fibrin and Furcation-Defects

A wide range of regenerative materials have been tried and tested in the treatment of furcation defects. Rosuvastatin (RSV) is a new synthetic, second-generation, sulfur-containing, hydrophilic statin with potent anti-inflammatory and osseodifferentiation mechanisms of action. Platelet-rich fibrin (PRF) is a platelet concentrate having sustained release of various growth factors with regenerative potential to treat periodontal defects. Porous hydroxyapatite (HA) bone grafting material has a clinically satisfactory response when used to fill periodontal intrabony defects. This double-masked randomized study is designed to evaluate the potency of a combination of 1.2 mg RSV in situ gel with a 1:1 mixture of autologous PRF and HA bone graft in the surgical treatment of mandibular Class II furcation defects compared with autologous PRF and HA bone graft placed after open-flap debridement (OFD).. One hundred five mandibular furcation defects were treated with OFD + placebo gel (group 1), PRF + HA with OFD (group 2), or 1.2 mg RSV gel + PRF + HA with OFD (group 3). Clinical and radiologic parameters (i.e., probing depth [PD], relative vertical and relative horizontal clinical attachment level [rvCAL and rhCAL], intrabony defect depth, and percentage of defect fill) were recorded at baseline and 9 months postoperatively.. Mean PD reduction was greater in group 2 (3.68 ± 1.07 mm) and group 3 (4.62 ± 1.03 mm) than group 1 (2.11 ± 1.25 mm), and mean rvCAL and rhCAL gain were greater in group 2 (3.31 ± 0.52 and 2.97 ± 0.56 mm, respectively) and group 3 (4.17 ± 0.70 and 4.05 ± 0.76 mm) compared with group 1 (1.82 ± 0.78 and 1.62 ± 0.64 mm). A significantly greater percentage of mean bone fill was found in group 2 (54.69% ± 1.93%) and group 3 (61.94% ± 3.54%) compared with group 1 (10.09% ± 4.28%).. Treatment of furcation defects with 1.2 mg RSV in situ gel combined with autologous PRF and porous HA bone graft results in significant improvements of clinical and radiographic parameters compared with OFD alone. These results imply that the combination of RSV, PRF, and HA has synergistic effects, explaining their role as a regenerative material in the treatment of furcation defects.

Topics: Blood Platelets; Fibrin; Furcation Defects; Humans; Hydroxyapatites; Periodontal Index; Rosuvastatin Calcium

The treatment of molar furcation defects remains a considerable challenge in clinical practice. The identification of clinical measurements influential to treatment outcomes is critical to optimize the results of surgical periodontal therapy. The present study aimed to explore the clinical and radiographical effectiveness of autologous platelet-rich fibrin (PRF) and autologous platelet-rich plasma (PRP) in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis.. Seventy-two mandibular degree II furcation defects were treated with either autologous PRF with open flap debridement (OFD; 24 defects) or autologous PRP with OFD (25), or OFD alone (23). Clinical and radiological parameters such as probing depth, relative vertical clinical attachment level and horizontal clinical attachment level along with gingival marginal level were recorded at baseline and 9 mo postoperatively.. All clinical and radiographic parameters showed statistically significant improvement at both the test sites (PRF with OFD and PRP with OFD) compared to those with OFD alone. Relative vertical clinical attachment level gain was also greater in PRF (2.87 ± 0.85 mm) and PRP (2.71 ± 1.04 mm) sites as compared to control site (1.37 ± 0.58 mm), and relative horizontal clinical attachment level gain was statistically significantly greater in both PRF and PRP than in the control group.. The use of autologous PRF or PRP were both effective in the treatment of furcation defects with uneventful healing of sites.

Topics: Adult; Autografts; Blood Transfusion, Autologous; Bone Regeneration; Chronic Periodontitis; Debridement; Dental Plaque Index; Female; Fibrin; Follow-Up Studies; Furcation Defects; Gingival Recession; Humans; Male; Mandibular Diseases; Molar; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Platelet Transfusion; Platelet-Rich Plasma; Surgical Flaps; Treatment Outcome

Platelet-rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. This double-masked randomized study is designed to evaluate the effectiveness of autologous PRF in the treatment of mandibular degree II furcation defects compared with open flap debridement (OFD).. Using a split-mouth design, 18 patients with 36 mandibular degree II furcation defects were randomly allotted and treated either with autologous PRF and OFD or OFD. Plaque index, sulcus bleeding index, probing depth, relative vertical and horizontal clinical attachment level, gingival marginal level, and radiographic bone defect were recorded at baseline and 9 months postoperatively. Comparison between indices between the test and control groups was performed using the paired t test except for plaque index and sulcus bleeding index data, which used the χ(2) test.. All clinical and radiographic parameters showed statistically significant improvement at the sites treated with PRF and OFD compared to those with OFD alone.. Within the limitation of this study, significant improvement with autologous PRF implies its role as a regenerative material in the treatment of furcation defects.

