Treatment of Class II furcation defects with PRP/bioactive glass/calcium sulfate

Objectives: This study histologically evaluated healing of surgically created Class II furcation defects treated using a combination of platelet-rich plasma (PRP), new spherical bioactive glass (NBG, Biogran II^®) particles and calcium sulfate (CS, Calcigen^TM Oral).

Methods: The second and fourth mandibular premolars of eight mongrel dogs were used in this study. Class II furcation defects were surgically created and immediately treated. Using a split-mouth design, teeth were randomly divided into two groups: group C (control) - defect filled with blood clot only; and group T (test) - defect filled with a combination of PRP, NBG and CS. Flaps were repositioned to cover all defects. Animals were euthanized 90 days post-surgery. Mesio-distal serial sections were evaluated histometrically, using image-analysis software, and histologically. Linear and area measurements of periodontal healing were evaluated and calculated as a percentage of original defect. Percentage data were transformed into arccosine for statistical analysis (analysis of variance; P<0.05). Furcations were considered to have total bone fill when newly formed bone was seen throughout the previously created defect.

Results: Regeneration of bone and connective tissue was incomplete in most of the specimens. Histologically, total bone fill of the furcation defects was observed in 2 specimens of group C and in 4 specimens of group T. However, group C had significantly more bone formation and periodontal regeneration than group T. A considerable amount of remaining NBG particles was observed in most specimens of group T.

Conclusions: When the histometric analysis of periodontal healing is considered, the combination of PRP, NBG and CS was not more effective than the surgical debridement alone in the treatment of Class II furcation defects. However, the histologic evaluation did show a favorable result using this combined therapy with regard to total bone fill of the defect. This study was supported by BIOMET 3i, Inc.