Evaluation of platelet-rich fibrin and tricalcium phosphate bone graft in bone fill of intrabony defects using cone-beam computed tomography: A randomized clinical trial

Abstract

Background: Platelet-rich fibrin (PRF) is the second-generation platelet concentrate first described by Choukron et al . It incorporates leukocytes, platelets, and growth factors within dense fibrin matrix, can be used in periodontal regeneration alone or in combination with bone grafts. Aim: This study assesses bone fill in intrabony defects, following the use of β tricalcium phosphate (TCP) bone graft with and without PRF. Materials and Methods: Thirty sites with intrabony defects in periodontitis patients were selected, randomly allotted into three groups: Group A open flap debridement (OFD), Group B OFD with β TCP with PRF, and Group C β TCP. Clinical parameters such as plaque index, gingival index, sulcus bleeding index, and PPD recorded at baseline and 6 months. Radiographic parameters include cementoenamel junction (CEJ) to base of defect, CEJ to alveolar crest, depth of defect, and bone fill assessed using the cone-beam computed tomography (CBCT). The comparison between the test group and control group in terms of clinical and radiographical parameters was assessed using the independent sample t -test. Results: Significant reduction in probing depth measurements, defect fill observed in both β TCP with PRF and β TCP alone groups compared to OFD. However, intergroup comparison assessed using the independent sample t -test found to be statistically nonsignificant ( P < 0.05 is considered significant). Conclusion: All three treatment strategies resulted in significant reduction in probing depth and bone fill at 6 months. Bone fill achieved in β TCP with PRF was more compared to β TCP alone and OFD at 6 months follow-up. CBCT can be accurately used to assess the morphology of intrabony defect and also in evaluating bone fill.

Efficacy of biologics for the treatment of periodontal infrabony defects: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

“…One‐hundred and twenty‐two treatment arms employed EMD 13 , 18,19,39,49,50,67,70,73,75–77,79,82,84–86,89,90,93,94,96–99,102,105–109 , 112–116,121–123,125,126,130,136–138,140–142,146,151,153,156–158,160,167–169,175 , 177,178,180,182–195,200–202,205–207,209–212 ,. 12 used rhPDGF‐BB 17,129,133,139,148,152,155,181 , 43 included PRF 19,71,72,74,78,80,81,83 , 88,91,92,103,110,115,120,131,144,145,149,150,154,162–165,170–174,196–198,203,204 , and 31 used PRP 68,87,95,100,101,117–119,124,127,128,132,134,135,143,147 , 159,161,166,173,174,179,199 . All in all 28 treatment arms also included a barrier membrane …”

“…The outcomes of flap procedures alone were reported in 54 study arms 18,39,49,70,72,74,76,78,80 , 82,84,86,87,89–92,94,105–109,113,121,128,131,149,152,158,163,164,169–173,175,177 , 178,190,195,198,200,203–205,210,212 . A total of 88 studies utilized BGs 17,19,49,50,67–71,75–78,80,81,83,84,86–88,91,94,95,97–102,104,110–112 , 114,116–120,122–124,126,127,129,130,132–135,137–148,150,153–157,159,161,164,166 , 167,170,174,179–181,187,192,193,196,197,199,206,208,209,211 , with 7 having utilized an autogenous BG 19,70,110,114,119,150,209 , 16 an allograft 67–69,77,78,81,88,116,123,124,135,147,156,157,166,197 , 28 a xenograft…”

Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects

“…In the present study, the radiographic parameters were assessed through CBCT, as it allows three-dimensional assessment and volumetric analysis which may depict a better representation of an intrabony defect than linear measurements, and could be an effective alternative for the surgical re-entry [ Figure 3b - d and 4b - d ]. [ 20 21 22 23 ] A significant gain in the bone volume ( P ≤ 0.05) and a highly significant defect fill ( P ≤ 0.001), defect resolution ( P ≤ 0.001) was observed in group A as compared to group B at 6 months post operatively. Our radiographic results are in agreement with the studies done by Elegandy et al,[ 18 ] Kasaj et al[ 12 ] and Pradeep et al[ 20 ]…”

Comparison between the regenerative potential of different types of platelet concentrates in periodontal intrabony defect management

“…Moreover, synergistic effect for bone regeneration was reported when PRF combined with decalcified freeze-dried bone allograft in IBDs in chronic periodontitis. [ 24 25 ]…”