Efficacy of PRF and Xenograft in Treating Mandibular Molar Furcation Involvements

August 12, 2026 updated by: Thanh Si Ho, University of Medicine and Pharmacy at Ho Chi Minh City

Efficacy of Platelet-Rich Fibrin Combined With Xenograft in the Treatment of Mandibular Molar Furcation Involvements

The purpose of this randomized controlled clinical trial is to compare the effectiveness of advanced platelet-rich fibrin (A-PRF+) combined with xenograft versus a collagen membrane combined with xenograft in the treatment of degree II furcation involvements in mandibular first molars. Adult patients with periodontitis will randomly receive either the A-PRF+ treatment or the collagen membrane treatment during periodontal flap surgery. The study will evaluate clinical periodontal healing, bone regeneration using 3D imaging (CBCT), patient comfort (pain levels and satisfaction), and changes in the TWEAK biomarker in gingival crevicular fluid over a 6-month period.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Furcation involvements in molars pose a significant challenge in periodontal therapy. This study aims to evaluate a regenerative approach using advanced platelet-rich fibrin (A-PRF+) to enhance clinical and radiographic outcomes. The study includes adult patients with periodontitis who have a degree II furcation involvement (Hamp 1975) on a mandibular molar, with a probing pocket depth of ≥ 5mm after initial non-surgical therapy.

Eligible patients will be randomly allocated to one of two surgical interventions:

Test Group: Open flap debridement followed by the application of A-PRF+ mixed with a xenograft (Cerabone), covered by an A-PRF+ membrane.

Control Group: Open flap debridement followed by the application of a xenograft (Cerabone) covered by a resorbable collagen membrane (Guided Tissue Regeneration).

Clinical parameters including Plaque Index (PlI), Gingival Index (GI), Probing Pocket Depth (PPD), Gingival Recession (GR), Vertical Clinical Attachment Level (VCAL), and Horizontal Clinical Attachment Level (HCAL) will be recorded at baseline and 6 months post-surgery using customized acrylic stents.

Radiological assessments using Cone Beam Computed Tomography (CBCT) will measure furcation volume, bone fill, and new bone gray level at baseline and 6 months. Patient-reported outcomes, including pain perception (VAS), painkiller consumption, and post-operative satisfaction (Likert scale), will be monitored during the first week. Additionally, Gingival Crevicular Fluid (GCF) samples will be collected to analyze the concentration of the TWEAK biomarker via ELISA at baseline, 1 month, and 3 months post-surgery.

Study Type

Interventional

Enrollment (Estimated)

22

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Vietnam
    • Ho Chi Minh City (HCMC)
      • Ho Chi Minh City, Ho Chi Minh City (HCMC), Vietnam, 700000
        • Recruiting
        • Faculty of Dentistry, University of Medicine and Pharmacy at Ho Chi Minh City
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients over 18 years old
  • Patients diagnosed with periodontitis who have completed non-surgical treatment: scaling and root planing
  • Patients attending a follow-up visit at least 5 weeks after non-surgical treatment, demonstrating compliance and good oral hygiene cooperation
  • Presence of a mandibular molar with a Degree II furcation involvement according to Hamp (1975), presenting a residual periodontal pocket at the buccal site (PPD ≥ 5mm) after non-surgical treatment, and showing radiolucency in the furcation area on CBCT imaging
  • Plaque Index (PlI) < 1 following non-surgical treatment
  • Width of keratinized gingiva ≥ 2mm
  • Teeth with furcation defects where gingival recession does not extend apically beyond the buccal furcation fornix (no supragingival furcation exposure)
  • Teeth without occlusal trauma, pulpal or periapical pathologies, and no combined periodontic-endodontic lesions
  • Degree II furcation involvement according to Hamp (1975) and Subclass A or B according to Tarnow and Fletcher (1984)
  • The defect is located apical to the interproximal alveolar bone crest on CBCT imaging

Exclusion Criteria:

