Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지
DOI QR코드

DOI QR Code

Platelet-rich fibrin along with a modified minimally invasive surgical technique for the treatment of intrabony defects: a randomized clinical trial

  • Ahmad, Nabila (Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences) ;
  • Tewari, Shikha (Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences) ;
  • Narula, Satish Chander (Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences) ;
  • Sharma, Rajinder Kumar (Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences) ;
  • Tanwar, Nishi (Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences)
  • Received : 2019.04.02
  • Accepted : 2019.09.11
  • Published : 2019.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The modified minimally invasive surgical technique (M-MIST) has been successfully employed to achieve periodontal regeneration. Platelet-rich fibrin (PRF) is known to enhance wound healing through the release of growth factors. This study aimed to observe the outcomes of periodontal surgery when M-MIST was used with or without PRF for the treatment of isolated intrabony defects. Methods: This randomized clinical trial was conducted on 36 systemically healthy patients, who had chronic periodontitis associated with a single-site buccal probing pocket depth (PPD) and clinical attachment level of ≥5 mm. Patients were randomly divided into 2 groups: the test group treated with M-MIST and PRF, and the control group treated with M-MIST alone. The primary periodontal parameters analyzed were PPD, relative attachment level (RAL), and relative gingival margin level. The radiographic parameters analyzed were change in alveolar crest position (C-ACP), linear bone growth (LBG), and percentage bone fill (%BF). Patients were followed up to 6 months post-surgery. Results: Intragroup comparisons at 3 and 6 months showed consistently significant improvements in PPD and RAL in both the groups. In intergroup comparisons, the improvement in PPD reduction, gain in RAL, and the level of the gingival margin was similar in both groups at 3 and 6 months of follow-up. Furthermore, an intergroup comparison of radiographic parameters also demonstrated similar improvements in C-ACP, LBG, and %BF at 6 months of follow-up. Conclusions: M-MIST with or without PRF yielded comparable periodontal tissue healing in terms of improvements in periodontal and radiographic parameters. Further investigation is required to confirm the beneficial effects of PRF with M-MIST.

