Surgical re-entry evaluation of regenerative efficacy of bioactive Gengigel(®) and platelet-rich fibrin in the treatment of grade II furcation: A novel approach

Gurkirat Kaur Sandhu, Paramjit Kaur Khinda, Amarjit Singh Gill, Harveen Singh Kalra, Gurkirat Kaur Sandhu, Paramjit Kaur Khinda, Amarjit Singh Gill, Harveen Singh Kalra

Abstract

The furcation area creates situations in which routine periodontal procedures are somewhat limited, and surgical procedures are generally required. The introduction of bioactive agents, such as platelet concentrates, enamel matrix derivatives, bone morphogenic proteins, and matrix macromolecules such as hyaluronic acid has expanded the scope for better outcomes in furcation treatment. Hyaluronic acid is a naturally occurring nonsulfated high molecular weight glycosaminoglycan that forms a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics, cell migration, and proliferation. Platelet-rich fibrin (PRF) is an immune and platelet concentrate containing all the constituents of a blood sample, which are favorable for healing and immunity. The purpose of the present case report was to assess through surgical re-entry, the regenerative capacity of Gengigel(®) in conjunction with PRF in a patient with grade II furcation defect. It was observed that the combined approach resulted in significant furcation defect fill on re-evaluation at 6 months.

Keywords: Furcation; Gengigel®; hyaluronic acid; platelet-rich fibrin.

Figures

Figure 1
Figure 1
(a) Gengigel® (0.8% Hyaluronic acid, Ricerfarma, Milano, Italy). (b) Miller's Class I gingival recession in mandibular left first molar region. (c) Radiovisiographic examination showing radiolucency in the mandibular left first molar furcation area
Figure 2
Figure 2
(a) Crevicular incision. (b) Exposure of defect site after debridement. (c) Intra-operative furcation defect measurement using Q2N Naber's probe having horizontal dimension ~ 3 mm (grade II furcation). (d) Application of Gengigel® (0.8% Hyaluronic acid) in the defect site
Figure 3
Figure 3
(a and b) Placement of Platelet-rich fibrin in the defect site after presuturing. (c) Placement of Platelet-rich fibrin membrane. (d) Six months postoperative furcation defect assessment through surgical re-entry using Q2N Naber's probe showing residual horizontal dimension of

Figure 4

One week postoperative

Figure 4

One week postoperative

Figure 4
One week postoperative

Figure 5

Six months postoperative follow-up

Figure 5

Six months postoperative follow-up

Figure 5
Six months postoperative follow-up

Figure 6

Surgical re-entry probing at 6…

Figure 6

Surgical re-entry probing at 6 months follow-up

Figure 6
Surgical re-entry probing at 6 months follow-up

Figure 7

Six months follow-up radiograph

Figure 7

Six months follow-up radiograph

Figure 7
Six months follow-up radiograph
All figures (7)
Figure 4
Figure 4
One week postoperative
Figure 5
Figure 5
Six months postoperative follow-up
Figure 6
Figure 6
Surgical re-entry probing at 6 months follow-up
Figure 7
Figure 7
Six months follow-up radiograph

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