Comparison of GTR, T-PRF and open-flap debridement in the treatment of intrabony defects with endo-perio lesions: a randomized controlled trial

Abstract

Background: Titanium-prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. Material and Methods: A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later. Results: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. Conclusion: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions.

Use of Platelet-Rich Fibrin in the Treatment of Periodontal Intrabony Defects: A Systematic Review and Meta-Analysis

“…No selective reporting was found. Other bias was found in the studies of Rosamma et al [13] and Ustaoğlu et al [37] for no measurement calibration. According to the Cochrane Collaboration's tool for assessing the risk of bias, thirteen [21-24, 26-30, 32-34, 36] of the selected studies presented a moderate risk of bias, whereas five studies [13,25,31,35,37] exhibited a high risk of bias.…”

“…A PRISMA flow diagram that depicts this selection process is displayed in Figure 1 Table 1. All the 18 studies were RCTs, of which 9 [13,[21][22][23][24][25][26][27][28] were split-mouth design and 9 [29][30][31][32][33][34][35][36][37] were parallel arm design. All the subjects were systematically healthy adults who suffered periodontitis with intrabony defects, except for one study [37] in which participants had periodontal-endodontic lesions with intrabony defects.…”

“…The use of PRF as sole biomaterial or in combination with bone substitute grafting was used in the test group, while OFD alone or combined with bone substitute grafting was used in the control group. In terms of results assessment, there was no measurement calibration reported in two studies [13,37]. Customized acrylic stents with grooves were used for measurement of clinical parameters using a periodontal probe, except for the two studies [13,23] using a periodontal probe only.…”

Evaluation of titanium-prepared platelet-rich fibrin and leucocyteplatelet-rich fibrin in the treatment of intra-bony defects: Arandomized clinical trial

“…The results of the present study regarding a decreased PI, a reduction in PPD, a gain in CAL, and an improvement in bone fill nine months postoperatively were consistent with a recent study by Ustaouglu et al 38 They achieved a significant reduction in PPD, gain in CAL, and improvement in defect depth nine months postoperatively in their T-PRF, GTR (guided tissue regeneration), and OFD study groups. However, they reported no significant difference between the T-PRF and GTR groups.…”

“…These improvements in radiographic parameters in the present study might be because longer resorption time of T-PRF stimulated more cells, which in turn increased osteoprotegerin levels, and new bone was formed through osteoblastogenesis. 37 The results of the present study regarding a decreased PI, a reduction in PPD, a gain in CAL, and an improvement in bone fill nine months postoperatively were consistent with a recent study by Ustaouglu et al 38 They achieved a significant reduction in PPD, gain in CAL, and improvement in defect depth nine months postoperatively in their T-PRF, GTR (guided tissue regeneration), and OFD study groups. However, they reported no significant difference between the T-PRF and GTR groups.…”