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A Cone Beam Computed Tomographic Evaluation of Healing of Apicomarginal Defects Using Autologous Platelet Aggregates

Not Applicable
Conditions
Chronic Apical Periodontitis
Interventions
Procedure: Periapical surgery using autologous platelet aggregate
Procedure: Periapical surgery without autologous platelet aggregate
Registration Number
NCT04389346
Lead Sponsor
Postgraduate Institute of Dental Sciences Rohtak
Brief Summary

This study will evaluate the effect of PRF (platelet rich fibrin) on the healing of apicomarginal defects. Healing of the defects will be assessed 2 dimensionaly by periapical radiograph and 3 dimensionaly using CBCT.

Detailed Description

Patients with apicomarginal defects as per the inclusion criteria will be randomly divided into two groups - (1) Test group - The denuded root surface will be covered by PRF (Choukron's method) and (2) Control group -No use of autologous platelet aggregate during periapical surgery. Radiographic and clinical healing will be assessed after 12 months, 2D healing will be assessed by Rud and Molven criteria and 3D healing will be assessed by Modified Penn 3D criteria.The clinical parameters recorded including periodontal pocket depth (PD), clinical attachment level (CAL) and gingival margin position (GMP) will be measured on buccal aspect of the interproximal space and mid buccal aspect of the involved teeth using Williams 'O' periodontal probe.Routine examination procedure will be used to evaluate any evidence of signs and/or symptoms.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
32
Inclusion Criteria
  • A negative response to vitality tests with radiographic evidence of periapical radiolucency with no general medical contraindications for oral surgical procedures.
  • Apicomarginal communication having probing depth > 6mm.
  • Patients with no general medical contraindications for oral surgical procedures.
  • Recurrent episodes of purulent discharge.
  • Failed previous root canal treatment.
  • Failed previous surgery with persistent bony lesion.
  • Adequate final restoration with no clinical evidence of coronal leakage.
Exclusion Criteria
  • Clinical or radiographic evidence of root fracture.
  • Resorptive processes involving more than apical third of the root.
  • Any systemic disease contraindicating oral surgery including uncontrolled diabetes and pregnancy.
  • Any condition effecting rate of healing like smoking.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Periapical surgery with PRF groupPeriapical surgery using autologous platelet aggregateAutologous platelet aggregate (PRF) will be placed over the denuded root surface, following apicoectomy and before flap repositioning.
Control group without PRFPeriapical surgery without autologous platelet aggregateFlap will be repositioned following apicoectomy without placement of any autologous platelet aggregate.
Primary Outcome Measures
NameTimeMethod
Change in periapical radiolucencyBaseline to 12 Months

2 blinded caliberated operators will score the periapical radiolucency at baseline and 12 months by following scoring

scores for 2D healing

Score1-Complete healing defined by re-establishment of the lamina dura Score 2- Incomplete healing (scar tissue) Score 3- Uncertain healing Score 4- Unsatisfactory healing

scores for 3D healing Score1- Complete healing Score 2- Limited healing Score 3- Uncertain healing Score 4- Unsatisfactory healing

Secondary Outcome Measures
NameTimeMethod
Clinical successBaseline to 12 Months

Clinical success will be assessed by absence of clinical signs and symptoms such as pain, swelling , sinus or tenderness on palpation or percussion

Trial Locations

Locations (1)

Ankita Ramani

🇮🇳

Rohtak, Haryana, India

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