Injectable Platelet-Rich Fibrin With Minimally Invasive Non-Surgical Technique in Treatment of Grade II Furcation Defects

Periodontitis is a multifactorial inflammatory disease that occurs due to the challenge between the host response and specific periodontal pathogens, leading to a gradual destruction of the periodontal supporting tissues over time.

Different regenerative approaches have been proposed including guided tissue regeneration (GTR); bone grafts, bioactive agents such as enamel matrix derivative (EMD) and platelet concentrates.

Using the minimally invasive nonsurgical technique (MINST) implements magnification with microscope/loupes and delicate instruments, to perform the periodontal debridement with more effective root debridement and less soft tissue trauma. MINST significantly improve the visualization and root decontamination, and at the same time preserve the gingival margin and consequently improve the aesthetic results and tissue stability.

Inclusion criteria

• Patients of both genders >18 years old, medically free of systemic diseases affecting periodontal regeneration.
• Diagnosis of stage III, grade B periodontitis (according to the AAP/EFP classification 2018) with the presence of class II furcation defect in either the maxillary (buccal) or mandibular arch (buccal or lingual) as determined by clinical evaluation and confirmed by radiographic evaluation.
• Gingival margin and interdental bone positioned coronally to the furcation entrance.
• Commitment to maintenance visits and follow-up.
• Absence of primary endodontic lesions.

Exclusion criteria

• Patients suffering from any systemic diseases that may affect the outcome of periodontal therapy, including diabetes, immune deficiencies, etc;
• Patients that received periodontal surgical treatments in the past 12 months.
• Smoking (current or in past 5 years)
• Prolonged treatment with antibiotics or anti-inflammatory agents within 6 months prior to periodontal therapy.
• Pregnant and lactating females.
• Teeth with hopeless prognosis
• Third molars