Efficacy of the entire papilla preservation technique with or without L-PRF for the treatment of infrabony defects: pilot clinical study

Abstract

Objectives: infraosseous periodontal defects are a challenge for restoring periodontal health. Regenerative techniques such as Entire Papilla Preservation (EPP) offer valid, minimally invasive alternatives. Platelet concentrates like leukocyte- and platelet-rich fibrin (L-PRF) may enhance the healing process. This pilot study aims to describe and assess the effectiveness of EPP for treating interproximal infra-bony defects, with and without L-PRF, focusing on clinical and radiographic parameters.

Materials and methods: The study included 11 cases from 7 patients treated at University of Los Andes Health Center. Periodontal defects with probing depth ≥6 mm were treated using EPP. L-PRF was added in 5 defects, placed intraosseously. Clinical and radiographic parameters were evaluated at baseline and 6 months post surgery.

Results: Probing depth decreased by a mean of 4.3 mm (p<0.05), with a clinical attachment level gain of 3.63 mm (p<0.05). No significant differences were observed between groups. Gingival margin position tended to recess in the EPP group (variation: -1 mm ± 0.7 mm), but remained stable in the EPP + L-PRF group (variation: 0.3 mm ± 0.5mm). Postoperative pain on the VAS scale was significantly lower at 24 and 72 hours with L-PRF (p<0.03). No complications were reported.

Conclusions: EPP has a positive effect on clinical and radiographic parameters, whether used alone or with L-PRF. L-PRF appears to improve postoperative pain and gingival margin stability in the medium term. This technique offers a low cost, minimally invasive option for periodontal regeneration with minimal complications.

Keywords: Bone regeneration; Guided Tissue Regeneration; Microsurgery; Periodontitis; Treatment Outcome.