1. What data in particular will be shared?
   Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response - Clinical Study Report
   
   
3. Who will be able to view these files?
   Response - Anyone
   


4. For what types of analyses will this data be available?
   Response - Any purpose.
   


5. By what mechanism will data be made available?
   Response - Proposals should be directed to [peri.srivani.96@gmail.com].
   


6. For how long will this data be available start date provided 31-12-2022 and end date provided 28-09-2025?
   Response - Immediately following publication. No end date.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - NIL

Periodontitis results in increased pocket depth, intrabony defects, gingival recession, tooth mobility, furcation involvement. Intrabony defect is defined as periodontal defect surrounded by one, two or three bony walls or a combination of thereof. Various regenerative materials are incorporated into the intrabony defects by open flap debridement and guided tissue regeneration. In conventional surgical approach ,large flaps are raised to completely and exceedingly expose the area of interest and the results were unsatisfactory due to limited regenerated periodontal tissue. Thus, an alternative approach to access the intra-bony defects was proposed. This approach is called minimally invasive surgical techniques which uses incisions just large enough for debridement and generally involves reflecting the papilla only by using specialized instruments to access the intra-bony defect.

The introduction of operative microscopes and microsurgical instruments resulted in increased surgical effectiveness by improving the visual acuity & accuracy and better control of the surgical instruments resulting in reduced flap reflection. Following the principles of papilla preservation flap, Cortellini and Tonetti recommended the use of the minimally invasive surgical technique (MIST) with microsurgical instruments and operating microscope that demonstrated better healing in terms of  significant gain in attachment level, pocket depth reduction, and minimal gingival recession in the treatment of isolated deep intrabony defects.

The Modified-MIST (M-MIST) was introduced by Cortellini & Tonnetti to reduce surgical invasiveness by limiting the incision line to the buccal side. This fulfilled the following objectives: (i) to maintain the interdental papillary height by minimizing its tendency to collapse; (ii) to increase the likelihood of primary wound closure; (iii) to reduce the chances of gingival recession; (iv) to improve flap stability; (v) to maintain space for regeneration; (vi) reduce patient morbidity (vii) better ergonomics.

Various randomised controlled clinical trials have been conducted to study the efficacy of M-MIST in the treatment of intrabony defects with and without regenerative materials such as enamel matrix derivative (EMD), bone mineral derived xenograft (BMDX), and recombinant human platelet derived growth factor (rhPDGF). Very few clinical trials have been attempted to study the use of M-MIST with autologous platelet-rich-fibrin (PRF).

PRF is considered a second-generation platelet concentrate; it has trimolecular fibrin morphology with a 74% composition of leukocytes, and is known to have osteoconductive, immunomodulatory, and neo-angiogenic properties. In vitro studies have demonstrated that PRF acts as a scaffold for the culture of human periosteal cells and can be applied in bone tissue engineering. Furthermore, it releases autogenous growth factors gradually and manifests a stronger effect on the proliferation and differentiation of osteoblasts. Clinical studies have also demonstrated convincing results of PRF in achieving periodontal regeneration in intrabony defects, class II furcation defects, coronally advanced flaps with multiple gingival recession, and sinus augmentation during implant placement.

Considering the benefits of PRF for augmenting bone and soft tissue healing, it is hypothesized that PRF could act as an adjunct to M-MIST, potentially yielding better results than M-MIST alone in the treatment of isolated intrabony defects. Thus, the aim of this study is to observe the outcomes of periodontal surgery in which M-MIST is used with or without PRF for the treatment of isolated intrabony defects.