Evaluation of efficacy of autologous platelet-rich fibrin with demineralized-freeze dried bone allograft in the treatment of periodontal intrabony defects

Abstract

Background:Platelet-rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. The purpose of the study was to clinically evaluate and compare the efficacy of autologous PRF combined with demineralized freeze-dried bone allograft (DFDBA) to DFDBA alone in the treatment of periodontal intrabony defects.Materials and Methods:In a split mouth study design, 10 patients having two almost identical intrabony defects with clinical probing depth of at least 6 mm were selected for the study. Selected sites were randomly divided into two groups. In Group I, mucoperiosteal flap elevation followed by the placement of DFDBA was done. In Group II, mucoperiosteal flap elevation followed by the placement of homogeneous mixture of PRF with DFDBA was done. Clinical and radiographic parameters were recorded at baseline and at 6 months post-operatively.Results:Both treatment groups showed a significant probing pocket depth reduction, clinical attachment gain, defect fill, and defect resolution 6 months after surgery compared to baseline. However, there was a significantly greater probing pocket depth reduction and clinical attachment gain when PRF was added to DFDBA.Conclusion:Within limits of the study it may be concluded that a combination of PRF with DFDBA demonstrated better results in probing pocket depth reduction and clinical attachment level gain as compared to DFDBA alone in the treatment of periodontal intrabony defects.

Successful management of a case of true radicular dens invaginatus using platelet‐rich fibrin and guided tissue regeneration

“…Periodontal regeneration aims to regenerate bone, cementum and periodontal ligament lost due to the disease process and the reasoning behind the techniques chosen in this case is described below . The use of DFDBA faciliates periodontal regeneration due to its osteoinductive and osteoconductive properties.…”

“…These growth factors are progressively released over a period of time as the fibrin network disintegrates . Studies have shown that PRF with DFDBA results in probing pocket depth reduction and gain in clinical attachment level when compared to DFDBA alone . This was attributed to the haemostatic effect of PRF and also its effects as a biologic connector that holds the graft materials together .…”

“…Studies have shown that PRF with DFDBA results in probing pocket depth reduction and gain in clinical attachment level when compared to DFDBA alone . This was attributed to the haemostatic effect of PRF and also its effects as a biologic connector that holds the graft materials together . Although few studies have reported the beneficial effect of PRF on proliferation and differentiation of osteoblast, limited availability of PRF restricts its sole use to fill large through‐and‐through bony defects .…”

L-PRF: A “Super” Biomaterial for Naturally Guided Hard/Soft Tissue Bioengineering and Regeneration of Oro-Dental, Periodontal and Jaw Defects

“…Five RCTs addressing the prospective application of L-PRF in the treatment of Periodontal IBD were found. The identified studies allowed for the following comparisons: (a) L-PRF/Open flap surgery vs. Open flap surgery [10][11][12], (b) L-PRF/Bio-Oss® constructs (Bio-Oss®, Geistlich Pharma North America, Inc.) vs. L-PRF [13] and (c) L-PRF/DFDBA constructs vs. DFDBA (Demineralized Freeze-Dried Bone Allograft) [14]. All patients included in those studies were periodontally stable and systemically healthy individuals who presented: similar bilateral IBD of at least 5 mm probing depth, located in vital asymptomatic teeth with no furcation involvement.…”

“…The presented PD reduction and CAL gain values were superior to previously-reported values in meta-analysis performed for open flap surgery [9], suggesting the additional benefits of L-PRF over the conventional approach. Treatment with L-PRF/particulate bone-graft substitutes (Bio-Oss® [13] and DFDBA [14]) provided additional statistically-significant benefits, in terms of PD reduction, CAL gain and bone defect fill vs. graft substitutes, after 6 months. Nonetheless, the absence of "simultaneously-run" L-PRF-alone control renders it difficult to distinguish between the effects of L-PRF and other potential variables in the study.…”