Division of Odonto-Stomatology, School of Medicine, Ho Chi Minh City, Vietnam; Vietnam National University, Ho Chi Minh City, Vietnam.
J Evid Based Dent Pract. 2021 Sep;21(3):101545. doi: 10.1016/j.jebdp.2021.101545. Epub 2021 Mar 19.
To comparatively assess the outcomes of the treatment of periodontal intrabony defects with platelet-rich fibrin (PRF) combined with open-flap debridement (OFD), guided tissue regeneration (GTR) or OFD alone based on clinical, radiographic, and wound healing parameters for 12 months of follow-up.
Ninety intrabony defects were randomly divided into 3 different groups and treated as group 1 (PRF + OFD), group 2 (GTR), or group 3 (OFD alone). Clinical parameters, including the plaque index, gingival index, bleeding on probing, probing depth (PD), clinical attachment loss (CAL), and tooth mobility were assessed at 3, 6, and 12 months. Additionally, the wound healing index was assessed at 7 and 14 days postsurgery. Radiographic parameters, including bony defect fill and alveolar crestal resorption, were measured at 6 and 12 months postsurgery and calculated using image analysis software.
Intragroup comparisons showed consistently significant improvements in all the clinical and radiographic parameters in the 3 groups at 12 months postsurgery. Compared to baseline, in group 1, the PD decreased to 2.37 ± 0.56; 3.30 ± 0.84; 4.80 ± 0.71 mm, and CAL decreased to 2.23 ± 0.90; 3.33 ± 0.71; 5.00 ± 0.46 mm; in group 2, the PD decreased to 2.30 ± 0.60; 3.23 ± 0.86; 4.63 ± 0.67 mm, and CAL decreased to 2.00 ± 0.98; 3.20 ± 0.71; 4.53 ± 0.57 mm); and in group 3, the PD decreased to 1.87 ± 0.68; 2.57 ± 1.36; 3.37 ± 1.00 mm, and CAL decreased to 1.60 ± 0.93; 2.23 ± 1.22; 3.37 ± 1.22 mm at 3, 6, and 12 months postsurgery, respectively. The bone fill percentages in group 1 (26.45 ± 16.47 and 45.25 ± 5.20%), group 2 (22.20 ± 15.76 and 42.15 ± 6.39%) and group 3 (10.21 ± 6.47 and 23.13 ± 6.98%) were observed at 6 and 12 months postsurgery. The alveolar crestal resorption levels were -1.07 ± 0.52 and -1.70 ± 0.60 mm in group 1, -1.03 ± 0.72 and -1.47 ± 0.73 mm in group 2 and 0.37 ± 0.62 and 0.43 ± 0.73 mm in group 3, respectively. The percentages of sites with a WHI score of 1 were 93% and 100% in group 1, 81%, and 94% in group 2 and 45% and 71% in group 3 at 7 and 14 days postsurgery, respectively.
Compared to GTR, PRF yielded comparable treatment outcomes and periodontal tissue healing in terms of improvements in clinical and radiographic parameters. Compared to OFD alone, PRF also significantly improved these parameters in the treatment of intrabony defects.
通过临床、影像学和伤口愈合参数，比较评估富血小板纤维蛋白（PRF）联合翻开瓣清创术（OFD）、引导组织再生术（GTR）或 OFD 单独治疗牙周骨内缺损 12 个月的治疗效果。
90 个骨内缺损随机分为 3 组，分别为第 1 组（PRF+OFD）、第 2 组（GTR）和第 3 组（OFD 单独治疗）。分别于术后 3、6 和 12 个月评估菌斑指数、牙龈指数、探诊出血、探诊深度（PD）、临床附着丧失（CAL）和牙齿松动度等临床参数。此外，还在术后 7 和 14 天评估伤口愈合指数。术后 6 和 12 个月，使用图像分析软件测量影像学参数，包括骨缺损填充和牙槽嵴吸收。
组内比较显示，3 组在术后 12 个月的所有临床和影像学参数均有持续显著改善。与基线相比，第 1 组 PD 降低至 2.37±0.56、3.30±0.84、4.80±0.71mm，CAL 降低至 2.23±0.90、3.33±0.71、5.00±0.46mm；第 2 组 PD 降低至 2.30±0.60、3.23±0.86、4.63±0.67mm，CAL 降低至 2.00±0.98、3.20±0.71、4.53±0.57mm；第 3 组 PD 降低至 1.87±0.68、2.57±1.36、3.37±1.00mm，CAL 降低至 1.60±0.93、2.23±1.22、3.37±1.22mm，分别在术后 3、6 和 12 个月。第 1 组（26.45±16.47%和 45.25±5.20%）、第 2 组（22.20±15.76%和 42.15±6.39%）和第 3 组（10.21±6.47%和 23.13±6.98%）的骨填充百分比在术后 6 和 12 个月时观察到。第 1 组牙槽嵴吸收水平为-1.07±0.52 和-1.70±0.60mm，第 2 组为-1.03±0.72 和-1.47±0.73mm，第 3 组为 0.37±0.62 和 0.43±0.73mm，分别在术后 7 和 14 天。第 1 组的 WHI 评分在第 7 和 14 天分别为 93%和 100%，第 2 组为 81%和 94%，第 3 组为 45%和 71%。
与 GTR 相比，PRF 在改善临床和影像学参数方面取得了与 GTR 相当的治疗效果和牙周组织愈合效果。与 OFD 单独治疗相比，PRF 也显著改善了这些参数在骨内缺损的治疗效果。
