Clinical and Radiographic Evaluation of Platelet Rich Plasma in Combination with Demineralised Freeze-Dried Bone Allograft in the Treatment of Periodontal Intrabony Defects: A Comparative Study
Juliet Josephi1, Kranthi K Reddy2, Hema Seshan2, Vikram Reddy3, Jagadish Reddy3, Mahipal Nera1, Madhusudhana Rao4
1 Senior Lecturer, Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
2 Professor, Department of Periodontics, Faculty of Dental Sciences, Ramaiah University, Bengaluru, Karnataka, India
3 Reader, Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
4 Reader, Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Telangana, India
Senior Lecturer, Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Telangana
Source of Support: None, Conflict of Interest: None
Aim: Demineralized Freeze-Dried Bone Allograft (DFDBA) has repeatedly demonstrated significant improvements in soft and hard clinical tissue parameters for the treatment of intraosseous periodontal defects. Platelet-derived growth factor (PDGF) has the primary effect of a mitogen, initiating cell division. It was shown that osteoblasts proliferate in response to PDGF alone or with the addition of a progression factor to induce mitosis. However there is no evidence to evaluate whether a combination of PRP and DFDBA-Allograft enhances the clinical outcome compared to treatment with DBM mixed with saline solution. Therefore, the purposes of this study were to compare the clinical and radiographic outcomes obtained with the combination of PRP and DFDBA to those obtained with DFDBA mixed with saline solution in the treatment of periodontal intrabony defects.
Materials and Method: This study was carried out for a period of 12 months. 20 intrabony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with a combination of Platelet Rich Plasma and DFDBA-Allograft. The control sites were debrided and grafted with DFDBA-Allograft with saline. Probing depth, clinical attachment level and gingival margin position were recorded at baseline, 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls.
Results: On completion of 12 months, the DFDBA + PRP sites had significantly lower mean PD (7.0 mm versus 2.10 mm; P <0.003) and CAL (7.0mm versus 1.90 mm; P <0.003) compared to the DFDBA+saline sites. At 12months, there was no significant difference between the study groups for mean gingival margin position (P >0.05).
Conclusion: Overall, both therapies led to significant improvements of the investigated parameters. The combination of PRP and DFDBA-Allograft was more effective in terms of improving clinical parameters than DFDBA-Allograft alone. There is a need for further long term controlled studies evaluating the adjunctive benefits of a combination of PRP and DFDBA-Allograft as compared to DFDBA-Allograft alone in the treatment of periodontal intrabony defects.