Use of platelet-rich plasma in periodontal surgery—a prospective randomised double blind clinical trial

Abstract

The aim of this prospective controlled randomized clinical trial was to evaluate the additional effect of platelet-rich plasma (PRP) in attachment gain. Twenty-two patients showing contralateral intrabony defects were included. Defects were randomized to beta-TCP (Cerasorb) in combination with PRP (test) or alone (control). Probing pocket depth (PPD), clinical attachment level (CAL), and relative AL (RAL) were assessed at the first, initial, re-evaluation (or basis examinations) and 6 months after surgery. Defect dimensions were recorded at baseline surgery (day 0) and during re-entry surgery (after 6 months), with vertical depth of the defect as primary outcome variable. An early healing index (EHI) was assessed 3 days, 1, 2 and 4 weeks after surgery. Both treatments led to clinical improvements. The median reduction of open vertical depth was 1.9 mm (interquartile intervals, 0.75 and 2.5 mm) at test sites, compared with 2.6 mm (1.8 and 3.5 mm) at control sites (p = 0.19, Wilcoxon). The median reductions of PPD and CAL at the four sites in close proximity to the defect in the interproximal area at test sites were 0.8 and 0.28 mm, and at control sites 0.4 and 0.13 mm, respectively. The EHI showed a reduction from grade 3 after 3 days to grade 1 after 4 weeks. PRP did not improve the results achieved with beta-TCP in the treatment of intrabony defects.

Effect and timing of non-surgical treatment prior to periodontal regeneration: a systematic review

“…The length of clinical and radiographic follow-up after surgery ranged from 6 months to 10 years. The reported PPD reductions from baseline to last follow-up after surgery ranged from 0.5 [22] to 9.3 mm [19] (median across studies 4.1 mm), while CAL reductions ranged from 0.6 [23] to 8.2 mm [19] (median across studies 3.2 mm). Sixty-eight studies reported baseline and follow-up linear radiographic bone changes after surgery, ranging from overall bone gains of 0.2 [24] to 9.3 mm [19] (median across studies 3.3 mm).…”

Adjunctive Platelet-Rich Plasma (PRP) in Infrabony Regenerative Treatment: A Systematic Review and RCT’s Meta-Analysis

“…Out of these, 3 papers were further rejected for the following reasons: two studies did not provide a control group [13, 14] and one was not a fully RCT [15]. Two articles were rejected because they did not provide comprehensive data and/or standard deviations to be analysed [16, 17]. …”

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

“…But when the local conditions are not optimum, PRP gels alone are not strong enough to promote a clinical filling equivalent to the dense bone filling reached with a bone substitute [50]. Most of the randomized controlled clinical trials(RCTs) demonstrated that the addition of PRP to certain regenerative materials, doi: 10.7243/2050-1218-2-11 namely bioactive glass [51], b-TCP [52], BM and e-PTFE membranes [53], b-TCP and e-PTFE membranes [54], BM and collagen membranes [23] and BM and EMD [55], failed to confer statistically significant additive benefits in the therapy of periodontal intraosseous defects. However, according to other RCTs such adjunctive positive outcomes may result from other combinations of PRP, namely together with BM [28], DFDBA [56] and hydroxyapatite [22].…”