A Comparative Evaluation of Xenograft, Platelet Rich Fibrin And Guided Tissue Regeneration Membrane In The Treatment Of Mandibular Grade II Furcation Defects
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Keywords
“Grade-II mandibular furcation defects, PRF, GTR, Xenograft, CBCT”.
Abstract
One of the most exacting facets in therapy of periodontitis is the regeneration of periodontium affected by tooth furcation involvement. The furcation region has a complex anatomy that requires the use of specialized instruments called furcation curettes to treat it. Grade-II mandibular furcation defects are furthermore amenable to treatment and various techniques and materials have been employed to treat them with moderate success.
AIM: The current study aimed to compare the surgical outcome of grade II furcation therapy with xenograft alone, xenograft along with GTR and xenograft along with PRF membrane.
MATERIALS AND METHODS: This was a corresponding arm prospective randomized and interventional trial conducted within 18 different patients (27 defects) possessing Grade- II mandibular tooth furcation defects. The patients were spitted into three groups. In Group A, 6 patients with 9 defects have been treated by the positioning of Xenograft while in the Group B, 6 patients with 9 defects were treated by the positioning of Xenograft as graft and Guided Tissue Regeneration membrane while in Group C, 6 patients with 9 defects were treated by the positioning of Xenograft as graft and PRF as membrane. Clinical specifications including “Plaque Index (PI)”, “Probing Depth (PD)”, “Relative Vertical Clinical Attachment Level (RVCAL)”, “Relative Horizontal Clinical Attachment Level (RHCAL)”, and quantity of Bone fill by using CBCT, were approximated at baseline and Six months post-operatively. Differentiation between the groups was analyzed by employing ANNOVA test, whereas the paired t-test was used to analyse the mean values within the groups.
RESULTS: On comparing those results between the groups it was observed that excepting from the Probing pocket depth (PD) and Depth of defect fill all other specifications were not arithmetically significant. The Probing depth inbetween the groups at baseline (5.73±0.79) in Group-A, 6.18 ± 0.75 in Group B) and (6.09±0.70) was not arithmetically significant, however after six months it was observed that in group A it was 1.73±0.79 , in the group B 1.36±0.50 and in the group C 2.09± 0.70 which was arithmetically significant (p<0.05). Similarly, the depth of the defect between the groups at baseline (3.67 ± 0.44 in the Group A, 3.95 ± 0.70 in the Group B and 3.46 ± 0.43 in the Group C) were not statistically remarkable, however 6 months postoperatively it was observed that in group A, the defect fill was1.51 ±0.34, in group B it was 1.26±0.26 and in group C it was 1.35± 0.27 which was arithmetically significant. (p<0.05).
CONCLUSION: Xenograft alone (Group A) Xenograft and Guided Tissue Regeneration membrane (Group B) Xenograft and Platelet Rich Fibrin membrane (Group C) were biocompatible with the tissues. There was a well-defined improvement in all the specifications assessed in all the three of the groups. However, patients in the Group B have showed better results than in Group C and in Group A.
References
2. Dhruv Bipinchandra Mehta, Neeraj Chandrahas Deshpande, Shivani Ashwinikumar Dandekar et.al., Comparative evaluation of platelet rich fibrin membrane and collagen membrane along with demineralized freeze dried bone allograft in Grade II furcation defects: A randomized controlled study. Journal of Indian Society of Periodontology – 2018 Aug ; 22{ 4}, July-August 2018.
3. Anitha Logaranjani Kannan et.al., Efficacy of combination therapy using anorganic bovine bone graft with resorbable GTR membrane vs. open flap debridement alone in the management of grade II furcation defects in mandibular molars – A comparative study. J Int Soc Prev Community Dent. 2014 Nov; 4(Suppl 1): S38–S43.
4. Asimuddin S, Koduganti RR, Panthula VNR, Jammula SP, Dasari R, Gireddy H et.al., Effect of Autologous Platelet Rich Fibrin in Human Mandibular Molar Grade II Furcation Defects- A Randomized Clinical Trial. J Clin Diagn Res. 2017 Apr; 11(4):ZC73-ZC77
5. Sánchez-Pérez A, Moya-Villaescusa MJ et.al., Periodontal disease affecting tooth furcations. A review of the treatments available. Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e554-7.
6. Loos B, Nylund K, Claffey N, Egelberg J et.al., Clinical effect of root debridement in molar and non-molar teeth. A 2-year follow-up. J Clin Periodontol 1989; 16:498-504.
7. Laxman VK, Khatri M, Devaraj CG, Reddy K and Reddy R. Evaluation of a new furcation stent as a fixed reference point for class II furcation measurements. Journal of Contemporary Dental Practice 2009; 10:18-25.
8. Karthikeyan BV, Sujatha V, Prabhuji ML. Furcation Measurements: Realities and Limitations. J Int Acad Periodontol. 2015. October; 17(4):103–15.
9. Shyam Padmanabhan, Ahila Dommy, Sanjeela R. Guru et.al., Comparative Evaluation of Cone-beam Computed Tomography versus Direct Surgical Measurements in the Diagnosis of Mandibular Molar Furcation Involvement. Contemp Clin Dent. 2017 Jul-Sep; 8(3): 439–445.
10. Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol. 2006 Jul;77(7):1261-6.
11. Camargo PM, Lekovic V, Weinlaender M, Nedic M, Vasilic N, Wolinsky LE, et.al., A controlled re-entry study on the effectiveness of bovine porous bone mineral used in combination with a collagen membrane of porcine origin in the treatment of intrabony defects in humans. J Clin Periodontol 2000;27:889-96
12. Taheri M, Molla R, Radvar M, Sohrabi K, Najafi MH et. al., An Evaluation of Bovine derived xenograft with and without bio absorbable collagen membrane in the treatment of mandibular class II furcation defects. Aust Dent J 2009.;54(3):220-227
13. Choukroun J, Diss A, Simonpieri A, Girard MO, Schoeffler C, Dohan SL, Dohan AJ, Mouhyi J, Dohan DM. Platelet-rich fibrin (PRF): a second- generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Mar;101(3):e56-60.
14. Mehta DB, Deshpande NC, Dandekar SA et. al., Comparative evaluation of platelet-Rich fibrin membrane and collagen membrane along with demineralized freeze-dried bone allograft in grade II furcation defects: a randomized controlled study. J Indian Soc Periodontol. 2018;22(4):322-327
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