Use of platelet rich plasma in the management of periodontal intra-osseous defects: A clinical study

Abstract

Background:Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment, and alveolar bone around the affected tooth. Alveolar bone support and attachment apparatus regeneration has been achieved through various processes and have given elusive results. An expedient and cost-effective approach to obtain autologous platelet-derived growth factor (PDGF) and transforming growth factor (TGF)-β is the use of platelet-rich plasma (PRP). PRP is obtained by sequestrating and concentrating platelets by gradient density centrifugation.Aims:The current study was aimed at evaluating the regenerative potential of platelet-rich plasma in comparison with open flap debridement.Settings and Designs:This study was a randomized controlled clinical trial conducted in the Department of Periodontics and Oral Implantology, KIDS, Bhubaneswar, Odisha.Materials and Methods:Twenty periodontal infrabony defects in 10 patients; 6 males and 4 females of age between 25–45 years were included in this study and were followed up for a period of 6 months.Statistical Analysis:Both the groups showed a mean plaque index of 2.10 and 2.50 at baseline, 1.75 and 2.05 at 3 months, and 1.28 and 1.53 at the end of 6 months. The mean reduction of 0.35 and 0.45 at three months and 0.82 and 0.97 at six months was achieved, which was statistically significant. (P < 0.001). When comparison was done between the two groups it was not found to be statistically significant (P < 0.05). In each of the group there was definitive reduction in plaque score over a period of time.Results and Conclusion:There was no statistically significant difference in the treatment outcome between open flap debridement and PRP alone. Platelet-rich plasma application holds promise and needs further exploration.

Platelet-rich plasma stimulated proliferation, migration, and attachment of cultured periodontal ligament cells

“…Platelet-rich plasma (PRP) has been widely utilized in the periodontal regeneration. [ 1 2 ] Theoretically, PRP can deliver several concentrated growth factors, for example, platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β) that may act simultaneously to form a cascade of different signal proteins with multiple pathway. [ 3 ] Other than growth factors, the fibrin clot produced by fibrinogen within PRP could up-regulate type I collagen expression by periodontal ligament (PDL) cells.…”

Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study

“…The ultimate goal of periodontal therapy is the creation of an environmental that is conducive to maintain patient dentition in a state of optimum health, comfort and function [ 17 ]. The deep intraosseous periodontal defects presents a major challenge in achieving the goal as it increases the risk of disease progression and recurrence after systematic traditional periodontal therapy.…”

“…Regenerative periodontal therapy aims to reform and reconstitute the supporting tissues of teeth which have been lost due to periodontal disease and trauma. Several regenerative therapeutic procedures have been developed for this purpose; have met with partial or marginal success [ 17 ]. These include root surface biomodification, use of various types of bone grafts, guided tissue regeneration and combination of the above.…”

“…It has been used in periodontal defects with various alloplasts, bovine and natural porous bone mineral along with barrier membrane. [ 15 - 17 ]. The positive impact of PRP on bone healing is attributed to angiogenic, proliferate and differentiating effect of PDGF and TGF present in high concentration.…”

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“…Platelet-rich plasma (PRP) has been widely utilized in the periodontal regeneration. [1,2] Theoretically, PRP can deliver several concentrated growth factors, for example, platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β) that may act simultaneously to form a cascade of different signal proteins with multiple pathway. [3] Other than growth factors, the fibrin clot produced by fibrinogen within PRP could up-regulate type I collagen expression by periodontal ligament (PDL)…”