Evaluation of Advanced PRF Combined With Nano-crystalline Hydroxyapatite for Management of Grade II Furcation Defects

Study Overview
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Brief Summary
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this study is to evaluate the use of advanced platelet rich fibrin (A-PRF) + nano-crystalline hydroxyapatite bone substitute combined with open flap debridement (OPD) versus open flap debridement alone in the management of mandibular molar grade II defects. In the management of mandibular molar grade II furcation defects, no difference exists in gain of horizontal clinical attachment level between the use of advanced platelet rich fibrin (A-PRF) + with nano-crystalline hydroxyapatite bone substitute combined with open flap debridement (OPD) and open flap debridement (OPD) alone .

Official Title
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Clinical and Radiographic Evaluation of Advanced Platelet Rich Fibrin Combined With Nano-crystalline Hydroxyapatite Bone Substitute for Management of Mandibular Molar Grade II Furcation Defects

Conditions
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Periodontitis

Intervention / Treatment
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* Procedure: Advanced PRF (A-PRF) + nano-crystalline hydroxyapatite bone substitute combined with open flap debridement
* Procedure: Open flap debridement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient-related criteria: Systemically healthy patients. Compliance with oral hygiene instructions and the maintenance program provided. Accepts the 6 months follow-up period. Provide informed consent. Teeth related criteria: Mature permanent tooth. Asymptomatic mandibular molar with buccal Glickman class II furcation involvement. Probing depth (PD) ≥ 5 mm and vertical PD ≥ 3 mm after Phase I therapy (scaling and root planing). Presence of radiolucency in the furcation area on an intra-oral periapical radiograph Exclusion Criteria: Patient-related criteria: Patients taking drugs known to interfere with periodontal wound healing in the last six months. Pregnant or nursing women. Smokers. Uncooperative patients. Teeth related criteria: Teeth with interproximal supra-bony or intrabony defects. Teeth with gingival recession. Teeth with grade II or III mobility.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Test Group<br>Advanced PRF (A-PRF) + nano-crystalline hydroxyapatite bone substitute combined with open flap debridement (OFD). | Procedure: Advanced PRF (A-PRF) + nano-crystalline hydroxyapatite bone substitute combined with open flap debridement<br>* will treated with OFD +A- PRF+ nano-crystalline hydroxyapatite bone substitute,10 mL of blood will be drawn from only patient assigned to the intervention group by vein puncture of the antecubital vein and is collected in sterile glass test tube, without any anticoagulant. The blood will be quickly collected, and the tube will immediately centrifuge at 1500 rpm for14 min at room temperature. After centrifugation, the A-PRF clot will be removed from the tube using sterile tweezers and placed on sterile woven gauze. Membrane will prepared by compressing clots between two pieces of woven gauze.<br>|
| Active Comparator: Control Group<br>Open flap debridement alone. | Procedure: Open flap debridement<br>* a periodontal access flap will be initiated by intrasulcular incisions on the buccal and lingual aspects. The incisions will be carried as far interproximally as possible to preserve the entire Interdental papillae and to achieve primary wound closure.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relative Vertical Clinical Attachment Level (RVCAL) | relative vertical clinical attachment level (RVCAL) along with gingival marginal level (GML) will be measured from the apical level of customized acrylic stents with grooves to ensure a reproducible placement of a periodontal probe | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relative Horizontal Clinical Attachment Level (PHCAL) | relative vertical clinical attachment level (RVCAL) along with gingival marginal level (GML) will be measured from the apical level of customized acrylic stents with grooves to ensure a reproducible placement of a periodontal probe | 6 months | 
| Probing Depth (PD) | Probing depth measured from the gingival margin to the base of the pocket. | 6 months | 
| Gingival margin Level (GML) | • Williams graduated probe will be used for vertical measurement and gingival margin level and Nabers probe for horizontal measurements. | 6 months |