Clinical evaluation of advanced platelet rich fibrin combined with nano-crystalline hydroxyapatite bone substitute for management of mandibular molar grade II furcation defects: a randomized controlled clinical trial.

Background: the current randomized controlled trial assessed for the effect of advanced platelet rich fibrin (A-PRF) + nano-crystalline hydroxyapatite bone substitute (n-HA) with open flap debridement (OFD) versus OFD alone in the management of mandibular molar grade II defects.Methods twenty-eight sites in twenty-four patients with mandibular class II furcation involvement were selected and randomized into test (A-PRF+ n-HA+ OFD; n=14) and control (OFD; n=14) groups. All were assessed for clinical outcomes such as probing pocket depth (PPD), vertical clinical attachment level (VCAL) (primary outcome), horizontal clinical attachment level (HCAL), gingival recession and post-operative pain.Results: A Statistically significant gain was in VCAL gain at 3,6,9 months and significant PPD reduction at 3 and 6 months were recorded in favor of the test group, while there was no significant difference between the two groups in HCAL at 3,6 and 9 months. Both groups show statistically significant reduction in post-operative pain after 7 days.Conclusion: (A-PRF+n-HA+OFD) or OFD were effective in treating class II furcation involvement in mandibular molar teeth with respect to PPD reduction, VCAL gain and HCAL. The test group showed more significant reduction changes in PPD and VCAL gain compared to control group. Both groups showed statistically significant reduction in post-operative pain as measured with VAS score.