A Chitosan Brush and Enamel Matrix Derivative for Non-surgical Treatment of Furcations

Inclusion criteria

• The patient is 18 years of age or older
• The patient does not have any systemic diseases that may affect the results of the study
• The patient has a plaque index of 20% or less at the study entry
• The patient has a history of severe localized or generalized periodontitis (stage III or IV)
• Completed the first and second steps of periodontal treatment (According to Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline) (Sanz M. et al.)
• Buccal and/or lingual Class 2A and/or 2B furcation involvement (FI) defects on both sides of the Mandibular first and/or second molars after completing the first and second steps of periodontal treatment.
• Buccal Class 2A and/or 2B furcation involvement (FI) defects on both sides of the maxillary first and/or second molars after completion of the first and second step of periodontal treatment if furcation involvement on the palatal side (mesiopalatal and distopalatal) does not exceed Class 1.
• Psychological appropriateness
• Consents to all follow-up visits

Exclusion criteria

• Patients who have systemic diseases that may affect the results of the study
• Use of medications that may affect study results (anti-osteoporotic drugs, statins, corticosteroids, anticoagulants)
• Patients who use calcium channel blockers, cyclosporine A or antiepileptic drugs if there are clinically visible hyperplastic changes in the gingival margin.
• Patients who have received any type of systemic antibiotics in the last six months prior to the start of the study and patients starting antibiotics during the study
• Patients requiring antibiotic premedication prior to periodontal treatment
• Oncological disease
• Chemotherapy and/or radiotherapy (active or history)
• Pregnancy and breastfeeding
• Any condition or current treatment which, in the opinion of the investigator and/or consulting physician, may present an unreasonable risk
• Psychoemotional disorders and depression
• Use of antipsychotic medication or antidepressants
• Lack of patient motivation to undertake adequate dental care at home or complete periodontal treatment, patients residing outside Latvia
• Molars with combined endodontic-periodontal lesions, active endodontic infection
• Prosthetic factors for molars not allowing clinical measurements
• Huge restoration or amalgam fillings that could potentially cause fractures or furcation involvement
• Enamel pearls or filling or crown margins
• Decay or root resorption
• Tooth mobility degree 3
• Molars in which the gingival margin is positioned apically from the entrance into the furcation area
• Clinical attachment level and or pockets mesial and distal to the furcation involvement defect of 6 or more mm
• Strong vomiting reflex that would prevent adequate periodontal treatment
• People close to the study subjects, work colleagues, relatives, etc.