comparison of bone fill in bony defect around tooth using self blood product vs without any material
- Conditions
- Other specified bacterial diseases,
- Registration Number
- CTRI/2023/08/056629
- Lead Sponsor
- not applicable
- Brief Summary
Periodontitisresults in increased pocket depth, intrabony defects, gingival recession, toothmobility, furcation involvement.Intrabony defectis defined as periodontal defect surrounded by one, two or three bony walls ora combination of thereof. Variousregenerative materials are incorporated into the intrabony defects by open flapdebridement and guided tissue regeneration.In conventionalsurgical approach ,large flaps are raised to completely and exceedingly exposethe area of interest and the results were unsatisfactory due to limitedregenerated periodontal tissue. Thus, an alternative approach to access theintra-bony defects was proposed. This approach is called minimally invasivesurgical techniques which uses incisions just large enough for debridement andgenerally involves reflecting the papilla only by using specialized instrumentsto access the intra-bony defect.
The introductionof operative microscopes and microsurgical instruments resulted in increasedsurgical effectiveness by improving the visual acuity & accuracy and bettercontrol of the surgical instruments resulting in reduced flap reflection.Following theprinciples of papillapreservation flap, Cortellini and Tonettirecommended the use of the minimally invasive surgical technique (MIST) withmicrosurgical instruments and operating microscope that demonstrated betterhealing in terms of significant gain inattachment level, pocket depth reduction, and minimal gingival recession in thetreatment of isolated deep intrabony defects.
The Modified-MIST(M-MIST) was introduced by Cortellini & Tonnetti to reduce surgicalinvasiveness by limiting the incision line to the buccal side. This fulfilledthe following objectives: (i) to maintain the interdental papillary height byminimizing its tendency to collapse; (ii) to increase the likelihood of primarywound closure; (iii) to reduce the chances of gingival recession; (iv) toimprove flap stability; (v) to maintain space for regeneration; (vi) reducepatient morbidity (vii) better ergonomics.
Various randomisedcontrolled clinical trials have been conducted to study the efficacy of M-MISTin the treatment of intrabony defects with and without regenerative materialssuch as enamel matrix derivative (EMD), bone mineral derived xenograft (BMDX),and recombinant human platelet derived growth factor (rhPDGF).Very few clinicaltrials have been attempted to study the use of M-MIST with autologousplatelet-rich-fibrin (PRF).
PRF is considereda second-generation platelet concentrate; it has trimolecular fibrin morphologywith a 74% composition of leukocytes, and is known to have osteoconductive,immunomodulatory, and neo-angiogenic properties. In vitro studieshave demonstrated that PRF acts as a scaffold for the culture of humanperiosteal cells and can be applied in bone tissue engineering. Furthermore, itreleases autogenous growth factors gradually and manifests a stronger effect onthe proliferation and differentiation of osteoblasts. Clinical studieshave also demonstrated convincing results of PRF in achieving periodontalregeneration in intrabony defects, class II furcation defects, coronallyadvanced flaps with multiple gingival recession, and sinus augmentation duringimplant placement.
Considering thebenefits of PRF for augmenting bone and soft tissue healing, it is hypothesizedthat PRF could act as an adjunct to M-MIST, potentially yielding better resultsthan M-MIST alone in the treatment of isolated intrabony defects. Thus, the aimof this study is to observe the outcomes of periodontal surgery in which M-MISTis used with or without PRF for the treatment of isolated intrabony defects.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 30
- 1)25 years of age or older.
- 2)Stage II or III Periodontitis 3)Presence of at least a single site with PPD and clinical attachment level (CAL) ≥5 mm on the buccal surface associated with a 3-walled osseous defect depth of ≥3 mm bilaterally or in both maxillary and mandibular arches.
- 4)Adequate width of attached gingiva, 5)Plaque index < 30 %.
- 1)Previous periodontal surgery within the last 6 months in area of interest.
- 2)Systemic conditions which are generally considered to be a contraindication to periodontal surgery.
- 3)Pregnant or lactating females 4)Current or former smokers.
- 5)Hopeless tooth.
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- Patients on systemic medications such as corticosteroids or Calcium channel blockers or taking long-term NSAIDS or taking bisphosphonates or calcium supplements.
- 7)patients who had periodontal sites with fractured and perforated roots 8) teeth with grade III mobility and furcation involvement 9) non-vital tooth with or without periapical pathology.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method change in clinical attachment level and radiographic Defect depth reduction % from baseline to 6 months postoperative baseline to 6 months postoperative
- Secondary Outcome Measures
Name Time Method Probing pocket depth plaque index
Trial Locations
- Locations (1)
SCB Dental College and Hospital
🇮🇳Cuttack, ORISSA, India
SCB Dental College and Hospital🇮🇳Cuttack, ORISSA, IndiaPeri SrivaniPrincipal investigator8763516008peri.srivani.96@gmail.com