Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation

Abstract

The objective of this work is to compare the clinical and radiographic outcomes of demineralized freeze-dried bone allograft (DFDBA)/platelet-rich plasma (PRP) combination with PRP alone for the treatment of infrabony defects 18 months after surgery and to examine the influence of radiographic defect angle on the clinical and radiographic outcomes. Twenty-eight infrabony defects were treated with DFDBA/PRP combination or PRP alone. Clinical parameters and radiographic measurements were compared at baseline and 18 months. Interquartile range was performed to classify the defect angles. Mann-Whitney, Wilcoxon test, and Pearson correlation were used to analyze the data. The DFDBA/PRP combination exhibited more favorable gains in both clinical and radiographic parameters than PRP alone group (p < 0.05). A correlation existed between defect angle, defect depth, and clinical/radiographic outcomes for the defects treated with DFDBA/PRP. The narrow defects presented more favorable clinical attachment level values (CAL) gain, probing pocket depth (PPD) reduction and defect resolution than wide defects in the combination group (p < 0.05). The influence of baseline defect angle was not significant in the PRP-alone group (p > 0.05). The results indicate that DFDBA/PRP combination is more effective than PRP alone for the treatment of infrabony defects, and the amount of CAL gain, PPD reduction, and bone fill increases when the infrabony defect is narrow and deep before DFDBA/PRP combination treatment.

Effects of platelet-rich fibrin on healing of intra-bony defects treated with anorganic bovine bone mineral

“…Similarly, Ilgenli et al 36 reported a defect angle gain of 10.8º at 18 months after surgery in intra-bony defects treated with a DFDBA-PRP combination. In the present study, the defect angle increased from 37.87 ± 5.25º to 51.15 ± 4.02º in the test group and from 41.37 ± 5.92º to 53.09 ± 4.03º in the control group.…”

“…32,35 Conversely, the reduction in the depth of the defect obtained in the present study is lower compared to the reductions observed in a previous study which reported a 3.8-mm defect fill at the 18-month evaluation of defects treated with a DFDBA-PRP combination. 36 This can be attributed to the difference in the re-evaluation period, graft material and initial defect depth.…”

“…These results are in concordance with those of the aforementioned studies. 36,37 Several studies 15,16,17,38 have examined the suitability of autologous PRF for treatment of human intra-bony defects and revealed that PRF improves clinical 15 and radiographical 15,16,17,38 parameters. However, in the present study, no statistically significant differences were observed between both groups, except for the significant CAL gain noted in the test group.…”

The effect of platelet-rich plasma (PRP) combined with a bone allograft on human periodontal ligament (PDL) cells

“…The outcomes showed that the treatment with a combination of PRP with DFDBA or FDBA clinically improved the intrabony periodontal defects (Piemontese et al 2008;Ilgenli et al 2007) and enhanced the alveolar ridge and sinus augmentation for implant placement (Kassolis et al 2000). Furthermore, it has been showed that the application of the combination of PRP with a bovine derived xenograft (Yilmaz et al 2007), a porous hydroxyapatite graft Yamamiya et al 2008) and a bovine-derived matrix and peptide 15 (Hanna et al 2004;Pradeep et al 2009) had positive effect in the healing of intrabony defects.…”

Background and rationale of platelet gel in orthopaedic surgery

“…In orthopaedics, platelet gel is generally considered a tool for promoting bone repair, especially when combined with bone allografts [40]. Platelet gel seemed to be useful particularly in clinical situations where the bone repair was compromised, such as in diabetic fractures [41].…”