1.
Platelet-rich fibrin in combination with decalcified freeze-dried bone allograft for the management of mandibular degree II furcation defect: A randomised controlled clinical trial
Agarwal A, Manjunath RGS, Sethi P, Shankar GS
Singapore dental journal. 2020;:1-8
Abstract
Background: Treatment of furcation involvement of molars with periodontal disease remains challenging and unpredictable. Platelet-rich fibrin (PRF) has received the attention of researchers due to its pleiotropic properties essential for periodontal wound healing. The osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully used in periodontal regeneration. Aim: The present study aimed to explore the effectiveness of PRF alone and with DFDBA in the treatment of mandibular degree II furcation defects in subjects with chronic periodontitis. Material and Methods: Patients treated were from the Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly. A total of 60 mandibular molars were treated with either open flap debridement (OFD) alone, PRF+OFD combination or OFD+PRF+DFDBA combination. The soft and hard tissue parameters such as vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival marginal level (GML), horizontal probing depth (HPD), vertical bone fill (VBF), horizontal bone fill (HBF) and furcation width (FW) were determined at baseline and 9 months postoperatively. A paired t-test was conducted to assess the statistical significance between time period within each group for clinical and radiographic parameters. ANOVA and post-hoc Tukey's tests were also conducted for intergroup comparison of soft and hard tissue parameters. Statistical significance was set at p<0.05. Results and Discussion: After 9 months, all treatment groups showed significant (p<0.001) improvement in soft and hard tissue parameters, except GML in all the three groups and HBF and FW in the OFD group as compared to baseline. The mean VBF change was highest in the OFD+PRF+DFDBA group (1.90+0.45) mm, followed by that in the PRF+OFD and OFD groups (1.60+0.88 and 0.45+0.51mm, respectively). Conclusions: It was shown that both PRF+OFD and PRF+DFDBA+OFD combinations were significantly advantageous for the management of mandibular degree II furcation defects. However, the PRF+DFDBA+OFD combination has significantly greater benefits than PRF+OFD combination in terms of VBF.
2.
Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail
Agarwal A, Gupta ND, Jain A
Acta Odontologica Scandinavica. 2016;74((1)):36-43.
Abstract
OBJECTIVE Polypeptide growth factors of platelet rich fibrin (PRF) have the potential to regenerate periodontal tissues. Osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully utilized in periodontal regeneration. The aim of the present randomized, split mouth, clinical trial was to determine the additive effects of PRF with a DFDBA in the treatment of human intrabony periodontal defects. MATERIALS AND METHODS Sixty interproximal infrabony defects in 30 healthy, non-smoker patients diagnosed with chronic periodontitis were randomly assigned to PRF/DFDBA group or the DFDBA/saline. Clinical [pocket depth (PD), clinical attachment level (CAL) and gingival recession (REC)] and radiographic (bone fill, defect resolution and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. RESULTS Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the PRP/DFDBA group exhibited statistically significantly greater changes compared with the DFDBA/saline group in PD (4.15 +/- 0.84 vs 3.60 +/- 0.51 mm), CAL (3.73 +/- 0.74 vs 2.61 +/- 0.68 mm), REC (0.47 +/- 0.56 vs 1.00 +/- 0.61 mm), bone fill (3.50 +/- 0.67 vs 2.49 +/- 0.64 mm) and defect resolution (3.73 +/- 0.63 vs 2.75 +/- 0.57 mm). CONCLUSION Observations indicate that a combination of PRF and DFDBA is more effective than DFDBA with saline for the treatment of infrabony periodontal defects.
3.
Platelet-rich plasma combined with decalcified freeze-dried bone allograft for the treatment of noncontained human intrabony periodontal defects: a randomized controlled split-mouth study
Agarwal A, Gupta ND
International Journal of Periodontics & Restorative Dentistry. 2014;34((5):):705-11.
Abstract
The aim of the present randomized split-mouth clinical trial was to compare plateletrich plasma (PRP) combined with a demineralized freeze-dried bone allograft (DFDBA) to DFDBA with a saline solution in the treatment of noncontained human periodontal intrabony defects. Forty-eight noncontained interproximal intrabony defects in 24 healthy nonsmoking patients diagnosed with chronic periodontitis were randomly assigned to the test group (PRP/DFDBA) or the control group (DFDBA/saline). Clinical (probing pocket depth, clinical attachment level [CAL], and gingival recession [REC]) and radiographic (bone fill, defect resolution, and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the test group exhibited statistically significantly greater changes compared with the control group in CAL (3.15 + 0.50 versus 2.40 + 0.61 mm), REC (0.54 + 0.59 versus 1.23 + 0.47 mm), bone fill (3.02 + 0.50 versus 2.37 + 0.47 mm), and defect resolution (3.29 + 0.53 versus 2.69 + 0.38 mm). Findings indicate that a combination of PRP and DFDBA is more effective than DFDBA with saline for the treatment of noncontained intrabony defects.