Advanced Platelet Rich Fibrin in Periodontal Angular Defects

Alexandria University22 enrolled

Overview

The aim of this study is to clinically and radiographically evaluate the efficacy of advanced platelet-rich fibrin (A-PRF) when used with biphasic alloplast in the management of intrabony defects in patients with moderate to severe chronic periodontitis.

Biphasic alloplasts have been successfully used in management of intrabony defects. Advanced platelet-rich fibrin is believed to contain higher amount of growth factors and white blood cells than the well known PRF. Although there are some studies on the use of PRF in the treatment of intrabony defects, to date none of them evaluate the effect of the A-PRF. Therefore, a randomized controlled clinical trial was conducted to compare the healing of intrabony defects treated with A-PRF/biphasic alloplast combination and to those obtained with biphasic alloplast mixed with saline. Using a parallel arm design, 22 intrabony defects were randomly treated with either biphasic alloplast mixed with saline (control group) or with A-PRF/ biphasic alloplast combination (test group). The following clinical parameters were recorded at baseline, three and six months postoperatively : plaque index (PI), modified gingival index (MGI), probing depth (PD), clinical attachment level (CAL), while these radiographic measurements were recorded at baseline and six months postoperatively: bone fill and bone density.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Intrabony Periodontal Defect

Interventions

Advanced platelet-rich fibrin mixed with biphasic alloplastPROCEDURE

mucoperiosteal flaps will be reflected to expose the defects , which will be debrided properly and finally filled with the freshly prepared Advanced platelet-rich fibrin mixed with the biphasic alloplast.

Biphasic alloplast mixed with salinePROCEDURE

mucoperiosteal flap will be reflected to expose and clean the intrabony defect ,then it will be filled with biphasic alloplast mixed with saline.

Eligibility

Sex: ALLMin age: 25 YearsMax age: 55 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * They should be diagnosed as having moderate -severe chronic periodontitis according to the American Academy of Periodontology classification on gingival and periodontal diseases (1999) * Clinical attachment loss (CAL) ,radiographic evidence of the presence of at least one intrabony defect. * Patient's age between 25 to 55 years. * Both sexes. * No periodontal surgeries in the area of interest during the previous 6 months. * The presence of intrabony defects (IBD) ≥3 mm deep (distance between alveolar crest and deepest point in the defect estimated from radiographs and confirmed upon surgical exposure). * An interproximal probing depth (PD) ≥5 mm and clinical attachment loss (CAL) ≥3mm after phase I therapy in maxillary/ mandibular teeth. * The presence of an adequate zone of keratinized gingiva at the facial aspect of the selected tooth. Exclusion Criteria: * Patients who could not maintain O'leary plaque index (54) ≤10% after phase I therapy. * Aggressive periodontitis patients. * Patients with systemic conditions known to affect the periodontal status, or, under medications known to affect the outcomes of periodontal therapy. * Pregnancy/lactation. * Smoking and tobacco use in any form. * Non vital teeth and teeth with grade III mobility.

Locations (1)

Periodontology department, Faculty of Dentistry, Alexandria University

Alexandria, Egypt

Outcomes

Primary Outcomes

Clinical attachment level change

The distance from cemento-enamel junction to the depth of the sulcus recorded by a periodontal probe at baseline , 3 and 6 months postoperatively

Time frame: Baseline , 3 and 6 months posoperatively

Secondary Outcomes

Probing depth change:

The distance from the gingival margin to the depth of the sulcus recorded by a periodontal probe at baseline and 6 months postoperatively

Time frame: Baseline , 3 and 6 months postoperatively

Radiographic bone density

Measuring the bone density before and after the procedure using CBCT

Time frame: Baseline and 6 months postoperatively

Radiographic bone fill

The actual bone formation in the intrabony defect measured on a CBCT in comparison to the baseline CBCT

Time frame: Baseline and 6 months postoperatively

Data from ClinicalTrials.gov

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