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Randomized Controlled Trial
. 2025 Jul 14;30(1):623.
doi: 10.1186/s40001-025-02891-y.

Role of placental extracts in enhancing periodontal flap surgery healing: insights from periostin biomarker analysis

M Rathana  1 , Rashmi Paramashivaiah  1 , Munivenkatappa Laxmaiah Venkatesh Prabhuji  1 , Shaeesta Khaleelahmed Bhavikatti  2 , Mohammad Fareed  3 , Mohmed Isaqali Karobari  4   5
Affiliations
Randomized Controlled Trial

Role of placental extracts in enhancing periodontal flap surgery healing: insights from periostin biomarker analysis

M Rathana et al. Eur J Med Res. .

Abstract

Background: The elimination of the causative agent and the facilitation of tissue regeneration are the fundamental objectives of periodontal therapy. Various adjunctive agents have been investigated to optimize treatment outcomes with surgical interventions. Periostin is a matricellular protein predominantly expressed in periodontal tissues, playing a key role in tissue remodeling, inflammation, and wound healing. The human placental extract has been used in periodontal surgery and compared with open flap debridement alone, with gingival crevicular fluid (GCF) periostin levels assessed to gauge periodontal wound healing.

Methods: Sixteen systemically healthy patients diagnosed with Stage III Grade C periodontitis were enrolled in the study. Participants were randomly assigned to either the test group (n = 8) or the control group (n = 8), with a total of nine males and seven females distributed across the groups. The test group underwent open flap debridement (OFD), followed by applying human placental extract gel absorbed into a gelatin sponge, while the control group received only OFD. Clinical parameters were assessed at baseline and 3 month post-treatment. GCF periostin levels were measured at baseline, 6 weeks, and 3 months.

Results: The test group demonstrated a mean probing pocket depth (PPD) reduction of 4.75 ± 1.28 mm, compared to 3.12 ± 1.12 mm in the control group, with the difference being statistically significant. The relative attachment level (RAL) gain was 4.37 ± 1.18 mm in the test group and 2.75 ± 0.70 mm in the control group; however, this difference was not statistically significant. At 3 months, the mean healing index score was 4.50 ± 0.53 in the test group and 3.62 ± 0.51 in the control group, with a statistically significant intergroup difference. The Plaque Index (PI), Gingival Index (GI), and Gingival Bleeding Index (BI) showed moderate reductions at 3 months; however, intergroup differences were not statistically significant, except for BI, where the difference at 3 months was -0.180.

Conclusions: The adjunctive use of placental extract gel in surgical periodontal therapy demonstrated beneficial effects on healing outcomes. In addition, periostin shows promise as a biomarker for periodontal wound healing.

Keywords: Human placental extract; Marker; Periodontitis; Periostin; Surgical periodontal therapy; Wound healing.

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Conflict of interest statement

Declarations. Research involving human participants and/or animals: The present study was designed as a prospective, randomized, controlled clinical trial. The study protocol was reviewed and approved by the institutional review board of Krishnadevaraya College of Dental Science and the hospital ethical committee (REF: Ethical comm/015/2020–21). The study was conducted in full accordance with the declared ethical principles (World Medical Association Declaration of Helsinki, version VI, 2002). All patients completed initial therapy, including oral hygiene instructions, scaling, and root planning. Consent for publication: Not applicable. Informed consent: An informed consent was signed by all the participants. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Absorbable gelatin sponge
Fig. 2
Fig. 2
Gelatin foam (A) and Gelatin foam fragments soaked in placental gel (B)
Fig. 3
Fig. 3
Surgical procedure for test group: (A) sulcular incision given, (B) flap reflection and debridement done, (C) placement of the placental extract soaked in gelatin sponge, (D) sutures placed, and (E) periodontal dressing placed
Fig. 4
Fig. 4
Age distribution of the study population
Fig. 5
Fig. 5
Gender distribution of the study population
Fig. 6
Fig. 6
Comparison of mean probing pocket depth across the study groups
Fig. 7
Fig. 7
Distribution of Healing Index scores across the study groups
Fig. 8
Fig. 8
Distribution of GCF periostin levels across the study groups
See this image and copyright information in PMC

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