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
研究概览
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Thanh Si Ho, Doctor of Dental Surgery
- 电话号码:+84944510521
- 邮箱:sithanhlk2000@gmail.com
学习地点
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Ho Chi Minh City (HCMC)
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Ho Chi Minh City、Ho Chi Minh City (HCMC)、越南、700000
- 招聘中
- Faculty of Dentistry, University of Medicine and Pharmacy at Ho Chi Minh City
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接触:
- Thanh Si Ho, Doctor of Dental Surgery
- 电话号码:+84944510521
- 邮箱:sithanhlk2000@gmail.com
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-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:A-PRF+ and Xenograft
Open flap debridement followed by the application of A-PRF+ mixed with xenograft (Cerabone), covered by an A-PRF+ membrane
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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
其他名称:
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有源比较器:Collagen Membrane and Xenograft
Open flap debridement followed by the application of xenograft (Cerabone) covered by a resorbable collagen membrane
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Open flap debridement surgery.
The furcation defect is filled with bovine xenograft (Cerabone) and covered with a resorbable collagen membrane before suturing
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Horizontal Clinical Attachment Level (HCAL)
大体时间:Baseline and 6 months post-surgery
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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
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Baseline and 6 months post-surgery
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Probing Pocket Depth (PPD)
大体时间:Baseline and 6 months post-surgery
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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
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Baseline and 6 months post-surgery
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Plaque Index (PlI)
大体时间:Baseline, 3 months, and 6 months post-surgery
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Assessed at 4 sites per tooth using the Loe and Silness (1963) criteria
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Baseline, 3 months, and 6 months post-surgery
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Gingival Index (GI)
大体时间:Baseline and 6 months post-surgery
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Assessed using the Loe and Silness (1963) criteria to evaluate gingival inflammation
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Baseline and 6 months post-surgery
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Vertical Clinical Attachment Level (VCAL)
大体时间:Baseline and 6 months post-surgery
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Measured using a UNC-15 periodontal probe and a customized acrylic stent
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Baseline and 6 months post-surgery
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Gingival Recession (GR)
大体时间:Baseline, 3 months, and 6 months post-surgery
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Evaluated using a 3D intraoral scanner (3Shape TRIOS) and a customized acrylic stent
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Baseline, 3 months, and 6 months post-surgery
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Radiographic Vertical Bone Level (VBL)
大体时间:Baseline and 6 months post-surgery
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Measured on Cone Beam Computed Tomography (CBCT) images from the furcation fornix to the base of the defect
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Baseline and 6 months post-surgery
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Furcation Defect Volume
大体时间:Baseline and 6 months post-surgery
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Evaluated using CBCT images and 3D segmentation software (ITK-SNAP)
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Baseline and 6 months post-surgery
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New Bone Gray Level
大体时间:Baseline and 6 months post-surgery
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Evaluated using CBCT and ImageJ software to assess the density of newly formed bone
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Baseline and 6 months post-surgery
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TWEAK Biomarker Concentration
大体时间:Baseline, 1 month, and 3 months post-surgery
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Measured in Gingival Crevicular Fluid (GCF) using Enzyme-Linked Immunosorbent Assay (ELISA)
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Baseline, 1 month, and 3 months post-surgery
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Post-operative Pain Perception
大体时间:12 hours, 1 day, and 3 days post-surgery
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Assessed using a 10-cm Visual Analog Scale (VAS) where 0 indicates "no pain" and 10 indicates "worst imaginable pain"
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12 hours, 1 day, and 3 days post-surgery
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Post-operative Painkiller Consumption
大体时间:Up to 3 days post-surgery
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Recorded as the total number of analgesic tablets consumed by the patient
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Up to 3 days post-surgery
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Post-operative Patient Satisfaction
大体时间:3 days and 7 days post-surgery
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Evaluated using a 5-point Likert scale (from 1 = very dissatisfied to 5 = very satisfied) regarding post-operative swelling and chewing ability
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3 days and 7 days post-surgery
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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