Bioactive glass versus autologous platelet-rich fibrin for treating periodontal intrabony defects: A comparative clinical study

Abstract

Background: To compare treatment modalities: Open flap debridement (OFD) alone (Group I), OFD in combination with PerioGlas^® (Group II), and OFD in combination with autologous platelet-rich fibrin (PRF) (Group III) for periodontal intrabony defects (IBDs).

Aim: To evaluate on clinical and radiographic basis, effectiveness of PerioGlas^®, and PRF in treating IBDs.

Settings and design: IBDs selected on the basis of the inclusion criteria were randomly assigned to Groups I, II, and III by coin toss method.

Materials and methods: The study was conducted on patients reporting to the department of periodontology and oral implantology. Thirty-eight patients with ninety periodontal IBDs of moderate to severe periodontitis were selected and assigned to Groups I, II, and III. In each patient, a minimum number of two sextants were present with pocket depths ≥5 mm in at least three teeth.

Statistical analysis: Statistical analysis based on mean values, standard deviation, and P values.

Results: Compared to baseline, 9 months postoperatively: (1) mean probing pocket depth reduction for Group I was 3.68 mm ± 0.72, for Group II was 5.57 mm ± 1.10, and for Group III was 6.11 mm ± 0.92. (2) The mean relative attachment level gain for Group I was 4.14 mm ± 0.76, for Group II was 6.57 mm ± 1.45, and for Group III was 6.74 mm ± 1.55. (3) Mean radiographic IBD fill for Group I was 69.29% mm ± 7.73, for Group II was 74.44% mm ± 8.57, and for Group III was 75.01% mm ± 7.85.

Conclusion: This study shows marked improvements in the clinical parameters and radiographic outcomes with both PerioGlas^® and autologous PRF to treat periodontal IBDs as compared to OFD alone.

Keywords: Autologous platelet-rich fibrin; bioactive glass (PerioGlas®); intrabony defects; open flap debridement.

Figure 1

(a) Baseline measurement; (b) incisions placed; (c) debridement done; (d) intrabony defect depth measured; (e) PerioGlas^® being placed in the intrabony defect; (f) sutures given; (g) 9 months recall; (h) radiovisiography baseline-linear radiographic interpretation with AutoCAD computer software (parallel lines showed the base of the defect and crest of alveolar bone); (i) radiovisio graphy 9 months-linear radiographic interpretation with AutoCAD computer software (parallel lines showed the base of the defect and crest of alveolar bone)

Figure 2

(a) Baseline measurement; (b) incisions placed; (c) debridement done; (d) intrabony defect depth measured; (e) autologous platelet-rich fibrin placed in the intrabony defect; (f) sutures given; (g) periodontal dressing given; (h) 9 months recall; (i) radiovisiography baseline-linear radiographic interpretation with AutoCAD computer software (parallel lines showed the base of the defect and crest of alveolar bone); (j) radiovisiography 9 months-linear radiographic interpretation with AutoCAD computer software (parallel lines showed the base of the defect and crest of alveolar bone)