Pavani Mudambi Prakash, Reddy Konda Reddy Krishna Mohana, Reddy Bavigadda Harish, Biraggari Sunil Kumar, Babu C Hema Chandra, Chavan Vinay
Department of Periodontics, Meghna Dental College, Nizamabad, Telangana, India.
Department of Periodontics, Pulla Reddy Dental College, Kurnool, Andhra Pradesh, India.
J Indian Soc Periodontol. 2021 Mar-Apr;25(2):138-143. doi: 10.4103/jisp.jisp_621_19. Epub 2021 Mar 1.
Platelet-rich fibrin (PRF) is the second-generation platelet concentrate first described by Choukron . It incorporates leukocytes, platelets, and growth factors within dense fibrin matrix, can be used in periodontal regeneration alone or in combination with bone grafts.
This study assesses bone fill in intrabony defects, following the use of β tricalcium phosphate (TCP) bone graft with and without PRF.
Thirty sites with intrabony defects in periodontitis patients were selected, randomly allotted into three groups: Group A open flap debridement (OFD), Group B OFD with β TCP with PRF, and Group C β TCP. Clinical parameters such as plaque index, gingival index, sulcus bleeding index, and PPD recorded at baseline and 6 months. Radiographic parameters include cementoenamel junction (CEJ) to base of defect, CEJ to alveolar crest, depth of defect, and bone fill assessed using the cone-beam computed tomography (CBCT). The comparison between the test group and control group in terms of clinical and radiographical parameters was assessed using the independent sample -test.
Significant reduction in probing depth measurements, defect fill observed in both β TCP with PRF and β TCP alone groups compared to OFD. However, intergroup comparison assessed using the independent sample -test found to be statistically nonsignificant ( < 0.05 is considered significant).
All three treatment strategies resulted in significant reduction in probing depth and bone fill at 6 months. Bone fill achieved in β TCP with PRF was more compared to β TCP alone and OFD at 6 months follow-up. CBCT can be accurately used to assess the morphology of intrabony defect and also in evaluating bone fill.
富血小板纤维蛋白(PRF)是第二代血小板浓缩物,最初由乔克隆描述。它在致密的纤维蛋白基质中包含白细胞、血小板和生长因子,可单独用于牙周再生或与骨移植联合使用。
本研究评估使用含和不含PRF的β-磷酸三钙(TCP)骨移植后骨内缺损的骨填充情况。
选择30例牙周炎患者的骨内缺损部位,随机分为三组:A组为开放性翻瓣清创术(OFD),B组为OFD联合β-TCP和PRF,C组为β-TCP。在基线和6个月时记录菌斑指数、牙龈指数、龈沟出血指数和探诊深度等临床参数。影像学参数包括牙骨质釉质界(CEJ)至缺损底部、CEJ至牙槽嵴、缺损深度以及使用锥形束计算机断层扫描(CBCT)评估的骨填充情况。使用独立样本t检验评估试验组和对照组在临床和影像学参数方面的差异。
与OFD组相比,PRF联合β-TCP组和单独使用β-TCP组的探诊深度测量值显著降低,缺损填充情况良好。然而,使用独立样本t检验进行的组间比较发现差异无统计学意义(P<0.05被认为具有统计学意义)。
所有三种治疗策略在6个月时均导致探诊深度显著降低和骨填充。在6个月的随访中,PRF联合β-TCP组的骨填充量比单独使用β-TCP组和OFD组更多。CBCT可准确用于评估骨内缺损的形态以及评估骨填充情况。