Comparative Evaluation of Platelet Rich Fibrin Membrane vs. Collagen Membrane in Combination with Hydroxy-Apatite (HA) for the Treatment of Mandibular Molar Furcation Defects – A Randomized Clinical Control Trial

Abstract

Aim: A clinical trial to compare the relative efficacy of hydroxyapatite in combination with either PRF (Platelet rich fibrin) or collagen membrane in treatment of grade II furcation defects of mandibular molars. Methodology: The sample consisted of 35 Grade II mandibular molar furcation defects planed for open flap debridement (OFD) (Group 1, n=12), Platelet-rich fibrin membrane + Hydroxyapatite (HA) with OFD (Group 2, n=12), and Collagen membrane (CM) + HA with OFD (Group 3, n=11). These were recorded at baseline and 9 months postoperatively for plaque index (PI), gingival index (GI), probing depth (PPD), relative vertical and relative horizontal clinical attachment levels (RVCAL and RHCAL), and intrabony defect depth (IBD). Results: PI and GI scores decreased significantly in all three groups at 9 months postoperatively as compared to baseline scores. After 9 months of follow up visits mean PD reduction was greater in Group 2 (3.66 ± 0.98 mm) and Group 3 (3.45 ± 1.5 mm) than Group 1 (2.08 ± 0.90 mm), and mean RVCAL and RHCAL gain were greater in Group 2 (3.25 ± 0.75 mm and 3.92 ± 0.29 mm, respectively) and Group 3 (3.09 ± 0.70 mm and 3.89 ± 0.54 mm) compared with Group 1 (1.33 ± 0.77 mm and 2.25 ± 0.62 mm). A significant reduction in IBD depth was found in Groups 2 (2.16*0.38 mm) and 3 (1.58*0.35 mm) than in Group 1 (0.70*0.15 mm). The differences in PI, GI, PPD, RVCAL, and RHCAL between Groups 2 and 3 at baseline and 9 months were not statistically significant. There was a statistically significant difference in the depth reduction of IBD between Groups 2 and 3 at nine months. Conclusion: Within the scope of this study, it can be stated that the use of HA in conjunction with PRF or CM in the treatment of grade II mandibular furcation abnormalities resulted in a considerable reduction in GI PI, PPD, RVCAL, RHCAL, and IBD depth on follow up visit at 9 months after surgery. However, the combination of HA with PRF membrane exhibited significant improvement in radiographic parameters in comparison to the combination of HA with Collagen membrane.