Treating Intrabony Defect With MINST VS MINST Extended PRF

Cairo University48 enrolled

Overview

This study evaluates a minimally invasive non-surgical technique (MINST) for treating periodontal intrabony defects, with or without the addition of Extended Platelet-Rich Fibrin (e-PRF). The goal is to determine which approach provides better bone regeneration and gum healing. Study Procedures Control Group: Local anesthesia by infiltration at the treatment site Instrumentation of the root surface up to the bottom of the periodontal pocket Efforts are made to minimize trauma to soft tissues and interdental papilla using subpapillary access Cleaning is performed using piezo-electric devices with delicate tips, avoiding aggressive root smoothing or gingival curettage 3-4× magnification loupes are used to improve precision Intervention Group: All the above procedures Followed by injection of e-PRF, a preparation derived from the patient's own blood Blood is collected in 4 mL tubes and centrifuged at 700 g for 8 minutes The platelet-poor plasma is heated to create an albumin gel The remaining buffy coat (rich in platelets and growth factors) is mixed with the cooled albumin gel to form Alb-PRF, which is applied to the defect

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Periodontal Intrabony Defects

Interventions

Extended Platelet-Rich Fibrin (e-PRF)BIOLOGICAL

Autologous extended platelet-rich fibrin (e-PRF) prepared from the participant's peripheral blood. Whole blood is centrifuged to obtain liquid platelet-rich fibrin, while the platelet-poor plasma is heated to form denatured albumin gel. The cooled albumin gel is mixed with the liquid platelet-rich fibrin to produce e-PRF, which is applied into the periodontal intrabony defect immediately after completion of the MINST procedure

Modified Minimally Invasive Non-Surgical Technique (MINST)PROCEDURE

Modified minimally invasive non-surgical periodontal therapy performed under local anesthesia using piezoelectric ultrasonic instruments with thin tips and magnification loupes. The procedure aims to thoroughly debride the periodontal pocket while minimizing soft tissue trauma and preserving root cementum by avoiding intentional root surface smoothing and gingival curettage.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Adults aged above 21 years. Clinical diagnosis of Stage III periodontitis. Presence of at least two isolated interproximal intrabony defects located in different quadrants. Intrabony defect associated with a single-rooted tooth or mandibular molar without furcation involvement. Probing depth (PD) ≥ 6 mm. Radiographic intrabony defect depth between 3 and 7 mm. Absence of periapical pathology at the study site. Absence of acute periodontal infection. Absence of subgingival restorations that could interfere with clinical measurements. Absence of Grade II or Grade III tooth mobility. Ability and willingness to provide written informed consent. Exclusion Criteria: Pregnancy or lactation. Non-surgical periodontal therapy within the previous 6 months. Surgical periodontal therapy within the previous 12 months. History of radiotherapy to the head and neck region. Current smoking. Eligibility note: Former smokers and never-smokers are eligible.

Outcomes

Primary Outcomes

Change in Probing Depth (PD)

Change in periodontal probing depth (PD), measured in millimeters using a UNC-15 periodontal probe with a standardized probing force. Measurements are obtained using a patient-specific acrylic stent to ensure reproducibility.

Time frame: Baseline and 6 months after treatment

Secondary Outcomes

Clinical Attachment Level (CAL)

Time frame: Baseline, 3 months, and 6 months after treatment

Change in Gingival Recession (GR) measured using a UNC-15 periodontal probe

Time frame: Baseline, 3 months, and 6 months after treatment

Change in Radiographic Intrabony Defect Depth measured using standardized periapical radiographs and ImageJ software

Time frame: Baseline and 6 months after treatment

Patient Satisfaction (VAS)

0 indicates no pain or discomfort and 10 indicates the worst imaginable pain or discomfort.

Time frame: During the first postoperative week after treatment