss associated with the furcation defect, measured on three-dimensional imaging. |
Countries
Bulgaria
Outcome results
None listed