Efficacy of autologous platelet rich fibrin (PRF) and hydroxyapatite bioactive glass (HABG) in the management of intra bony defects -A randomized controlled trial

Abstract

The ultimate aim of periodontal therapy is regeneration. Traditionally, many techniques and agents were used. The therapeutic outcome in treatment of intra bony defects can be augmented with the use of growth factors alongside bone grafts. The present clinical trial was designed to assess the efficacy of an alloplastic composite graft and the combination of autologous platelet rich fibrin with the graft in the management of intra bony defects. A total of 45 systemically healthy patients with intra bony defects indicated for flap surgery were selected from the outpatient department of periodontics. The patients were divided into three groups with the help of a computer generated random number table. Age, sex, and periodontal parameters (probing pocket depth, clinical attachment level, gingival marginal level, plaque index, modified sulcus bleeding index) and presence of intra bony defects were recorded. The defects in group I patients were treated with autologous PRF along with the graft, group II with graft, and group III with open flap debridement alone. All the patients were recalled at 3, 6, 9 months after surgery, and the periodontal parameters were recorded in each recall. The baseline parameters were compared with 9 month post op periodontal parameters by non parametric test for ANOVA (Kruskal Wallis). Maximum pocket depth reduction (5.86±1.03) maximum gain in attachment (4.64± 1.08), reduction in modified sulcus bleeding index were seen in group I, which is statistically significant between the groups. Though change in gingival marginal level is minimum for group I (1.21± 0.42), it was not statistically significant. Group I showed the maximum percentage of sites with bone fill (92.9%) which was also statistically significant when analyzed by the chi-square test. The Combination of autologous PRF with the hydroxy apatite bioglass graft in the management of intra bony defects showed improved clinical and radiographic outcome.