The efficacy of inorganic bovine bone combined with leukocyte and platelet-rich fibrin or collagen membranes for treating unfavorable periodontal infrabony defects. Randomized noninferiority trial

Department of Innovative Technologies, in Medicine and Dentistry, "G. D'Annunzio" University, Chieti-Pescara, Italy. Department of Surgical Science, Plastic and Reconstructive Surgery, Tor Vergata University, Rome, Italy. "Luisa D'Annunzio" Institute for High Culture, Pescara, Italy.

Journal of periodontology. 2021
BACKGROUND Growing evidence shows the efficacy of platelet concentrates in periodontal therapy. This study aimed to demonstrate that an inorganic bovine bone graft (IBB) in combination with a leukocyte and platelet rich fibrin (L-PRF) is noninferior to a combination with a collagen membrane (CM) when managing unfavorable infrabony defects (IBDs). METHODS All patients exhibited at least one unfavorable IBD; they were randomly assigned to two groups, 31 treated with L-PRF+IBB and 31 with CM+IBB. A clinical and radiographic examination was carried out at baseline and 12 months later. Clinical attachment level (CAL), gingival recession (GR), probing pocket depth (PPD), and radiographic defect bone level (DBL) post-therapy changes were compared between the two treatments. A non-inferiority margin = 1mm was set to determine the efficacy of the test treatment (-1mm for GR); a second non-inferiority margin = 0.5mm (-0.5mm for GR) was chosen for clinical relevance. RESULTS Twelve months after surgery a significant improvement of clinical and radiographic parameters was observed at both experimental sites. The 90% CIs of the CM+IBB - L-PRF+IBB mean difference for CAL gain [-0.810mm (-1.300 to -0.319)] and DBL gain [-0.648mm (-1.244 to -0.052)] were below the 0.5 mm non-inferiority margin; GR Increase [1.284mm (0.764 to 1.804)] remained above the -0.5mm, while PPD reduction [0.499mm (0.145 to 0.853)] crossed its 0.5mm margin. CONCLUSIONS The L-PRF+IBB treatment of unfavorable IBDs offers non-inferior efficacy for CAL gain, showing less GR and more DBL gain too, while for PPD reduction it is inferior to the CM+IBB treatment. This article is protected by copyright. All rights reserved.
Study details
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine