Periodontitis is a disease that is characterized by the destruction of periodontal tissue, if left untreated it will lead to different types of bone deformities. One such deformity is furcation defect. Various surgical regenerative techniques have been proposed in order to treat furcation defects of periodontitis-affected teeth. The use of autologous platelet concentrates (APCs) is gaining popularity as a source of multiple growth factors in high concentrations, for regenerative treatments in many clinical applications¹. Autologous platelet concentrates are advantageously used as a cost-effective adjunct to surgical regenerative therapy, even in combination with bone grafts and barrier membranes². Several randomized controlled trials have reported improvement of post-operative soft and hard tissue healing, and improved bone fill and attachment gain.

Platelet rich fibrin (PRF) is a second-generation autologous platelet concentrate introduced by Choukron et al 2001. Ghanaati et al in 2014 introduced a modification of PRF clots (A-PRF) by using low speed centrifugation concept which significantly increases the platelet and leuckocyte number and also releases significantly higher concentrations of key growth factors³. Further Miron et al in 2015 introduced liquid variety of PRF (i-PRF) which may accelerate the wound-healing processes with increased vascularization. The benefits of i-PRF show slow and sustained release of growth factors, by releasing the expression of transforming growth factor-β and collagen-1 mRNA along with cells migration for tissue regeneration⁴.

Abdallah et al in 2017 introduced a “PRF block” consisting of L-PRF mixed with i- PRF and synthetic bone graft formed into a cohesive block. This block forms a volumetric matrix which can be used to fill various osseous defects⁵. Jayasheela et al used A-PRF block in infrabony defects which showed significant gain in the bone volume, high defect fill, defect resolution. In A-PRF block, the cut membrane of the A-PRF acts as a biological matrix and promotes migration of osteoprogenitor cells to the centre of the graft⁶. Therefore, we hypothesize that formation of cohesive mass obtained from the use of A-PRF block could perform better compared to bone grafts in management of furcation defects owing to the better handling characteristics and sustained delivery of growth factors. Here, we are using demineralized bovine bone matrix (DMBM) which has been found to enhance mesenchymal cells differentiate into giant cells and chondrocytes, cartilage formation and bone formation in the vascularized areas of matrix; which enhances new tissue formation within the period of 30days. DMBM has osteoconductive and osteoinductive properties due to the inherent bone morphogenetic protein that remains behind which stimulates the adjacent undifferentiated cells to form bone⁷. To the best of our knowledge, there are no studies where A-PRF block with xenograft was used in the management of Grade â…¡ furcation defects, so the aim of the present study is to evaluate the clinical and radiographic outcomes of Grade II furcation defects treated with A-PRF block and GTR membrane.