Benefits of Platelet Rich Fibrin In Mandibular Molar Furcation Defects

Study Overview
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Brief Summary
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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
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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.

Official Title
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Effect of Autologous Platelet Rich Fibrin In Human Mandibular Molar Grade II Furcation Defects- A Clinical and Radiological Study

Conditions
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Chronic Periodontitis

Intervention / Treatment
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* Procedure: Furcation treatment with PRF
* Procedure: Furcation Treatment with Allograft and GTR
* Device: allograft and guided tissue regeneration (GTR) membrane (DFDBM and Healiguide)
* Device: autologous platelet-rich fibrin


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective, randomized, parallel arm, interventional trial
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 11 Patients with Grade II Manibular Molar Furcation<br>Group A- Furcation Treatment with PRF | Procedure: Furcation treatment with PRF<br>* PRF Placed into the furcation after flap elevation and debridement<br>* Other names: Furcation Management with Platelet rich fibrin;Device: autologous platelet-rich fibrin<br> <br> |
| Experimental: 11 Patients with Grade II Mandibular Molar Furcation D<br>Group B- Furcation Treatment with Allograft and GTR | Procedure: Furcation Treatment with Allograft and GTR<br>* Allograft and GTR placed into furcation after flap elevation and debridement<br>* Other names: Furcation Management with DFDBM and Healiguide;Device: allograft and guided tissue regeneration (GTR) membrane (DFDBM and Healiguide)<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vertical clinical attacment level | The Vertical clinical attachment level was assessed preoperatively and 9 months after surgery | 9 months Post treatment | 
| Horizontal clinical attachment level | The horizontal clinical attachment level was assessed preoperatively and 9 months after surgery. | 9 months Post treatment | 
| Bone fill | Bone fill was assessed radiographically and 9 months after surgery | 9 months Post treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Plaque Index | Plaque index was assessed preoperatively and 9 months after surgery | 9 Months Post treatment | 
| Probing depth | Probing depth was assessed preoperatively and 9 months after surgery | 9 Months Post treatment | 
| Gingival marginal level | Gingival marginal level was assessed preoperatively and 9 months after surgery | 9 months post treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic Periodontitis, Clinical Parameters, Furcation defects, Radiographic bone fill