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

Abstract

Background: Porous hydroxyapatite (HA) bone grafting material has been used to fill periodontal intrabony defects (IBDs), resulting in clinically acceptable responses. Platelet-rich fibrin (PRF) is a leukocyte and platelet preparation that concentrates various polypeptide growth factors and, therefore, has the potential for use as regenerative treatment for periodontal defects. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF + HA in treatment of IBDs in patients with chronic periodontitis.

Methods: Ninety IBDs were treated with autologous PRF with open-flap debridement (OFD), PRF + HA with OFD, or OFD (controls) alone. Clinical and radiologic parameters, including probing depth (PD), clinical attachment level (CAL), IBD depth, and percentage defect fill were recorded at baseline and 9 months postoperatively.

Results: Mean PD reduction was greater in PRF (3.90 ± 1.09 mm) and PRF + HA (4.27 ± 0.98 mm) groups than the control group (2.97 ± 0.93 mm), and mean CAL gain was greater in PRF (3.03 ± 1.16 mm) and PRF + HA (3.67 ± 1.03 mm) compared to controls (2.67 ± 1.09 mm). Furthermore, significantly greater percentage of mean bone fill was found in the PRF (56.46% ± 9.26%) and PRF + HA (63.39% ± 16.52%) groups compared to controls (15.96% ± 13.91%).

Conclusions: Treatment of IBD with PRF results in significant improvements of clinical parameters compared to baseline. When added to PRF, HA increases the regenerative effects observed with PRF in the treatment of 3-wall IBDs.

Keywords: Clinical trial; guided tissue regeneration, periodontal; hydroxyapatite; periodontitis; root planing; surgery.