Effect of advanced platelet-rich fibrin applications on periodontal regeneration in infrabony pocket treatment

Abstract

One of the regenerative periodontal treatments for infrabony pocket is open flap debridement (OFD) with the addition of growth factor derived from platelet concentrate. Advanced platelet-rich fibrin (A-PRF) is a further development of plateletrich fibrin (PRF) with a lower centrifugation speed (1,500 rpm, 14 minutes). The purpose of this study was to examine the differences in periodontal tissue regeneration after the application of A-PRF and PRF in the treatment of infrabony pockets evaluated from probing depth (PD), relative attachment loss (RAL), and alveolar bone height. The samples were taken from 20 infrabony pockets divided into 2 groups: 10 subjects were treated with OFD+A-PRF and OFD+PRF on the remaining subjects. Probing depth (PD) and relative attachment loss (RAL) measurement were performed on days 0, 30, and 90. Bone height measurements were performed using CBCT X-rays on days 0 and 90. The results showed that PD and RAL reduction in the group of OFD+A-PRF was significantly greater than that in the OFD+PRF group. Bone height reduction in both groups showed no difference. The conclusion obtained from this study is A-PRF application enhances periodontal tissue regeneration by generating greater probing depth and relative attachment loss reduction compared to PRF, as well as an increase in bone height similar to in the treatment of infrabony pockets.

Third-Generation Platelet Concentrates in Periodontal Regeneration: Gaining Ground in the Field of Regeneration

“…When compared to PRF, A-PRF improves periodontal weakened sites by regenerating tissues by increasing parameters like probing depth, lowering relative attachment loss, and increasing bone height, which is similar to infrabony pocket treatment [8]. A-PRF improves soft tissue recovery at extraction sites and reduces postoperative discomfort and the requirement for analgesics [7].…”

Comparative Evaluation of Clinical Efficacy of Leukocyte-Rich Platelet-Rich Fibrin with Advanced Platelet-Rich Fibrin in Management of Gingival Recession Defects: A Randomized Controlled Trial

“…A-PRF was found to contain increased levels of VEGF, responsible for angiogenesis, monocytes as a source for bone morphogenetic proteins (BMPs), and fibronectin for extracellular matrix formation [ 9 , 10 , 11 ]. Various in vitro and in vivo studies have shown the positive outcomes with A-PRF in hard and soft tissue regeneration [ 12 , 13 , 14 , 15 , 16 ]. However, the potential benefit of A-PRF in management of gingival recession has not yet been established.…”

Effect of advanced-platelet rich-fibrin combined with rosuvastatin application after open flap debridement of infrabony pocket

“…18 The different number of growth factors between A-PRF and PRF is enough to make significant differences in the value of PD and RAL according to Suwondo et al (2018) who compared OFD + PRF and OFD + A-PRF. 10 1.2% rosuvastatin gel was added in both groups in this study to maximize healing process and regeneration of soft and hard periodontal tissues. The pleiotropic effects of 1.2% rosuvastatin gel, such as antioxidants, anti-inflammation, osseo-modulation, and immunomodulation play role in the healing process of periodontal tissues by modifying host regeneration.…”

“…However, there was no difference in the increase in alveolar bone height because PRF only had an effect on the first initial stage, i.e., osteogenesis phase by optimizing osteoblast diffierentiation. 10 Pradeep et al (2016) showed that OFD + PRF + 1.2% rosuvastatin (RSV) gel was able to decrease the value of clinical attachment level (CAL) and PD and significantly repair the infrabony defect better than OFD + PRF and OFD treatment. 4 The 1.2% RSV gel acts as host modulation therapy which aims to reduce tissue damage and regenerate the inflamed tissue by modifying the response of host factors.…”