Topics: Adult; Blood Platelets; Blood Transfusion, Autologous; Chi-Square Distribution; Double-Blind Method; Female; Fibrin; Follow-Up Studies; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Mandible; Periodontal Debridement

To evaluate the effect of platelet rich fibrin (PRF) combining with Bio-oss in treating Class II furcation involvement.. Thirty patients who had Class Ⅱ furcation involvement in the mandibular first molar were included. They were all free of systemic disease. After initial periodontal therapy, they were randomly divided into 2 groups. In the experimental group, PRF combining with Bio-oss were placed in the areas with furcation defect and covered with PRF. In the control group, only flap surgery was performed. All patients were followed up for 6 months after operation. The efficacy was evaluated with clinical parameters and cone-beam computed tomography (CBCT). The data were analyzed with SPSS 2.0 software package.. Periodontal indexes including probing depth (PD), clinical attachment loss (CAL), horizontal probing depth (HPD) significantly decreased in both groups after operation (P<0.05); alveolar bone significantly increased in the experimental group (P<0.05).. The clinical effect of PRF combined with Bio-oss on Class II furcation involvement are remarkable.

Topics: Fibrin; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Minerals; Platelet-Rich Fibrin; Surgical Flaps

Multirooted teeth offer unique and challenging problems due to the furcation area, creates situations in which routine periodontal procedures are somewhat limited and special procedures are generally required.. The present case was showing the management of grade II furcation defect by platelet rich fibrin (PRF) and β-Tricalcium phosphate with coronally advanced flap.. Platelet rich fibrin and β-Tricalcium phosphate with coronally advanced flap have been shown to be a promising and successful approach for the treatment of furcation defect. Its gaining clinical attachment significantly manages both the gingival recession and furcation involvement simultaneously.

Topics: Biocompatible Materials; Blood Platelets; Calcium Phosphates; Female; Fibrin; Furcation Defects; Humans; Middle Aged; Oral Surgical Procedures; Surgical Flaps; Treatment Outcome

The purpose of this investigation was to test clinically the efficiency of a recently described bioabsorbable matrix as a guided tissue regeneration membrane. This matrix was prepared from an original reaction between elastin and fibrin monomers and is now extensively used in several domains of surgery. The study group was composed of 26 patients, with a total of 35 lesions (22 intrabony defects, 8 Class II furcations and 5 Class III furcations) presenting moderate to advanced adult periodontitis. After initial therapy, measurements were made with a calibrated periodontal probe. Probing depth (PD) and gingival margin location (GM) measurements were taken twice: immediately before surgery and after 6 months before re-entry. Clinical attachment level (CAL), vertical osseous level (VOL) and alveolar crest location (AC) measurements were taken during surgery and after 6 months with re-entry procedures for all the patients. Color change of the gingival margin was only observed in 4 defects and device exposure occurred in the proportion of 2 out of the 35 defects. No foreign body reaction was observed in any case. At the intrabony defects mean PD reduction was 5 mm (P < 0.001), and mean gain of CAL was 4 mm (P < 0.001). Mean VOL was 4.3 mm (P < 0.001), mean gingival recession was 0.9 mm (P < 0.05) and mean AC was 0.2 mm (NS). At the Class II furcation defects the mean PD reduction was 4.5 mm (P < 0.001), mean gain CAL vertical was 3.2 mm and CAL horizontal was 4.5 mm (P < 0.001). Gingival recession averaged 1 mm (NS). A complete closure was observed in 2 out of the 8 defects. At the Class III furcation defects the mean PD reduction was 3.6 mm (P < 0.05) and mean CAL-V gain was 1.5 mm (P < 0.02). However the 5 sites showed no horizontal attachment gain and none were unchanged. A very low gingival recession, gingival reaction, crestal bone loss, and device exposure occurred during this study. This preliminary study suggests that the use of a biosynthetic barrier may have beneficial effects in the treatment of intrabony defects and Class II furcation defects. Randomized controlled trials are necessary to evaluate the efficacy and safety of this bioabsorbable membrane in periodontal therapy.

Topics: Adult; Aged; Alveolar Bone Loss; Biocompatible Materials; Biodegradation, Environmental; Elastin; Female; Fibrin; Furcation Defects; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged