Surgical Treatment of Infrabony Defects With Autologous Platelet Concentrate or Bioabsorbable Barrier Membrane: A Prospective Case Series

Abstract

This case series of five similar, but not identical, bilateral paired infrabony defects suggests that an APC graft achieves a similar CAL gain and PD reduction to GPR using an MEM over a 52-week period. A larger, controlled clinical trial is needed to evaluate further the efficacy of autologous platelet-rich plasma for the treatment of infrabony defects.

A clinical and radiographic evaluation of the management of periodontal osseous defects with alloplast and platelet rich plasma

“…Histomorphometric analysis revealed a higher percentage of bone contact in cases where PRP was used in conjunction with bone graft [33]. Some authors showed that the filling with a PRP gel alone achieved a similar bone regeneration than the use of a membrane for guided tissue regeneration [46,47] or even than the filling with a bone substitute [48]. However, other authors demonstrated that PRP alone was not able to support a significant bone regeneration [25] and that PRP should be associated to other materials in order to give good results for the healing of periodontal lesions [49].…”

Comparative Evaluation of Platelet-rich Plasma and Guided Tissue Regeneration Membrane in the Healing of Apicomarginal Defects: A Clinical Study

“…PRP is much easier to manipulate, is easily secured in place, is inexpensive, produces no inflammatory reaction, and decreases the frequency of intraoperative and postoperative bleeding. This autologous product also eliminates the concern about immunogenic reactions and disease transmission as compared with GTR membrane (bovine origin) and graft materials (15,17,39).…”

“…Allogenic fibrin glue was shown to have space-maintaining ability in the surgical treatment of infrabony defects (40), which is associated with higher periodontal regeneration. It may be hypothesized that limited and similar alveolar bone formation in the treatment groups is the result of the physical and chemical properties of PRP (17,18). Thus, the PRP not only acts as a barrier in preventing apical migration of the epithelium during early phases of wound repair but also contributes to the new bone formation with time.…”

“…The aggregation of platelets releases chemotactic factors for leukocytes along with growth factors such as platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-a and -b, which promote tissue regeneration (16). One case series (17) and one histologic study (18) comparing autologous platelet concentrate with a bioabsorbable membrane in periodontal defects found similar results between the two groups, suggesting that autologous platelet concentrate could be used in lieu of a membrane for periodontal GTR applications (17,18). However, in endodontics, no reports have been found comparing the efficacy and equivalence of PRP with GTR membrane during the treatment of apicomarginal defects.…”

Periodontal and Endodontic Regeneration

“…Similarly, autologous platelet concentrate (APC) contains PDGFs that promote regeneration. One study comparing APC with a bioabsorbable membrane in infrabony defects found similar results between the 2 groups, suggesting that APC could be used in lieu of a membrane for periodontal GTR applications (72).…”