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. 2022 Jul-Aug;26(4):359-364.
doi: 10.4103/jisp.jisp_882_20. Epub 2022 Jul 2.

Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects

Jayasheela Mallappa  1 , Deepa Vasanth  1 , Triveni Mavinakote Gowda  1 , Rucha Shah  1 , Gunjiganuru Vemanaradhya Gayathri  1 , Dhoom Singh Mehta  1
Affiliations

Clinicoradiographic evaluation of advanced-platelet rich fibrin block (A PRF + i PRF + nanohydroxyapatite) compared to nanohydroxyapatite alone in the management of periodontal intrabony defects

Jayasheela Mallappa et al. J Indian Soc Periodontol. 2022 Jul-Aug.

Abstract

Background: Several bone grafting formulations have been given clinically acceptable outcomes in treating intrabony defects. Platelet rich fibrin (PRF), an autologous platelet concentrate holds potential to be used for regenerative treatment. The purpose of this study was to evaluate clinical and radiographic outcomes in periodontal intrabony defects treated with advanced-PRF block (A PRF + i PRF + nanohydroxyapatite [nHA]) compared to nHA alone.

Methods: Twenty-eight sites in chronic periodontitis patients having probing pocket depth (PPD) ≥6 mm and 3 walled intrabony defects (depth of ≥3 mm) were selected, randomly allotted into two groups: Group A was treated with A-PRF block and Group B with nHA (Sybograf™). Clinical parameters including plaque index (PI), gingival index (GI), PPD, relative attachment level (RAL) and radiographically linear and volumetric defect fill were assessed using cone beam computed tomography at baseline and 6 months postoperatively.

Results: Intragroup comparison using paired t-test and intergroup comparison using unpaired t-test was done. Group A demonstrated significantly higher reduction in PPD and gain in RAL when compared to Group B (P ≤ 0.05) at the end of 6 months. Similarly gain in bone volume was greater in Group A (0.1 ± 0.05) as compared to Group B (0.04 ± 0.02) (P ≤ 0.05).

Conclusion: Advanced-PRF block showed significant clinical and radiographic improvement as compared to nHA alone which depicts that, it may be an ideal graft to be used for the treatment of periodontal intrabony defects.

Keywords: Intrabony defects; nanohydroxyapatite; periodontal regeneration; platelet rich fibrin.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Experimental site A: (a) Preoperative clinical measurement of relative attachment level and probing pocket depth. (b) Intrasurgical measurement of the defect. (c) Preparation of A-platelet rich fibrin block (A platelet rich fibrin + i platelet rich fibrin + Sybograf™). (d) A-platelet rich fibrin block prepared. (e) Prepared graft placed in the defect secured with the suture. (f) 6-month postoperative view
Figure 2
Figure 2
Experimental site B. (a) Preoperative clinical measurement of relative attachment level and probing pocket depth. (b) Intrasurgical measurement of the defect. (c) Graft placement in the defect. (d) 6-month postoperative view
Figure 3
Figure 3
Experimental site A (a) Preoperative linear measurement of the defect of 3.2 mm. (b) 6 month postoperative linear measurement of the defect of 2.85 mm. (c) Coronal view of preoperative volumetric assessment of the defect area of 143 mm3. (d) Sagittal sectional view of preoperative volumetric assessment of the defect of 80 mm3. (e) Coronal view of postoperative volumetric assessment of the defect of 92 mm3. (f) Sagittal sectional view of postoperative volumetric assessment of the defect of 71mm3
Figure 4
Figure 4
Experimental site B. (a) Preoperative linear measurement of the defect of 7.5mm. (b) 6 month postoperative linear measurement of the defect of 6.45mm. (c) Coronal view of preoperative volumetric assessment of the defect of 148mm3. (d) Sagittal sectional view of preoperative volumetric assessment of the defect of 65mm3. (e) Coronal view of postoperative volumetric assessment of the defect of 131mm3. (f) Sagittal sectional view of postoperative volumetric assessment of the defect of 71mm3
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