  • Patients with systemic diseases affecting periodontal treatment outcomes, such as: diabetes mellitus, heart disease requiring anticoagulant therapy, blood disorders, immunodeficiency, etc
  • Pregnant or lactating patients
  • Patients who have used antibiotics or any other medications affecting periodontal treatment outcomes within the last 6 months
  • Patients who smoke tobacco.
  • Patients who have used aspirin or medications affecting blood coagulation within 2 weeks prior to the blood collection for PRF preparation
  • Patients with a history of allergy to local anesthetics
  • Defects associated with grade II tooth mobility that has not been splinted, or grade III tooth mobility according to Miller (2014)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: A-PRF+ and Xenograft
Open flap debridement followed by the application of A-PRF+ mixed with xenograft (Cerabone), covered by an A-PRF+ membrane
Procedure: A-PRF+ and Xenograft
Open flap debridement surgery. The furcation defect is filled with a mixture of A-PRF+ fragments and bovine xenograft (Cerabone), and then covered with an A-PRF+ membrane before suturing
Other Names:
  • Cerabone
  • Advanced Platelet-Rich Fibrin plus
  • A-PRF+
Active Comparator: Collagen Membrane and Xenograft
Open flap debridement followed by the application of xenograft (Cerabone) covered by a resorbable collagen membrane
Procedure: Collagen Membrane and Xenograft
Open flap debridement surgery. The furcation defect is filled with bovine xenograft (Cerabone) and covered with a resorbable collagen membrane before suturing
Other Names:
  • Cerabone
  • Collagen membrane
  • Guided Tissue Regeneration
  • Bio-Gide

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Horizontal Clinical Attachment Level (HCAL)
Time Frame: Baseline and 6 months post-surgery
HCAL is evaluated using a Nabers probe and a customized acrylic stent to measure the horizontal penetration from the buccal furcation entrance to the deepest point of the defect
Baseline and 6 months post-surgery
Probing Pocket Depth (PPD)
Time Frame: Baseline and 6 months post-surgery
PPD is measured using a UNC-15 periodontal probe and a customized acrylic stent to ensure measurement reproducibility. The measurement is recorded at the buccal aspect of the involved tooth
Baseline and 6 months post-surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Plaque Index (PlI)
Time Frame: Baseline, 3 months, and 6 months post-surgery
Assessed at 4 sites per tooth using the Loe and Silness (1963) criteria
Baseline, 3 months, and 6 months post-surgery
Gingival Index (GI)
Time Frame: Baseline and 6 months post-surgery
Assessed using the Loe and Silness (1963) criteria to evaluate gingival inflammation
Baseline and 6 months post-surgery
Vertical Clinical Attachment Level (VCAL)
Time Frame: Baseline and 6 months post-surgery
Measured using a UNC-15 periodontal probe and a customized acrylic stent
Baseline and 6 months post-surgery
Gingival Recession (GR)
Time Frame: Baseline, 3 months, and 6 months post-surgery
Evaluated using a 3D intraoral scanner (3Shape TRIOS) and a customized acrylic stent
Baseline, 3 months, and 6 months post-surgery
Radiographic Vertical Bone Level (VBL)
Time Frame: Baseline and 6 months post-surgery
Measured on Cone Beam Computed Tomography (CBCT) images from the furcation fornix to the base of the defect
Baseline and 6 months post-surgery
Furcation Defect Volume
Time Frame: Baseline and 6 months post-surgery
Evaluated using CBCT images and 3D segmentation software (ITK-SNAP)
Baseline and 6 months post-surgery
New Bone Gray Level
Time Frame: Baseline and 6 months post-surgery
Evaluated using CBCT and ImageJ software to assess the density of newly formed bone
Baseline and 6 months post-surgery
TWEAK Biomarker Concentration
Time Frame: Baseline, 1 month, and 3 months post-surgery
Measured in Gingival Crevicular Fluid (GCF) using Enzyme-Linked Immunosorbent Assay (ELISA)
Baseline, 1 month, and 3 months post-surgery
Post-operative Pain Perception
Time Frame: 12 hours, 1 day, and 3 days post-surgery
Assessed using a 10-cm Visual Analog Scale (VAS) where 0 indicates "no pain" and 10 indicates "worst imaginable pain"
12 hours, 1 day, and 3 days post-surgery
Post-operative Painkiller Consumption
Time Frame: Up to 3 days post-surgery
Recorded as the total number of analgesic tablets consumed by the patient
Up to 3 days post-surgery
Post-operative Patient Satisfaction
Time Frame: 3 days and 7 days post-surgery
Evaluated using a 5-point Likert scale (from 1 = very dissatisfied to 5 = very satisfied) regarding post-operative swelling and chewing ability
3 days and 7 days post-surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Medicine and Pharmacy at Ho Chi Minh City

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 25, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

August 9, 2026

First Submitted That Met QC Criteria

August 9, 2026

First Posted (Actual)

August 13, 2026

Study Record Updates

Last Update Posted (Actual)

August 14, 2026

Last Update Submitted That Met QC Criteria

August 12, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 26410 - ĐHYD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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