New Approach to the Non-Surgical Management of Periodontal Furcation Involvement Defects: Study Protocol

Objectives.
Background: Periodontitis is a complex, long-lasting inflammatory condition affecting the periodontium, leading to the deterioration of periodontal tissues and potentially resulting in tooth loss. Furcation involvement (FI) is a consequence of the advancement of periodontal disease caused by the destruction of the periodontal tissues situated between the roots of multirooted teeth. Non-surgical periodontal interventions are not fully effective in regenerating Class II FI defects. Some systematic reviews have indicated that host modulators and antimicrobials may offer additional advantages in the treatment of FI defects.
Objective: This randomised, single-blinded, split-mouth clinical trial aims to evaluate the effectiveness of using an oscillating chitosan brush in conjunction with enamel matrix derivative (EMD) for non-surgical periodontal therapy of furcation-involved defects in the molars.
Materials and methods: This study is being conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Riga Stradins University (protocol No. 2-PĒK-4/529/2023; date of approval:
11th of September 2023 and No. 2-PĒK-4/659/2024; date of approval: 04th of November 2024).
Inclusion criteria are stage III or IV periodontitis with first or second molars with Class IIA or IIB buccal or lingual furcation defects. Furcation defects in each quadrant will be randomly allocated to either the test group (Osscilating Chitosan Brush with EMD) or the control group (Osscilating Chitosan Brush alone).
Clinical periodontal measurements, such as mobility, recessions, probing pocket depth, furcation involvement, and clinical attachment level, will be evaluated at baseline and week 12. Samples of gingival crevicular fluid (GCF) and subgingival plaque from FI defects in test and control sites will be gathered at baseline and 4 weeks and sent for analysis of the proteomic profile of GCF and differences in the microbial profile.