Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India.
J Periodontol. 2019 Jan;90(1):52-60. doi: 10.1002/JPER.18-0146. Epub 2018 Aug 29.
The treatment of molar furcation involvement is unpredictable due to the complex anatomy and poor access for instrumentation. Previous studies have reported successful regeneration with endogenous regenerative material such as platelet rich fibrin (PRF) and bisphosphonates as alendronate (ALN). Hence, the present study was aimed to evaluate clinically and radiographically the efficacy of 1% ALN gel in combination with PRF (PRF+ALN) and PRF alone in the treatment of grade II furcation defects.
A split mouth study with 40 bilateral furcation defects was randomly divided into PRF group and PRF+ALN group. Bone defect volume was the primary outcome evaluated at the end of 6 months with CBCT while the secondary outcomes being changes in clinical parameters including Probing pocket depth (PPD), Clinical attachment level (CAL) and Horizontal probing depth (HPD) recorded at baseline, 3 and 6 months.
The mean reduction in PPD, CAL and HPD was 1.85 ± 0.59 mm, 1.9 ± 0.64 mm and 1.7 ± 0.73 mm respectively for PRF group and 2.85 ± 0.88 mm, 3.05 ± 0.98 mm and 2.3 ± 0.73 mm respectively for PRF+ ALN group (p < 0.05). At the end of 6 months, mean reduction in bone defect volume for PRF and PRF+ ALN group was 8.65 ± 3.84 mm and 11.98 ± 4.13 mm respectively.
PRF+ ALN treated defects exhibited better clinical and radiographic outcomes suggestive of enhanced periodontal regeneration when compared to PRF alone treated sites.
由于磨牙分叉区解剖结构复杂,器械进入困难,治疗效果难以预测。既往研究报道,富血小板纤维蛋白(PRF)和双膦酸盐(如阿仑膦酸钠)等内源性再生材料可成功再生。因此,本研究旨在评估 1%阿仑膦酸钠凝胶联合 PRF(PRF+ALN)和单独 PRF 治疗 II 度分叉缺损的临床和影像学疗效。
采用双侧分叉缺损随机分组的分口研究,将 40 个分叉缺损随机分为 PRF 组和 PRF+ALN 组。6 个月时采用 CBCT 评估骨缺损体积,主要结局指标;记录基线、3 个月和 6 个月时的临床参数变化,包括探诊袋深度(PPD)、临床附着水平(CAL)和水平探诊深度(HPD),为次要结局指标。
PRF 组 PPD、CAL 和 HPD 的平均降低量分别为 1.85±0.59mm、1.9±0.64mm 和 1.7±0.73mm,PRF+ALN 组分别为 2.85±0.88mm、3.05±0.98mm 和 2.3±0.73mm(P<0.05)。6 个月时,PRF 和 PRF+ALN 组骨缺损体积的平均减少量分别为 8.65±3.84mm 和 11.98±4.13mm。
与单独使用 PRF 相比,PRF+ALN 治疗的缺损在临床和影像学方面的效果更好,提示牙周再生增强。