Comparative evaluation of Titanium-platelet rich fibrin membrane and Collagen membrane along with Nanohydroxyapatite graft for the management of Grade II Furcation defects: A clinico-radiographic study.

Aim of this study is to determine if there is a difference in clinical and radiographic parameters of Grade II Furcation defects treated with open flap debridement utilizing Nanohydroxyapatite graft and Titanium platelet-rich fibrin, when compared to open flap debridement with Nanohydroxyapatite graft and Collagen membrane. After obtaining informed consent and recording a comprehensive case history, 40 sites presenting with Grade II Furcation defects were enrolled and randomly assigned into two groups: a control group treated with OFD + NcHA bone graft + Collagen membrane., and a test group treated with OFD + NcHA bone graft + T-PRF membrane. Following phase I periodontal therapy, clinical re-evaluation was conducted to confirm suitability. Defect sites were allocated using the manual lottery method, with allocation concealment and blinded assessment to minimize bias. All surgical

procedures were performed by a single operator using the kirkland flap. In control group, after periodontal debridement is done, Grade II Furcation defects will receive Nanocrystalline hydroxyapatite graft (Sybograf™) and Collagen membrane( Healiguide) . After packing the graft and membrane into the defect, the flaps will be repositioned to their original position and will be secured using sutures. In test group, the Grade II Furcation defects will receive a Nanocrystalline hydroxyapatite graft (Sybograf™) with T-PRF membrane. The T-PRF will be prepared from the patient’s own blood. The venous blood will be drawn into two (5mL) titanium coated tubes and centrifuged at 2800 rpm for 12 minutes. After centrifugation, the T-PRF clots will be removed from the tubes using sterile tweezers, separated from the RBC base , and placed on sterile woven gauze for 20 minutes to release the serum and compressed using PRF box to form T-PRF membrane. After packing the defects with the graft and membrane the flaps will be repositioned to their original position and will be secured using sutures. Sutures will be removed after 7-10 days postoperatively.  All clinical parameters will be re-evaluated at 3 and 6 months after surgery while radiographic bone fill will be re-assessed at 6 months postoperatively.