Minimally Invasive Flap With Platelet Rich Fibrin or Growth Factor Enhanced Matrix in Treatment of Intrabony Defect

: Twenty-one intra-bony defects in fifteen systemically healthy patients with moderate to severe chronic periodontitis were randomly classified into 3 groups, 7 sites each. Group І treated by MIST alone, group ІІ treated by MIST + ethylenediamine-tetraaceticacid (EDTA) + PRF and group III treated by MIST + EDTA + GEM 21S. The clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP), were recorded at baseline, 3, 6 and 9 months post-surgery. Cone beam computed tomography (CBCT) was performed at baseline and 9 months post-surgery to evaluate bone level and bone density.

• Minimal invasive flap technique (Procedure), also known as regenerative surgery: contained defect treated with Minimally invasive flap
• Minimally invasive flap with root conditioning (EDTA) and platelet rich fibrin (Procedure), also known as regenerative surgery: contained defect treated by Minimally invasive flap with root conditioning (EDTA) and platelet rich fibrin graft
• minimally invasive flap with root contioning by EDTA and growth factor enhanced matrix GEM21S (Combination product), also known as regenerative surgery: contained defect treated with Minimally invasive flap with root conditioning (EDTA) and growth factor enhanced matrix application in the defect

Primary outcomes

• the change in probing pocket depth [9 months]: the change in probing pocket depth was measured at baseline, 3,6 and 9 months evaluation period using periodontal probe
• the change bleeding on probing score [9 months]: the change in bleeding on probing measured at baseline,3,6 and 9 months evaluation period
• the change Clinical attachment level [9 months]: the change in Clinical attachment level measured at baseline, 3,6 and 9 months using the periodontal probe
• Cone beam radiograph [9 months]: Cone beam radiograph for measuring the change in area of the defect, depth of the depth and bone density at baseline, 3, 6 and 9 month post operative treatment using OnDemand software of cone beam

Sex: All, ages: 30 Years to 55 Years, accepts healthy volunteers

Inclusion Criteria:

• Presence of at least one tooth with PPD and CAL loss of ≥ 5 mm associated with an intra-bony defect of ≥ 2 mm according to Cortellini and Tonetti, 2007

Exclusion Criteria:

* Patients with uncontrolled or poorly controlled diabetes, life-threatening conditions, or requiring antibiotic prophylaxis were excluded.
* Smokers
* Pregnant patients.
* Patients with aggressive periodontitis.
* Patients with multiple interconnected vertical defect walls.

• malak m shoukheba, phd, Principal investigator, tanta university faculty of dentistry