Photobiomodulation and Platelets Rich in Growth Factors (PRGFs)-Assisted Flap Surgery in Treating Stage III Periodontal Defects
- Conditions
- Periodontal Diseases
- Registration Number
- NCT06641739
- Lead Sponsor
- Assiut University
- Brief Summary
Stage 3 periodontitis is a condition marked by swift and severe destruction of periodontal tissues. To effectively regenerate osseous defects resulting from periodontal disease, it is crucial to leverage the intrinsic regenerative potential of the periodontium via meticulously formulated therapeutic strategies
- Detailed Description
The main treatment methods of periodontal diseases involve scaling and root planning (SRP), and periodontal surgery. Periodontopathogens, can penetrate deep by crossing the epithelial barrier which may be difficult to be remove by nonsurgical periodontal therapy (NSPT) alone. A multitude of grafted and non-grafted approaches have been used in the management of Intra-bony defects. However, they do not provide predictable periodontal regeneration.
A systematic review on the use of platelet-rich fibrin (PRF) for managing periodontal defects highlights its promising potential in periodontal regeneration. It forms a fibrin matrix that promotes angiogenesis and enhances healing at defected sites. The review emphasizes PRF's ability to sustain the release of growth factors, which are crucial for osteoblastic proliferation, migration, and adherence. This makes PRF an effective scaffold for cellular elements, facilitating periodontal tissue regeneration.
Laser photobiomodulation (PBM) has emerged as a promising adjunctive treatment as it stimulates cellular processes, enhancing the natural regenerative capabilities of periodontal tissues. Recent studies have demonstrated that PBM, particularly with diode, significantly improves clinical outcomes when combined with conventional periodontal treatments. It promotes osteoblastic proliferation, migration, and adherence, thereby facilitating bone regeneration and reducing periodontal pocket depth. Additionally, PBM enhances angiogenesis and modulates the release of growth factors, creating an optimal healing environment.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 20
- Patients with PPD =5 mm and clinical attachment loss of ≥3 mm;
- Presence of 2 walled or 3 walled infra-bony defects posterior segments;
- Evidence of ≥3 mm of intra-bony defect depth evaluated by the visualization of peri-apical radiographs.
- Patients requiring antibiotic prophylaxis before the periodontal examination;
- Patients diagnosed with malocclusion at the site of the defect;
- Patients with systemic disease and/or on drugs that contraindicate periodontal surgery;
- Patients with a history of smoking and pan chewing;
- Sites with advanced class II & III furcation involvement.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method -Evaluation of the changes in the clinical attachment loss [Time Frame: at base line, 1 month and 3 months after treatment] Attachment level will be measured using UNC15(University of North Carolina) periodontal probe. Clinical attachment loss will be measured as the distance from the cemento-enamel junction to the base of the pocket.\[Time Frame: at base line, 1 month and 3 months after treatment\]
probing depth [Time Frame: at base line, 1 month and 3 months after treatment] The measurement will be recorded by UNC15(University of North Carolina) periodontal probe . Pocket depth will be measured as the distances from the free gingival margin to the base of the periodontal pocket.
- Secondary Outcome Measures
Name Time Method -Plaque index (PI) [Time Frame: at base line, 1 month and 3 months after treatment] It used to assess plaque accumulation around gingival margin.
The degree of plaque accumulation was recorded as follow:
* 0= No plaque around the gingival margin.
* 1= A thin film of plaque around the gingival margin. The plaque may be recognized only by running a probe across the tooth surface.
* 2= Moderate accumulation of soft deposits on the gingival margin and/or adjacent tooth surface, which can be seen by naked eye. 3= Abundance plaque accumulation within the gingival pocket and/or on the gingival margin and adjacent tooth surface and hard deposits on the tooth surface are seen.Gingival index (GI) [Time Frame: at base line, 1 month and 3 months after treatment] It used to assess gingival inflammation. The degree of gingival inflammation will be recorded as follow:
* 0 = Normal gingiva.
* 1 = Mild inflammation, slight change in color, slight edema and no bleeding on probing.
* 2= Moderate inflammation, redness, edema and bleeding on probing.
* 3= Severe inflammation, marked redness, edema and tendency to spontaneous bleeding.