Efficacy of PRF and Xenograft in Treating Mandibular Molar Furcation Involvements
Efficacy of Platelet-Rich Fibrin Combined With Xenograft in the Treatment of Mandibular Molar Furcation Involvements
調査の概要
詳細な説明
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.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Thanh Si Ho, Doctor of Dental Surgery
- 電話番号:+84944510521
- メール:sithanhlk2000@gmail.com
研究場所
-
-
Ho Chi Minh City (HCMC)
-
Ho Chi Minh City、Ho Chi Minh City (HCMC)、ベトナム、700000
- 募集
- Faculty of Dentistry, University of Medicine and Pharmacy at Ho Chi Minh City
-
コンタクト:
- Thanh Si Ho, Doctor of Dental Surgery
- 電話番号:+84944510521
- メール:sithanhlk2000@gmail.com
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:A-PRF+ and Xenograft
Open flap debridement followed by the application of A-PRF+ mixed with xenograft (Cerabone), covered by an A-PRF+ membrane
|
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
他の名前:
|
|
アクティブコンパレータ:Collagen Membrane and Xenograft
Open flap debridement followed by the application of xenograft (Cerabone) covered by a resorbable collagen membrane
|
Open flap debridement surgery.
The furcation defect is filled with bovine xenograft (Cerabone) and covered with a resorbable collagen membrane before suturing
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Horizontal Clinical Attachment Level (HCAL)
時間枠: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)
時間枠: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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Plaque Index (PlI)
時間枠: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)
時間枠: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)
時間枠: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)
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。