Bone Regeneration in Bilateral Mandibular Third Molar Trans-Alveolar Extraction Sockets With PRF v/S PRF Infused With Metronidazole- A Comparative Study

Abstract

BACKGROUNDPlatelet Rich Fibrin has stood the test of time as an excellent augmenter of bone regeneration. It is not only cost effective and easy to produce, it also releases the much-needed cytokine cascade that promotes both soft tissue healing and bone regeneration. It is however, of utmost importance to establish other potentials of this widely used autologous agent to accelerate bone regeneration. We wanted to explore if addition of an antibiotic to PRF to improves its inherent qualities. We wanted to assess radiographically the changes in bone regeneration rate and soft tissue healing between bilateral mandibular third molar trans-alveolar extraction sockets placed with platelet-rich fibrin (PRF) alone as compared to platelet rich fibrin (PRF) gel infused with Metronidazole. METHODSFifty patients undergoing bilateral mandibular third molar extractions were included in the study. PRF was inserted into the extraction socket on one side (Group A) and PRF gel infused with Metronidazole into the socket on the contra-lateral side (Group B). The soft tissue healing of the surgical sites after one week and bone regeneration rates of both the groups was assessed radiographically at 1 week, 1 month, 2 months, 3 months and 6 months and compared statistically. RESULTSThe study was done between May 2010 and January 2012 on 50 patients with 20 women (30%) and 30 men (70%) with a mean age of 25 years. The healing of soft tissues was considerably better in Group B. The bone regeneration was also significantly higher in Group B than Group A at each of the follow-up intervals. CONCLUSIONSPlatelet rich fibrin gel with Metronidazole could significantly increase the amount of new bone formation in comparison to that of PRF alone. Also, soft tissue healing was more satisfactory and predictive in those receiving PRF gel with Metronidazole.