Keywords

References

  1. Cortellini P, Tonetti MS. Clinical performance of a regenerative strategy for intrabony defects: scientific evidence and clinical experience. J Periodontol 2005;76:341-50. https://doi.org/10.1902/jop.2005.76.3.341
  2. Cortellini P, Tonetti MS. Microsurgical approach to periodontal regeneration. Initial evaluation in a case cohort. J Periodontol 2001;72:559-69. https://doi.org/10.1902/jop.2001.72.4.559
  3. Cortellini P, Tonetti MS. Minimally invasive surgical technique and enamel matrix derivative in intra-bony defects. I: clinical outcomes and morbidity. J Clin Periodontol 2007;34:1082-8. https://doi.org/10.1111/j.1600-051X.2007.01144.x
  4. Cortellini P, Tonetti MS. Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects. J Clin Periodontol 2009;36:157-63. https://doi.org/10.1111/j.1600-051X.2008.01352.x
  5. Cortellini P, Tonetti MS. Clinical and radiographic outcomes of the modified minimally invasive surgical technique with and without regenerative materials: a randomized-controlled trial in intra-bony defects. J Clin Periodontol 2011;38:365-73. https://doi.org/10.1111/j.1600-051X.2011.01705.x
  6. Mishra A, Avula H, Pathakota KR, Avula J. Efficacy of modified minimally invasive surgical technique in the treatment of human intrabony defects with or without use of rhPDGF-BB gel: a randomized controlled trial. J Clin Periodontol 2013;40:172-9. https://doi.org/10.1111/jcpe.12030
  7. Choukroun J, Adda F, Schoeffler C, Vervelle AP. An opportunity in perio-implantology: the PRF. Implantodontie 2001;42:55-62.
  8. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:e37-44. https://doi.org/10.1016/j.tripleo.2005.07.008
  9. Tatullo M, Marrelli M, Cassetta M, Pacifici A, Stefanelli LV, Scacco S, et al. Platelet Rich Fibrin (P.R.F.) in reconstructive surgery of atrophied maxillary bones: clinical and histological evaluations. Int J Med Sci 2012;9:872-80. https://doi.org/10.7150/ijms.5119
  10. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:e51-5. https://doi.org/10.1016/j.tripleo.2005.07.010
  11. Gassling V, Douglas T, Warnke PH, Acil Y, Wiltfang J, Becker ST. Platelet-rich fibrin membranes as scaffolds for periosteal tissue engineering. Clin Oral Implants Res 2010;21:543-9. https://doi.org/10.1111/j.1600-0501.2009.01900.x
  12. He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:707-13. https://doi.org/10.1016/j.tripleo.2009.06.044
  13. Patel GK, Gaekwad SS, Gujjari SK, S C VK. Platelet-rich fibrin in regeneration of intrabony defects: a randomized controlled trial. J Periodontol 2017;88:1192-9. https://doi.org/10.1902/jop.2017.130710
  14. Sharma A, Pradeep AR. Autologous platelet-rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. J Periodontol 2011;82:1396-403. https://doi.org/10.1902/jop.2011.100731
  15. Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D. Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. J Periodontol 2009;80:244-52. https://doi.org/10.1902/jop.2009.080253
  16. Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM. Sinus floor augmentation with simultaneous implant placement using Choukroun's platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. J Periodontol 2009;80:2056-64. https://doi.org/10.1902/jop.2009.090252
  17. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4:1-6. https://doi.org/10.1902/annals.1999.4.1.1
  18. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol 2018;89 Suppl 1:S159-72. https://doi.org/10.1002/JPER.18-0006
  19. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121-35. https://doi.org/10.3109/00016356408993968
  20. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-51. https://doi.org/10.3109/00016356309011240
  21. Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012;9:671-5. https://doi.org/10.1038/nmeth.2089
  22. Jayakumar A, Rajababu P, Rohini S, Butchibabu K, Naveen A, Reddy PK, et al. Multi-centre, randomized clinical trial on the efficacy and safety of recombinant human platelet-derived growth factor with ${\beta}$-tricalcium phosphate in human intra-osseous periodontal defects. J Clin Periodontol 2011;38:163-72. https://doi.org/10.1111/j.1600-051X.2010.01639.x
  23. Eickholz P, Horr T, Klein F, Hassfeld S, Kim TS. Radiographic parameters for prognosis of periodontal healing of infrabony defects: two different definitions of defect depth. J Periodontol 2004;75:399-407. https://doi.org/10.1902/jop.2004.75.3.399
  24. Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol 2004;4:26. https://doi.org/10.1186/1471-2288-4-26
  25. Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 2009;27:63-9. https://doi.org/10.1080/08977190802636713
  26. Blair P, Flaumenhaft R. Platelet alpha-granules: basic biology and clinical correlates. Blood Rev 2009;23:177-89. https://doi.org/10.1016/j.blre.2009.04.001
  27. Dohan Ehrenfest DM, Diss A, Odin G, Doglioli P, Hippolyte MP, Charrier JB. In vitro effects of Choukroun's PRF (platelet-rich fibrin) on human gingival fibroblasts, dermal prekeratinocytes, preadipocytes, and maxillofacial osteoblasts in primary cultures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:341-52. https://doi.org/10.1016/j.tripleo.2009.04.020
  28. Jaquet K, Krause K, Tawakol-Khodai M, Geidel S, Kuck KH. Erythropoietin and VEGF exhibit equal angiogenic potential. Microvasc Res 2002;64:326-33. https://doi.org/10.1006/mvre.2002.2426
  29. Ribeiro FV, Casarin RC, Junior FH, Sallum EA, Casati MZ. The role of enamel matrix derivative protein in minimally invasive surgery in treating intrabony defects in single-rooted teeth: a randomized clinical trial. J Periodontol 2011;82:522-32. https://doi.org/10.1902/jop.2010.100454
  30. Chandradas ND, Ravindra S, Rangaraju VM, Jain S, Dasappa S. Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: a randomized controlled trial. J Int Soc Prev Community Dent 2016;6:S153-9. https://doi.org/10.4103/2231-0762.189753
  31. Pradeep AR, Bajaj P, Rao NS, Agarwal E, Naik SB. Platelet-rich fibrin combined with a porous hydroxyapatite graft for the treatment of 3-wall intrabony defects in chronic periodontitis: a randomized controlled clinical trial. J Periodontol 2017;88:1288-96. https://doi.org/10.1902/jop.2012.110722
  32. Agarwal A, Gupta ND, Jain A. Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail. Acta Odontol Scand 2016;74:36-43. https://doi.org/10.3109/00016357.2015.1035672
  33. Lekovic V, Milinkovic I, Aleksic Z, Jankovic S, Stankovic P, Kenney EB, et al. Platelet-rich fibrin and bovine porous bone mineral vs. platelet-rich fibrin in the treatment of intrabony periodontal defects. J Periodontal Res 2012;47:409-17. https://doi.org/10.1111/j.1600-0765.2011.01446.x

Cited by

  1. Comparison of Regenerative Potential of Platelet-rich Fibrin Alone and in Combination with Bovine Bone Graft in Intraosseous Defect by Single Flap Approach: A Clinical and Radiographic Study vol.10, pp.6, 2019, https://doi.org/10.4103/jispcd.jispcd_200_19
  2. Effects of Connective Tissue Growth Factor on the Cell Viability, Proliferation, Osteogenic Capacity and mRNA Expression of Stem Cell Spheroids vol.11, pp.14, 2019, https://doi.org/10.3390/app11146572
  3. PRP and PRF-Subgroups and Divisions When Used in Dentistry vol.11, pp.10, 2021, https://doi.org/10.3390/jpm11100944