Platelet Rich Fibrin and Bone Graft in the Treatment of Intrabony Defect in Periodontitis Patients
PDF

Keywords

Bone graft
clinical attachment loss
periodontitis
platelet rich fibrin
pocket depth
regeneration

Abstract

Background: Porous hydroxyapatite and β-tricalcium phosphate (β-TCP + HA) bone grafting material has resulted in clinically acceptable responses when used to fill the periodontal intrabony defects. PRF is an autologous leukocyte and platelet preparation that concentrates various polypeptide growth factors which therefore holds potential to be used as regenerative treatment for periodontal defects.

Aim: The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with platelet rich fibrin compared to alloplastic bone graft material.

Materials and Methods: Twenty subjects (10 subject per group, one site/subject) were treated either with platelet rich fibrin or alloplastic bone graft (30% β-TCP+ 70% HA). Primary clinical parameters: PD, CAL were taken at baseline, three months, six months and nine months post-operatively. Standardised radiographic data were collected at baseline, six months and nine months postoperatively.

Results: Preoperative parameters were similar for both groups. Postsurgical measurements revealed a greater reduction in pocket depth in bone graft group (2.5 mm), greater CAL gain (2.2 mm) and greater defect fill (1.30 mm) as compared to platelet rich fibrin group (1.50 mm, 1.6 mm and 0.80 mm respectively ) at nine months.

Conclusion: Treatment of intrabony defects with alloplast (30% β TCP+ 70% HA) or platelet rich fibrin both resulted in a significant probing depth reduction, CAL gain and bone depth reduction, with significantly better improvement in bone graft group.

Keywords: Bone graft; clinical attachment loss; periodontitis; platelet rich fibrin; pocket depth; regeneration.

PDF

References

Preeja C, Arun S. Platelet-rich fibrin: Its role in periodontal regeneration. Saudi J Dent Res. 2014;5(2):117-22.

William VG. The potential role of growth and differentiation factors in periodontal regeneration. J. Periodontol. 1996;67:545-53.

Melcher AH. On the repair potential of periodontal tissues. J Periodontol. 1976;47(5):256-60.

Cortellini P, Tonetti MS. Clinical concepts for regenerative therapy in intrabony defects. Periodontol 2000. 2015;68(1):282-307.

Lekovic V, Milinkovic I, Aleksic Z, Jankovic S, Stankovic P, Kenney EB, Camargo PM. Platelet-rich fibrin and bovine porous bone mineral vs. platelet-rich fibrin in the treatment of intrabony periodontal defects. J Periodont Res. 2012;47(4):409-17.

Low SB, King CJ, Krieger J. An evaluation of bioactive ceramic in the treatment of periodontal osseous defects. Int J Periodontics Restorative Dent. 1997;17(4):358-67.

Giannoudis PV, Dinopoulos H, Tsiridis E. Bone substitutes: an update. Injury. 36 Suppl 3:S20-7.

Choukroun J, Adda F, Schoeffler C, Vervelle AP. Une opportunité en paro-implantologie: le PRF. Implantodontie. 2001;42:55-62.

Fujioka-Kobayashi M, Miron RJ, Hernandez M, Kandalam U, Zhang Y, Choukroun J. Optimized platelet-rich fibrin with the low-speed concept: growth factor release, biocompatibility, and cellular response. J Periodontol. 2017;88(1):112-21.

Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors. 2009;27(1):63-9

Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odont Scand. 1964;22(1):121-35.

Updegrave WJ. The paralleling extension-cone technique in intraoral dental radiography. Oral Surg Oral Med Oral Pathol. 1951;4(10):1250-61.

Schei O, Waerhaug J, Lovdal A, Arno A. Alveolar bone loss as related to oral hygiene and age. J Periodontol. 1959;30(1):7-16.

Björn HI, Halling AR, Thyberg HÅ. Radiographic assessment of marginal bone loss. Odontologisk Revy. 1969;20(2):165-79

Sharma A, Pradeep AR. Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial. J Periodontol. 2011;82(12):1705-12.

Thorat M, Pradeep AR, Pallavi B. Clinical effect of autologous platelet-rich fibrin in the treatment of intra-bony defects: a controlled clinical trial. J Clin Periodontol. 2011;38(10):925-32.

Czuryszkiewicz-Cyrana J, Banach J. Autogenous bone and platelet-rich plasma (PRP) in the treatment of intrabony defects. Adv Med Sci. 2006;51(Suppl 1):26-30.

Chadwick JK, Mills MP, Mealey BL. Clinical and radiographic evaluation of demineralized freeze-dried bone allograft versus platelet-rich fibrin for the treatment of periodontal intrabony defects in humans. J Periodontol. 2016;87(11):1253-60.

Tonetti MS, Pini-Prato G, Cortellini P. Periodontal regeneration of human intrabony defects. IV. Determinants of healing response. J Periodontol. 1993;64(10):934-40

Ehmke B, Rüdiger SG, Hommens A, Karch H, Flemmig TF. Guided tissue regeneration using a polylactic acid barrier. J Clin Periodontol. 2003;30(4):368-74.

Garrett S, Loos B, Chamberlain D, Egelberg J. Treatment of intraosseous periodontal defects with a combined adjunctive therapy of citric acid conditioning, bone grafting, and placement of collagenous membranes. J Clin Periodontol. 1988;15(6):383-9.

Silvestri M, Sartori S, Rasperini G, Ricci G, Rota C, Cattaneo V. Comparison of infrabony defects treated with enamel matrix derivative versus guided tissue regeneration with a nonresorbable membrane. J Clin Periodontol. 2003;30(5):386-93.

Cortellini P. Radiographic defect angle influences the outcomes of GTR therapy in intrabony defects. J Dent Res. 1999;78:2208.

Nasr HF, Aichelmann-Reidy ME, Yukna RA. Bone and bone substitutes. Periodontol 2000. 1999;19(1):74-86.